References

Australian Institute of Health and Wellness (AIHW). 2013. Mental health services in brief 2013. Cat. no. HSE 141. Canberra: AIHW. Retrieved on November 30, 2013, from: http://www.aihw.gov.au/publication-detail/?id=60129544726 .

American Counseling Association (2010). ACA Code of Ethics. Alexandria, VA: Author.

Americans with Disabilities Act of 1990, Pub. L. No. 101-336, § 2, 104 Stat. 328 (1991).

APA Presidential Task Force on Evidence-Based Practice. (2006). Evidence-based practices in psychology. American Psychologist, 61, 271-285.

Barbic, S., Krupa, T., & Armstrong, I. (2009). A randomized controlled trial of the effectiveness of a modified recovery workbook program: Preliminary findings. Psychiatric Services, 60, 491-497.

Brain and Behavior Research Foundation. (2013). Know Science. No Stigma. Bbrfoundation.org. Retived on November 25, 2013, from: http://bbrfoundation.org/news-releases/%E2%80%98know-science-no-stigma%E2%80%99-brain-behavior-research-foundation-announces-theme-for-may

Buck, J. (2011). The looming expansion and transformation of public substance abuse and treatment under the Affordable Care Act. Health Aff, 30, 1402-1410.

Celluci, T., Krogh, J., & Vik, P. (2006). Help seeking for alcohol problems in a college population. The Journal of General Psychology, 133, 421-433.

Center for Substance Abuse Treatment. (2006). National Summit on Recovery: Conference report. Rockville, MD: Substance Abuse and Mental Health Services Administration.

 

Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web- based Injury Statistics Query and Reporting System (WISQARS). (2010). Retrieved on October 19, 2013 from: www.cdc.gov/injury/wisqars/index.html. 

 

Changes in us spending on mental health and substance abuse treatment, 1986–2005, and implications for policy. (2011). Journal Tami L. Mark,

Katharine R. Levit,

Rita Vandivort-Warren,

Jeffrey A. Buck,

and Rosanna M. Coffey

Health Affairs. February 2011 30:2284-292.

Clarke, S., Oades, L. G., & Crowe, T. (2012). Recovery in mental health: A movement towards well-being and meaning in contrast to an avoidance of symptoms. Psychiatric Rehabilitation Journal, 35(4), 297-304.

 

Clark, W. (2007). Recovery as an organizational concept. [Web page]. Retrieved on November 26, 2013, from: http://www.glattc.org/Interview%20With%20H.%20Westley%20Clark,%20MD,%20JD,%20MPH,%20CAS,%20FASAM.pdf

Compton, M. T., Hankerson-Dyson, D., Broussard, B., Druss, B. G., Haynes, N., Strode, P., Thomas, G. V. (2011). Public-academic partnerships: Opening doors to recovery: A novel community navigation service for people with serious mental illnesses. Psychiatric Services, 62(11), 1270-2. Retrieved on September 10, 2013, from: http://search.proquest.com/docview/1318493271?accountid=13215

Coniglio, F. D., Hancock, N., & Ellis, L. A. (2012). Peer support within clubhouse: A grounded theory study. Community Mental Health Journal, 48(2), 153-60. doi: http://dx.doi.org/10.1007/s10597-010-9358-5

Congressional Budget Office. (2010). Selected CBO publications related to health care legislation, 20092010 [Web Page]. Retrieved on November 29, 2013, from http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/120xx/doc12033/12-23-selectedhealthcarepublications.pdf

Cook, J. A., Copeland, M. E., Hamilton, M. M., Jonikas, J. A., Razzano, L. A., Floyd, C. B., Hudson, W. B., Macfarlane, R.T., & Grey, D. D. (2009). Initial outcomes of a mental illness self-management program based on Wellness Recovery Action Planning.  Psychiatric Services, 60, 246-249.

Cook, J. A., Shore, S. E., Burke-Miller, J. K., Jonikas, J. A., Ferrara, M., Colegrove, S., & ... Hicks, M. E. (2010). Participatory action research to establish self-directed care for mental health recovery in Texas. Psychiatric Rehabilitation Journal, 34(2), 137-144.

Copeland, M. E. (1997). Wellness Recovery Action Plan. Brattleboro, VT: Peach Press.

Corrigan, P.W. (2004). How stigma interferes with mental health care. American Psychologist, 59, 614-625.

Cummings, J. R., Wen, H., & Druss, B. G. (2013). Improving access to mental health services for youth in the United States. Journal of the American Medical Association, 309(6), 553–554. doi:10.1001/jama.2013.437Edlund,

Davidson, L., Chinman, M. L., Sells D., & Rowe, M. (2006). Peer support among adults with severe mental illness: A report from the field. Schizophrenia Bulletin, vol. 32(3), 443-450. doi: 10.1093/schbul/sbj043

Davidson, L., & Rowe, D. (2007). ‘Recovery from’ and ‘recovery in’ serious mental illness: One strategy for lessening confusion plaguing recovery. Journal of Mental Health, vol. 16(4), 459-470.

Davidson, L., Shaw, J., Welborn, S., Mahon, B., Sirota, M., Gilbo, P., Pelletier, J. (2010). "I don't know how to find my way in the world": Contributions of user-led research to transforming mental health practice. Psychiatry, 73(2), 101-13. doi:http://dx.doi.org/10.1521/psyc.2010.73.2.101

Deane, F. P., Spicer, J., & Leathem, J. (1992).  Effects of videotaped preparation information on expectations, anxiety, and psychotherapy outcome. Journal of Consulting and Clinical Psychology, 60, 980-984.

