SAMHSA’s Working Definition of Recovery from Mental Disorders and Substance Use Disorders

As LaVerne mentioned in her Are You My Peer? blog post on 5/24, SAMHSA recently developed a working definition of recovery and established guiding principles that support recovery from mental and substance use disorders.  The following describes the components of this working definition through the lens of a person who is in long-term recovery from mental health and substance use issues. Each component of SAMHSA’s working definition is powerful and there is a great deal of meaning behind each of the terms.

Process of Change

Whether or not we are in a process of recovery, most of us can agree that life is ever-changing. One of the most important points that can be pulled from this part of the working definition is the word ‘process’.

For most, recovery is not something that works in any specific order. For example, some people may first work towards creating meaningful relationships with family members, others may choose to focus on making sure that they are on medications that work for them, and others may choose to address substance abuse issues through 12-step programs. Priorities are different for everyone and there may be times where people seem to digress.  However, even this perceived setback is part of the recovery process.

In my own recovery, finding the medication that worked for me was a process that can only be described as trial and error.  Additionally, because substance abuse was a major part of my life, getting and staying off of drugs and alcohol was a critical part of the success of my mental health recovery. There were times, even after extensive periods away from substances, that I returned briefly to using drugs and alcohol, relapsing. While I originally looked at these instances as complete failures, it was pointed out to me that, instead, these were opportunities for me to learn what didn’t work and to use those unsuccessful moments to refine and redefine the approach I would ultimately use to become and stay mentally, physically, and spiritually well.

Improve Health and Wellness

People with mental and substance use disorders die decades earlier than the rest of the population because of preventable medical issues like diabetes or cardiovascular, respiratory, or infectious diseases. These risk factors are complex and attributable to high rates of smoking, obesity, unsafe sexual practices, poverty, social isolation, trauma, incarceration, psychotropic medications, and a lack of access to quality, culturally appropriate services.

Because of a better understanding of the direct connection between our mental and physical health, there is now a greater emphasis on providing services and supports in a holistic way, even taking into account other areas of wellness such as social, environmental, emotional, spiritual, occupational, intellectual, and financial.

In my own personal recovery, in addition to 12 step programs and organized treatment services, I make sure that I eat a healthy diet, get plenty of rest, and enjoy lots of physical activity. I have found over the years that it is harder to maintain the positive direction I want to see my life go in if I do not view wellness in this broad way.

Self-Direction

Self-direction is one of the foundations of recovery because it empowers people to define their own goals, as well as the path(s) towards those goals.  People can optimize their autonomy by leading the services that help their recovery processes. Self-direction enables people to make better decisions and to gain or regain control over their lives.

While there has been much progress in making sure that people with mental and substance use disorders are able to live self-directed lives, most people still struggle with having the power to make decisions about where they live, where they work, and even the types of relationships they are able to have. There are many reasons for this, but much has to do with the fact that there is still a belief that people in recovery do not have the ability to make sound decisions regarding their lives. In fact, it is the complete opposite: people with mental and substance use disorders are experts on their own lives; research has shown that  people involved in self-directed treatment programs have reduced costs, increased satisfaction, and better outcomes (i.e. sustained employment and housing) than their peers.

Strive to Reach Full Potential

One of the most important components of a behavioral health system that has been transformed to be person-centered is the fact that the system becomes more focused on helping people reach their own potential. This is important because it implies that everyone is different and that everybody has the right to choose their own goals. The traditional mental health system historically grouped people and based services and supports on low expectations for those with mental and substance use disorders without recognizing their individual differences and talents.

Historically, the behavioral health system has taken a disempowering approach where service providers dictated treatment plans.  In the transformed systems of today, the individual, physician, and other wellness providers come together to discuss the individual’s goals and develop plans for success.

The system has changed greatly but not nearly enough – we now know that people with behavioral health conditions can live full lives with employment, family, friends, and the same rights afforded to people without these disorders.

Through a continued relationship between service providers, researchers, consumers, and government, the behavioral health field will continue to improve and become more focused on recovery and less on antiquated beliefs about what people with mental and substance abuse disorders are capable of doing in their lives.

Behavioral health, FCN TA Center, Peer, Recovery supports