Recovery in England: Transforming statutory services?

Abstract

English mental health policy has explicitly supported a focus on recovery since 2001. More recently, this has been elaborated through policy support for social inclusion, employment and well-being. We review several drivers for this political orientation, including a refocusing of the role of health services as a whole from treating illnesses to helping people to make the most of their lives, the shift to greater power for the individual, reflected in personal social care and personal health budgets, and the evidence informing clinical guidelines issued by the National Institute for Health and Clinical Excellence (NICE). A disjunction remains between policy and practice, with organizational policies espousing a recovery orientation and teams re-branding as ‘recovery and support’ teams, whilst pursuing clinical practices which prioritize symptomatic treatment rather than recovery support. The next phase of development in English statutory mental health services is therefore bridging this gap, through organizational transformation in mental health services towards a focus on recovery. We describe two funded initiatives to support this process of organizational transformation. The first (ImROC) is a national initiative to develop a pro-recovery organizational climate. The second (REFOCUS) is a multi-site cluster randomized controlled trial (ISRCTN02507940) investigating a team-level pro-recovery intervention.

Declaration of interest: Rachel Perkins is employed as a member of the ImROC programme project team. Mike Slade is Principal Investigator for the REFOCUS study, independent research commissioned by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (RP-PG-0707-10040). The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NHS Confederation, the NIHR, the Department of Health or the Centre for Mental Health. The authors alone are responsible for the content and writing of the paper.