Deane, F. P., & Chamberlain, K. (1994). Treatment fearfulness and distress as predictors of professional psychological help-seeking. British Journal of Guidance and Counseling, 22, 207-217.

Dixon L., Lucksted A., Stewart B., Burland J., Brown CH., Postrado L., McGuire C., & Hoffman M.. (2004). Outcomes of a peer-taught 12-week family- to-family education program for severe mental illness. Acta Psychiatr Scand 2004: 109: 207–215.

Fukui, S., Davidson, L. J., Holter, M. C., & Rapp, C. A. (2010). Pathways to Recovery (PTR): Impact of peer-led group participation on mental health recovery outcomes. Psychiatric Rehabilitation Journal, 34(1), 42-48.

Fukui, S., Starnino, V. R., & Nelson-becker, H. (2012). Spiritual well-being of people with psychiatric disabilities: The role of religious attendance, social network size and sense of control. Community Mental Health Journal, 48(2), 202-11. doi: http://dx.doi.org/10.1007/s10597-011-9375-z

Gary, F.A. (2005). Stigma: Barrier to mental health care among ethnic minorities. Issues in Mental Health Nursing, 26, 979-999.

Gaumond, P., & Whitter, M. (2009). Access to recovery (ATR) approaches to recovery-oriented systems of care: Three case studies. HHS Publication No. (SMA) 09-4440. Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, 2009.

Gehart, D. R. (2012). The Mental Health Recovery Movement and Family Therapy, Part I: Consumer-led reform of services to persons diagnosed with severe mental illness. Journal Of Marital & Family Therapy, 38(3), 429-442. doi:10.1111/j.1752-0606.2011.00230.x

Gehart, D. R. (2012). The Mental Health Recovery Movement and Family Therapy, Part II: A collaborative, appreciative approach for supporting mental health recovery. Journal Of Marital & Family Therapy, 38(3), 443-457. doi:10.1111/j.1752-0606.2011.00229.x

Gotham, H.J. (2006). Advancing the implementation of evidence-based practices into clinical practice: How do we get there from here? Professional Psychology: Research and Practice, 37, 606-613.

Halvorson, A., & Whitter M. (2009). Approaches to recovery-oriented systems of care at the state and local level: Three case studies. HHS Publication No. (SMA) 09-4438. Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, 2009.

Hipolito, M., Carpenter-Song, E., & Whitley, R. (2011). Meanings of recovery from the perspective of people with dual diagnosis. Journal of Dual Diagnosis, 7(3), July 2011, p.141-149.

Holter, M. C., Mowbray, C. T., Bellamy, C. D., MacFarlane, P., & Dukarski, J. (2004). Critical ingredients of consumer run services: Results of a national survey. Community Mental Health Journal, 40(1), 47-63. Retrieved on November 10, 2013, from http://ezproxy.clinton.edu/docview/228362929?accountid=43516

Humphreys, K., & McLellan, A. T. (2010). Brief intervention, treatment and recovery support services for Americans who have substance use disorders: An overview of policy in the Obama Administration. Psychological Services, 7, 275-284.

Ireland. (2012). Mental Health Commission Annual Report 2012: Including report of the Inspector of Mental Health Services. Ireland Government. Retrieved on November 29, 2013, from: http://www.mhcirl.ie/File/MHC_2012_Annual_Rpt.pdf

Jaccard, J., Litardo, H. A., & Wan, C. K. (1999). Subjective culture and social behavior. In J. Adamopoulos & Y. Kashima (Eds.), Social psychology and cultural context (p.95-106). Thousand Oaks, CA: Sage Publication.

Jaccard, J., Dodge, T., & Dittus, P. (2002). Parent-adolescent communication about sex and birth control: A conceptual framework. New Directions for Child & Adolescent Development, 97, 9-41.

Kaplan, K., Salzer, M. S., & Brusilovskiy, E. (2012). Community participation as a predictor of recovery-oriented outcomes among emerging and mature adults with mental illnesses. Psychiatric Rehabilitation Journal, 35(3), 219-229.

Kazak, A. E., Hoagwood, K., Weisz, J. R., Hood, K., Kratouchwill, T.R., Vargas, L.A., & Banez, G.A. (2010). A meta-systems approach to evidence-based practice for children and adolescents. American Psychologists, 65 (2), 85-97.

Kessler, R.C., Chiu W.T., Demler O., & Walters E.E. (2005). Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 2005 June 62(6):617-27.

Kleinman, B. P., Millery, M., Scimeca, M., & Polissar, N. L. (2002). Predicting long-term treatment utilization among addicts entering detoxification: The contribution of help seeking models. The Journal of Drug Issues, 32, 209-230.

Komiya, N., Good, G.E., & Sherrod, N.B. (2000). Emotional openness as a predictor of college students’ attitudes toward seeking psychological help. Journal of Counseling Psychology, 47, 138-143.

Maslow, A.H. (1987). Motivation and personality (3^rd Ed.). New York: Harper and Row, Publishers.

McHugh, R.K., & Barlow, D.H. (2010). The dissemination and implementation of evidence-based psychological treatments: A review of current efforts. Amercian Psychologist, 65 (2), 73-84.

Mowbray, C., Holter, M., Mowbray, O., & Bybee, D. (2005). Consumer-run drop-in centers and Clubhouses: Comparisons of services and resources in a statewide sample. Psychological services, 2(1), 54-55. doi:10.1037/1541-1559.2.1.54

Mowbray, C., Woodward, A., Holter, M., MacFarlane, P., & Bybee, D. (2009). Characteristics of users of consumer-run drop-in centers versus Clubhouses. The Journal Of Behavioral Health Services & Research, 36(3), 361-371. doi: 10.1007/s11414-008-9112-8

National Alliance on Mental Illness (NAMI). (n.d.). Facts about stigma and mental illness in diverse communities. Multicultural Action Center. Retrieved November 23, 2013 from: http://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=2&cad=rja&ved=0CC8QFjAB&url=http%3A%2F%2Fwww.nami.org%2FContentManagement%2FContentDisplay.cfm%3FContentFileID%3D5148&ei=MySWUruBKYrXyAHuoIDwCg&usg=AFQjCNFHBHxtv7d3huBbCWIRrlHGmtCbgw

National Alliance on Mental Illness. (n.d.). Support and programs. nami.org . Retrieved on November 23, 2013, from http://www.nami.org/Template.cfm?section=Find_Support

National Council for Community Behavioral Healthcare. (2010). Substance use disorders and the person-centered healthcare home. National Council for Community Behavioral Healthcare. Retrieved on November 29, 2013, from http://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=1&cad=rja&ved=0CD0QFjAA&url=http%3A%2F%2Fwww.thenationalcouncil.org%2Fwp-content%2Fuploads%2F2013%2F05%2FSubstance-Use-Condition-Report.pdf&ei=XSuZUpaiGYfxoATvqoDAAg&usg=AFQjCNFvqneJWz6veHlQ1OrKILMxLz1pJA&sig2=vdHVxVqn4FWxpB4SePnfxA

National Council for Community Behavioral Healthcare. (2011). Partnering with health homes and accountable care organizations: Considerations for mental health and substance abuse providers. Retrieved on November 29, 2013, from http://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=1&cad=rja&ved=0CEUQFjAA&url=http%3A%2F%2Fwww.thenationalcouncil.org%2Fwp-content%2Fuploads%2F2013%2F01%2FACO-Full-Paper-Laurie.pdf&ei=3CyZUq77L470oATrxoCoAw&usg=AFQjCNHp6CVV7icQEqbi5ISC2gwbQl8HvQ&sig2=FwlJoVARVugLbM130BEYKA

National Institute of Mental Health (NIMH.). (2005) Statistics: Any Disorder Among Adults. Retrieved on September 5, 2013, from http://www.nimh.nih.gov/statistics/1ANYDIS_ADULT.shtml

New Freedom Commission on Mental Health, Achieving the Promise: Transforming Mental Health Care in America. Final Report. DHHS Pub. No. SMA-03-3832. Rockville, MD: 2003. Retrieved September 20, 2013, from http://store.samhsa.gov/product/Achieving-the-Promise-Transforming-Mental-Health-Care-in-America-Executive-Summary/SMA03-3831

Olmos-Gallo, P., & de Roche, K. K. (2010). GUEST EDITORIAL: Monitoring outcomes in mental health recovery: The effect on programs and policies. Advances In Mental Health, 9(1), 8-16.

Olmstead v. L. C., 527 U.S. 581 (1999) Brief Filed: 3/99. Court: Supreme Court of the United States Year of Decision: 1999.

Onken, S., Dumont, J., Ridgway, P., Dorman, D., & Ralph, R. (2002). Mental health recovery: What helps and what hinders? A national research project for the development of recovery facilitating system performance indicators. Alexandria, VA: National Association of State Mental Health Program Directors.

Onken, S. J., Craig, C. M., Ridgway, P., Ralph, R. O., & Cook, J. A. (2007). An analysis of the definitions and elements of recovery: A review of the literature. Psychiatric Rehabilitation Journal, 31(1), 9. Retrieved from http://search.proquest.com/docview/204646546?accountid=13215

Pilgrim, D. (2009). Recovery from mental health problems: Scratching the surface without ethnography. Journal Of Social Work Practice, 23(4), 475-487. doi: 10.1080/02650530903375033

Pinto-Foltz, MD, Logsdon, MC. (2009). Conceptual model of research to reduce stigma related to mental disorders in adolescents. Issues in Mental Health Nursing, 30:788–795.

President’s New Freedom Commission on Mental Health. (2003). Achieving the promise: Transforming mental health care in America. 2003 Retrieved from http://www.mentalhealthcommission.gov/reports/FinalReport/toc.html

Prochaska, J.O., Velicer, W.F., Rossi, J.S., Goldstein, M.G., Marcus, B.H., et al. (1994) Stages of change and decisional balance for 12 problem behaviors. Health Psychology, 13(1):39–46. Accessed November 9, 2013.

Ridgeway, P., McDiarmid, D., Davidson, L., Bayes, J., & Ratzlaff, S. (2002). Pathways to Recovery: A strengths recovery self-help workbook. Lawrence, KS, University of Kansas School of Social Welfare.

Salyers, M. P., Mcguire, A. B., Rollins, A. L., Bond, G. R., Mueser, K. T., & Macy, V. R. (2010). Integrating assertive community treatment and illness management and recovery for consumers with severe mental illness. Community Mental Health Journal, 46(4), 319-29. doi: http://dx.doi.org/10.1007/s10597-009-9284-6

Scott, A., & Wilson, L. (2011). Valued identities and deficit identities: Wellness Recovery Action Planning and self-management in mental health. Nursing Inquiry, 18(1), 40-49. doi:10.1111/j.1440-1800.2011.00529.x

Scottish Government. (2012) Mental Health Strategy for Scotland: 2012-2015. Scottish Government. Retrieved on November 29, 2013, from: http://www.scotland.gov.uk/Publications/2012/08/9714/downloads#res398762

Segal, Steven P.,M.S.W., PhD., Silverman, C. J., PhD., & Temkin, Tanya L,M.A., M.P.H. (2010). Self-help and community mental health agency outcomes: A recovery-focused randomized controlled trial. Psychiatric Services, 61(9), 905-10. Retrieved from http://search.proquest.com/docview/750304984?accountid=13215

Silver, T., Bricker, D., Schuster, P., Pancoe, T., & Pesta, Z. Z. (2011). Outcomes of teaching mental health recovery processes to persons in recovery through an education and mentoring program. Best Practice In Mental Health, 7(2), 72-83.

Sheedy C. K., and Whitter M. (2009). Guiding Principles and Elements of Recovery-Oriented Systems of Care: What Do We Know From the Research?  HHS Publication No. (SMA) 09-4439. Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, 2009.

Souza, K. Z. (2002). Spirituality in counseling: What do counseling students think about it? Counseling and Values, 46, 213-217.

Sterling, E. W., Von Esenwein, S., A., Tucker, S., Fricks, L., & Druss, B. G. (2010). Integrating wellness, recovery, and self-management for mental health consumers. Community Mental Health Journal, 46(2), 130-8. doi: http://dx.doi.org/10.1007/s10597-009-9276-6

Substance Abuse and Mental Health Services Administration (SAMHSA). (2005) Transforming Mental Health Care in America, Federal Action Agenda: First Steps. Retrieved October 26, 2013, from http://store.samhsa.gov/product/Transforming-Mental-Health-Care-in-America/SMA05-4060

Substance Abuse and Mental Health Services Administration (SAMHSA). (2009) SAMHSA’s Resource Center to Promote Acceptance, Dignity and Social Inclusion Associated with
Mental Health (ADS Center). Retrieved October 26, 2013, from http://promoteacceptance.samhsa.gov/publications/myths_facts.aspx

Substance Abuse and Mental Health Services Administration (SAMSHA). (2011). Consumer-Operated Services: Getting Started with Evidence-Based Practices. HHS Pub. No. SMA-11-4633, Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, 2011.

Substance Abuse and Mental Health Services Administration (SAMHSA). (2011) Promoting recovery: Involving and supporting families. Retrieved October 26, 2013, from http://www.samhsa.gov/co-occurring/about/involving_and_supporting_families.aspx

Substance Abuse and Mental Health Services Administration (SAMHSA). (2012) SAMHSA's Working Definition of Recovery. Retrieved October 26, 2013, from http://content.samhsa.gov/ext/item?uri=/samhsa/content/item/10007447/10007447.html

Substance Abuse and Mental Health Services Administration (SAMHSA). (2013) Parity. SAMHSA's BETA. Retrieved November 29, 2013, from http://beta.samhsa.gov/health-reform/parity

Office of Applied Studies Treatment Episode Data Set (TEDS) 2005. (2008). Discharges from substance abuse treatment centers, DASIS Series. Rockville, MD: Substance Abuse and Mental Health Services Administration

Sullivan, Erin M.; Annest, Joseph L. et al. (2013) Suicide Among Adults Aged 35-64 Years – United States, 1999-2010. Center for Disease Control and Prevention, Morbidity and Mortality Weekly Report. May 3, 2013.

Svanberg, J., Gumley, A., & Wilson, A. (2010). How do social firms contribute to recovery from mental illness? A qualitative study. Clinical Psychology & Psychotherapy, 17(6), 482-496. doi:10.1002/cpp.681

Turton, P., Demetriou, A., Boland, W., Gillard, S., Kavuma, M., Mezey, G., & ... Wright, C. (2011). One size fits all: or horses for courses? Recovery-based care in specialist mental health services. Social Psychiatry & Psychiatric Epidemiology, 46(2), 127-136. doi: 10.1007/s00127-009-0174-6

U.S. Census Bureau. (2004) Population Estimates by Demographic Characteristics. Table 2: Annual Estimates of the Population by Selected Age Groups and Sex for the United States: April 1, 2000 to July 1, 2004 (NC-EST2004-02) Source: Population Division, U.S. Census Bureau Release Date: June 9, 2005. Retrieved on 27 September, 2013 from http://www.census.gov/popest/national/asrh/

U.S. Census Bureau. (2010). U.S. Census Bureau Population Estimates by Demographic Characteristics. Retrieved on 27 September, 2013 from http://quickfacts.census.gov/qfd/states/00000.html

U.S. Department of Health and Human Services. (2000) Report of the surgeon general’s conference on children’s mental health. Washington, D.C: Department of Health and Human Services, 2000.

U.S. Department of Health and Human Services. (1999) Mental Health: A Report of the Surgeon General. Rockville, MD: Department of Health & Human Services, 1999.

 Velligan, D. I., Medellin, E., Draper, M., Maples, N., Dassori, A., Moore, T. A., & Lopez, L. (2011). Barriers to, and strategies for, starting a long acting injection clinic in a community mental health center. Community Mental Health Journal, 47(6), 654-9. doi: http://dx.doi.org/10.1007/s10597-011-9389-6

Vogel, D. L., Wade, N. G., & Haake, S. (2006). Measuring the self-stigma associated with seeking psychological help. Journal of Counseling Psychology, 53, 325-337.

Vogel, D. L., & Wester, S. R. (2005). To seek help or not to seek help: The risks of self-disclosure. Journal of Counseling Psychology, 50, 351-361.

Vogel, D. L., Wester, S. R., Wei, M., & Boysen, G.A. (2005). The role of outcome expectations and attitudes on decisions to seek professional help. Journal of Counseling Psychology, 52, 45-470.

Williams, C. C., & Tufford, L. (2012). Professional competencies for promoting recovery in mental illness. Psychiatry: Interpersonal & Biological Processes, 75(2), 190-201. doi: 10.1521/psyc.2012.75.2.190

Windell, D., Norman, R., & Malla, A. K. (2012). The personal meaning of recovery among individuals treated for a first episode of psychosis. Psychiatric Services, 63(6), 548-53. Retrieved from http://ezproxy.clinton.edu:2048/login?url=http://search.proquest.com/docview/1370133393?accountid=43516

Whitley, R. (2011). Social Defeat or Social Resistance? Reaction to fear of crime and violence among people with severe mental illness living in urban 'recovery communities'. Culture, Medicine & Psychiatry, 35(4), 519-535. doi: 10.1007/s11013-011-9226-y

World Health Organization. (2012). Programme Budget, 2012–2013 (PDF). WHO. Retrieved 27 September 2013 from http://www.who.int/about/resources_planning/programme_budget_2012_13/en/index.html

World Health Organization. Ten facts on mental health. WHO. Retrieved 27 September 2013 from http://www.who.int/features/factfiles/mental_health/mental_health_facts/en/index.html

World Health Organization. (2001) Mental Health: New Understanding New Hope. WHO. Retrieved 27 September 2013 from http://www.who.int/whr/2001/media_centre/press_release/en/

Yanos, P. T., Stefanic, A., & Tsemberis, S. (2011). Psychological community integration among people with psychiatric disabilities and nondisabled community members. Journal Of Community Psychology, 39(4), 390-401. doi:10.1002/jcop.20441

Results of Life in Recovery

 If you’d like to improve your health you might stop smoking, but if you want to transform your life you need to adjust your thinking (mental inclination, attitude, and power of reason). This type of transformation doesn’t happen overnight. It comes about through phases. While the mental health system, services and supports, are transforming, this type of system-wide change will take time. SAMSHA (2012) has supplied consumers, families, and mental health professionals with four dimensions to support recovery, ten guiding principles of recovery, and a current working definition of recovery; which is, “A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.” Therefore, when individuals go through the process of change the positive benefits that they experience to their mental, physical, and social health is their recovery. In this current review of the literature, 103 sources were reviewed for information on recovery systems for individuals with a neurobiological disorder.

            First, the analysis revealed that there is not adequate funding for individuals with a neurobiological disorder. The United States spends $113 billion on mental health treatment (6% of their health care costs), but the indirect cost (loss of productivity) of mental illnesses is estimated to be $79 billion. Individuals with a neurobiological disorder need employment and income to support themselves. If mental health outcomes can be improved, then there is a possibility that the loss of productivity will decrease. There are many gaps in between mental health care needs and actual services that are delivered; as a result, most communities lack sufficient infrastructure, adequate facilities, and trained professionals to provide care to individuals with a neurobiological disorder. It is possible to measure recovery and justify an increase in financial resources; thereby, making it possible to improve the infrastructure, provide adequate facilities and trained mental health professionals.

            Research indicates that early identification and intervention can greatly improve outcomes for individuals with a neurobiological diagnosis. It will take strong leadership to develop and sustain a successful mental health system. While there has been legislation changes to increase access to community-based mental health services, it will take time and perseverance to see these changes implement. Once the changes have been implemented, then it will be possible to measure the effectiveness of the changes. If the changes help to remove some of the barriers to mental health care, then studies show that the policies will enhance the health and wellness for individuals with a neurobiological disorder and impact the community by providing a healthier environment. In the meantime, it important for researchers to continue to study the mental health care system, and to offer quality improvement mechanisms to improve treatment access and retention.

            Second, the United States needs to increase education and training for individuals with a neurobiological disorder. Neurobiological disorders are legitimate medical illnesses, like cancer, diabetes, heart disease, and so on so forth. Research shows that there are genetic and biological causes for psychiatric disorders; hence, the use of the term neurobiological disorders in this paper. Neurobiological disorders can be treated effectively. The recovery model has multiple facets and it is a nonlinear process; therefore, it would benefit consumers and families to know about the service options that are available at each stage, so that they can have a meaningful share in the opportunities available to them. By providing education and training to the consumer on their specific diagnosis it provides them with the opportunity to increase their knowledge and skills. However, recovery involves more than treating the diagnosis and symptoms because it is a multifaceted process that takes time.

            In order to attract the two-thirds of people with neurobiological symptoms that don’t seek care, the United States needs to remove common barriers that hinder people from seeking treatment. For instance, there are mountains of rules and regulations that consumers have to climb through to receive mental health services, because the mental health care system is not designed to be user friendly. The United States needs to increase recovery model education and training for mental health professionals, so they use the components of recovery to empower individuals with a neurobiological disorder to learn about their diagnosis, the system, resources, and to advocate for themselves. Most professionals have been introduced to recovery concepts and principles through federal program requirements or their agency’s administration policy; as a result, they should be held accountable when they do not promote recovery and follow the evidence based practices set forth by SAMSHA.

            Third, the United States needs to reduce the stigma and fear that surrounds a neurobiological disorder. Reducing stigma and improving mental health knowledge have the potential to enhance the mental health outcomes for individuals with a neurobiological disorder. By creating anti-stigma ads, it is possible to dispel inaccurate stereotypes and discourage the spread of myths, so that the public has a balanced view about mental health and treatment.

             There are shortcomings to this study; for instance, there are criticisms of Maslow’s hierarchy of needs that were not discussed (his theory is difficult to test scientifically), and the effects of medication on individuals with a neurobiological disorder were not looked at. There is limited research on the implementation and outcomes of recovery-oriented services and the mental health systems, since the changes in legislation and the SAMSHA working definition of recovery was released. More scientific research is needed to confirm or deny the changes to the quality of life for individuals; as well as, the long term effects to the individual, family, and community.

Conclusion

            In closing, neurobiological disorders are common all over the world. They can affect any person of any age, race, or socioeconomic status. While some obstacles have been removed from the mental health care system, there are still obstacles and challenges that are impeding the systems development, like the inadequate facilities and workforce. The components of recovery help to empower individuals with a neurobiological disorder to learn about their diagnosis, the system, resources, and to advocate for themselves. Since, it is estimated that approximately twenty-six percent of Americans, 57.7 million people or one in four adults, age 18 and older, suffer from a diagnosable neurological disorder in a given year it is important to continue understanding and researching all facets of neurobiological disorders.

            It is clear that much more research is needed; for example, the Affordable Care Act (ACA) will need to be evaluated to determine the effectiveness and the cost-effectiveness of the policy, after the policy has rolled out and some time is allotted for people to utilize the services; the Recovery Oriented Systems of Care (ROSC) model will need to be evaluated to determine the effectiveness (benefits) to the individual, the family, and the community; the ROSC model will need to be evaluated to determine the cost-effectiveness; and there is minimal research on the use and benefit of alternative medicine, just to name a few.

Recovery Transformation

SAMSHA (2012) redefined its definition of recovery as “a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential;” therefore, when individuals change the overall positive benefits to their mental, physical, and social health is their recovery. SAMSHA (2012) realized that recovery is multifaceted, so along with this definition they came up with the four dimensions that support recovery and the ten guiding principles of recovery. Consequently, the four major dimensions that support a life in recovery are: (1) taking care of one’s emotional and physical health; (2) a safe home or place to live; (3) a purpose to life through meaningful activities; and (4) community supports that create relationships and social networks (SAMSHA, 2012). In the article Working Definition of Recovery, SAMSHA (2012) defines the ten guiding principles of recovery as:

Recovery emerges from hope:  The belief that recovery is real provides the essential and motivating message of a better future – that people can and do overcome the internal and external challenges, barriers, and obstacles that confront them. Recovery is person-driven:  Self-determination and self-direction are the foundations for recovery as individuals define their own life goals and design their unique path(s). Recovery occurs via many pathways:  Individuals are unique with distinct needs, strengths, preferences, goals, culture, and backgrounds- including trauma experiences - that affect and determine their pathway(s) to recovery. Abstinence is the safest approach for those with substance use disorders. Recovery is holistic:  Recovery encompasses an individual’s whole life, including mind, body, spirit, and community. The array of services and supports available should be integrated and coordinated. Recovery is supported by peers and allies: Mutual support and mutual aid groups, including the sharing of experiential knowledge and skills, as well as social learning, play an invaluable role in recovery. Recovery is supported through relationship and social networks:  An important factor in the recovery process is the presence and involvement of people who believe in the person’s ability to recover; who offer hope, support, and encouragement; and who also suggest strategies and resources for change.  Recovery is culturally-based and influenced: Culture and cultural background in all of its diverse representations - including values, traditions, and beliefs - are keys in determining a person’s journey and unique pathway to recovery. Recovery is supported by addressing trauma: Services and supports should be trauma-informed to foster safety (physical and emotional) and trust, as well as promote choice, empowerment, and collaboration. Recovery involves individual, family, and community strengths and responsibility:  Individuals, families, and communities have strengths and resources that serve as a foundation for recovery.  Recovery is based on respect:  Community, systems, and societal acceptance and appreciation for people affected by mental health and substance use problems – including protecting their rights and eliminating discrimination – are crucial in achieving recovery (p.1-2). 

 

            Research suggests that as people progress through the recovery process their goals will change as their basic needs are met. According to humanist psychologist Abraham Maslow basic needs are vital for survival; for example, ‘physiological needs’ are water, food, and sleep; therefore, once these needs are met the individual would move onto meeting their ‘security needs’: safety, shelter, employment, and health care (1987). When setting goals it is important for consumers to have an understanding of the recovery process, because if they believe that recovery means a ‘cure’ to all their symptoms, then it might make recovery seem unreachable and be disheartening (Svanberg, Gumley, & Wilson, 2010). It is important to set appropriate and effective goals for each individual with a neurobiological disorder. If an appropriate and effective goal is set, then the individual will have a better chance of impacting their whole life (Clarke, 2012). Clarke, Oades, & Crowe (2012) explain that there are different stages of recovery goals; for example, “Avoidance goals aim to move or stay away from a negative or undesirable outcome (e.g. ‘to stop hearing voices’) whereas, approach goals aim to move towards or maintain a positive or desirable outcome (‘buy a car’) (p.298). Therefore, it is important to build on the individuals strengths when setting goals, and to acknowledge that “Individuals often experience setbacks within recovery which can lead to a few steps back before progressing again” and that is ok (Clark, p.303).            These recovery-oriented concepts are transforming the mental health care system (Clarke, 2012; Gehart, 2012; Onken et al., 2007; Pilgrim, 2009; Segal, Silverman, & Tempkin, 2010; Svanberg, Gumley, & Wilson, 2010).  

            This study is an analysis of the recovery system for individuals with a “neurobiological disorder,” [1] and it reveals that (1) there is not adequate funding for individuals with a neurobiological disorder; (2) there needs to be more education and training for individuals with a neurobiological disorder and professionals; as well as, accountability for professionals that do not promote recovery and follow the evidence based practices; and (3) society needs to reduce the stigma and fear that surrounds a neurobiological disorder, because evidence shows that change is possible.  

---

[1] In this paper, “Neurobiological disorder” refers to a diagnosis given to any person, who currently or at any time during the past year, have had a diagnosable mental, behavioral, or emotional disorder that would meet diagnostic criteria specified in the Diagnostic and Statistical Manual for Mental Disorders Fifth Edition (DSM - V). This term is not meant to be derogatory or demeaning to people who are dealing with mental health challenges.

Synopsis of Changes

             The organizational structure of mental health services has changed over the last few decades by shifting from institutional treatment to community-based treatment that focuses on a recovery-oriented approach (Gehart, 2012; Kaplan, Salzer, & Brusilovskiy, 2012; Onken, Craig, Ridgway, Ralph, & Cook, 2007; Pilgrim, 2009). These changes within the organizational structure of mental health services have made it possible for more individuals with a neurobiological disorder to live in communities. The United States government passed legislation which halted large group health plans (51 or more employees) from imposing annual or lifetime dollar limits on mental health benefits, because discriminating health insurance practices placed limits on insurance coverage for mental health and addictions treatment (SAMSHA, 2013). This was known as the Mental Health Parity Act (MHPA) of 1996. Yet, many consumers continued to receive inadequate services and treatment, and most communities continued to have inadequate resources (Corrigan, 2004; Komiya, Good, & Sherrod, 2000; Vogel, Wade, & Haake, 2006).  

            Consumer is a term that is preferred to be used; rather than, ‘client’, ‘patient’, or ‘service recipient’ (Gehart, 2012, Part I, p.431; President’s New Freedom Commission on Mental Health, 2003, p.4). This term is not meant to be derogatory or demeaning to people who are dealing with mental health challenges. In fact, the consumerism movement is the joining together of any individual who has had or is experiencing emotional and mental health challenges in a movement to regain their rights; thereby, “ridding society of discrimination and prejudice” (Holter, Mowbray, Bellamy, MacFarlane, & Dukarski, 2004, p.51).

The U.S. Supreme Court heard the case Olmstead v. L.C. (1999), and the justices determined that the Americans with Disabilities Act of 1990 requires states to place individuals with a neurobiological disorder in community settings when it is determined that community placement is appropriate; for that reason, the Olmstead v. L.C. case is used as the basis for making determinations about placement of individuals with a neurobiological disorder. As a result of the Olmstead v. L.C. case and the Consumerism movement, the New Freedom Commission on Mental Health (2003) recommended a policy shift that would transform mental health services and supports towards a ‘recovery-oriented approach.’ The idea of this type of transformation was a move in the right direction. According to Gehart (2012), “this approach draws upon some of the field’s best practices to create an approach that harmonizes with and supports the principles and ethics identified in the consumer-based, mental health recovery movement” (Part II, p.443). But, recovery is a broad term and without a clear definition and understanding of the term there were many misunderstandings surrounding its use by professionals and consumers. Since the policy that was developed lacked a clear definition Pilgrim (2009) pointed out that there was “little consensus on what recovery means in relation to mental illness” (p.477).  In order for there to be more of a consensus between professionals and consumers there needed to be a better description of what recovery meant and how recovery could be attained.

            In 2005, the Substance Abuse and Mental Health Services Administration (SAMSHA) came out with a definition of recovery, and they defined recovery as “A journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential.” Despite this definition of recovery there was still confusion surrounding the definition of recovery. Davidson and Roe (2007) tried to decrease the confusion that surrounded recovery by dividing recovery into two categories: ‘recovery from’ which involves an individual with a neurobiological disorder diagnosis becoming symptom free and not being admitted into a hospital or facility as a patient, and ‘recovery in’ which is when an individual with a neurobiological disorder endures their fluctuating symptoms as they change.

            SAMSHA was central to the transformation of the recovery system when they made the commitment that, “The Concept of recovery lies at the core of SAMSHA’s mission, and fostering the development of recovery-oriented systems of care (ROSC) is a SAMSHA priority” (Center for Substance Abuse Treatment, 2006, p.8). During this time period some other issues arose: sixty percent of consumers were leaving mental health and substance use disorders treatment before completion of their treatment (Substance Abuse and Mental Health Services Administration Office of Applied Studies Treatment Episode Data Set 2005, 2008); organizations were finding it difficult to measure the results of recovery and the government started feeling the pressure to reduce spending. As a result, the government started holding organizational programs, and professionals, accountable to provide measurable results.

It was apparent that the entire mental health system needed to be changed, so in 2009 SAMSHA started releasing recovery-oriented publications to provide direction in making efficient use of resources (Sheedy & Whitter, 2009; Gaumond & Whitter, 2009; Halvorson & Whitter, 2009; Laudet, 2009). Furthermore, SAMSHA created best practices and common terms that could be incorporated into the mental health and addictions field (Sheedy & Whitter, 2009; Gaumond & Whitter, 2009; Halvorson & Whitter, 2009; Laudet, 2009). The United States government realized that there were millions of Americans with neurobiological and/or substance disorders that were not receiving the same level of care as Americans with other general medical conditions; as a result, the U.S. passed the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 (Humphreys & McLellan, 2010). Then, SAMSHA (2010) released a three phase plan entitled Access To Recovery (ATR) Implementation Toolkit which was intended to help organizations receiving ATR grants to understand how to plan and implement recovery-oriented changes within their organization.

The MHPAEA's legislation was helping some Americans, but it was leaving millions of Americans without the needed medical insurance to get mental health services. Consequently, the U.S passed the Affordable Care Act (ACA) of 2010 (SAMSHA, 2013). However, there are challenges when implementing organizational changes. For example, some studies point to funding, administrative, and infrastructure challenges when implementing organizational changes (Halvorson & Whitter, 2009, p. 21). Halvorson & Whitter (2009) point out that “it’s important for all parties to be flexible during the alterations of the current mental health system;” however, the changes would continue over the next few years with the biggest changes being implemented in 2012 when the recovery process was transformed (p.17).

Stigma

Support groups are an important tool for facilitating recovery; for instance, recent studies have shown positive recovery outcomes/results with Wellness Recovery Action Planning (WRAP) (Copeland, 1997; Cook et al., 2009; Barbic, Krupa, & Armstrong, 2009; Sterling et al., 2010), the Recovery Workbook (Cook et al., 2009), and Pathways to Recovery: A Strengths Recovery Self-Help Workbook (PTR) (Fukui, 2010; Ridgeway, McDiarmid, Davidson, Bayes, & Ratzlaff, 2002). To illustrate, The WRAP program was developed by Mary Ellen Copeland, who is a mental health consumer. She wanted to live well and promote recovery (1997); with that being said, it is important for consumers to know that they are the central base of their own health and wellbeing. While some organizations have implemented WRAP into their programs, Scott and Wilson (2010) point out that it is important to allow consumers to decide if the WRAP lifestyle is something that they can achieve, because some consumers might feel that WRAP is not for them. It is vital to allow consumers to try skills and to determine what works for them and what doesn’t, so that they don’t become frustrated with the mental health system. Therefore, allowing consumers to remain engaged in services, and providing them with the elements of recovery that will help them to develop a set of tools that are beneficial to them.

            SAMSHA has recognized the family-to-family program, which is offered by the National Alliance on Mental Illness (NAMI), as a ‘prominent example’ of a program that promotes recovery by involving and supporting families. (SAMSHA, 2011). The NAMI organization offers a range of free educational programs and support programs. The educational and support programs are offered throughout the United States, and information about programs in specific locations can be assessed on their website. These programs include: Peer-to-Peer, NAMI Support Group, In Our Own Voice and much more (NAMI, n.d.: SAMSHA, 2011).

Spiritual Views

            When a consumer wishes to explore their spiritual views and religious resources, mental health professionals should be respectful and supportive because “spiritual well-being is moderately related to psychological well-being;” furthermore, Fukui, Starnino, & Nelson-Becker (2012) discovered that “involvement in religious activities contributed to increased self-perceptions regarding making sense of life…” and “…Attending religious community activities might help people find their path when searching for meaning in life” (p. 208). There are values that can be found in the bible that elevate one to learn forgiveness, honesty, love, self-respect, and other moral values[1]. For instance: 

The second is this: 'Love your neighbor as yourself.' There is no commandment greater than these (Mark 12:31, New International Translation).

 

Return evil for evil to no one (Romans 12:17, New World Translation, 2013 Revision).

 

Bear with one another; if anyone has a complaint against someone else, forgive him. Indeed, just as the Lord has forgiven you, so you must forgive (Colossians 3:13, Complete Jewish Bible).

 

            Life can be likened to a sailboat gliding along the water when the captain experiences a storm. The captain is forced to adjust the boats sails. Why? Because he is not in control of the storm, the strong winds and crashing waves. But by making adjustments, he may remain in control of his sailboat. In a comparable way, people often have no control over adversities that they encounter in life. But they can keep control of their life, to the extent possible, by adjusting the way they use physical, mental, and emotional resources. Thus, it can be beneficial to direct spiritual ones to versus found in the bible that will help them find more joy in life during trying times. For example:

It is important to focus on the here and now, because dwelling on past mistakes or bad deeds are not beneficial…

 

 But there is forgiveness with thee {GOD}, That thou mayest be feared (Psalm 130:4, American Standard Version).

 

It is possible to change with the help of God and his spirit…

 

Do not be conformed to this world, but be transformed by the renewal of your mind, that by testing you may discern what is the will of God, what is good and acceptable and perfect (Romans 12:2, English Standard Version).

 

Do not worry about tomorrow…

 

So never be anxious about the next day, for the next day will have its own anxieties. Each day has enough of its own troubles. (Matthew 6:34, New World Translation, 2013 Revision).

 

            Professionals have to make sure they don’t push religion on a consumer; as that could be a violation of some organizational policies and code of ethics. On the other hand, failure to recognize one’s spirituality can result in unethical treatment and be a failure of the helping professional to provide effective coping skills (Souza, 2002, p.216).

---

[1] This does not mean, or imply, that individuals that don’t believe in the bible or god cannot display moral values.