Recovery-oriented practices and essential components of recovery-oriented
systems
A recovery-oriented system of behavioral healthcare will offer the city's citizens an array of accessible services and supports from which they will be able to choose those which are most effective and responsive in addressing their particular behavioral health condition or combination of conditions. These services and supports will be culturally appropriate, build on individual, family, and community strengths, and have as their primary and explicit aim promotion of the person/family's resilience, recovery, and inclusion in community life.
Services and supports will be provided in an integrated and coordinated fashion within the context of a locally-managed system of care developed in collaboration with the surrounding community-thereby ensuring continuity of care both over time (e.g., across episodes) and across agency boundaries, and maximizing the person's opportunities for establishing, or reestablishing, a safe, dignified, and meaningful life in the communities of his or her choice.
The following proposal attempts to outline the various components of such a system of care. Prior to describing the different components of the system, it is important to mention first the roots of recovery-oriented system transformation in the Civil Rights Movement. Rather than referring to advances in the effectiveness of psychiatric medications or an accumulating body of research on clinical improvements or positive outcomes in serious mental illness or addictions, it has been through the advocacy efforts of people with behavioral health disorders that recovery has been pushed to the forefront of behavioral health policy and practice in the U.S. and else-where.
More than innovations in clinical practice, recovery refers to affording people with behavioral health conditions the right to "live, work, learn, and participate fully in the community." Based most recently on the Olmstead decision, but grounded in 30 years of consistent federal law preceding it, this right cannot be made contingent on improvements in the person's clinical or functional status, nor can it be indefinitely delayed based on a system's lack of available resources to support community tenure.
Citizens of
The challenge for a recovery-oriented system of care is to carry out this work in the most efficient and effective, and least coercive and restrictive, manner possible, both respecting the dignity and autonomy of its clients while ensuring the safety and well-being of the community.
Based on the stages of change model first introduced into treatment of addictions, the overarching principle for design of this system and its various components is that a person should be able to access effective and responsive services and supports regardless of where he or she is in the process of recovery from addiction, psychiatric disorder, or both. Realizing that addictions and psychiatric disorders co-occur at least as frequently as they occur independently, this model further allows for a person to be in different stages with respect to each of the conditions he or she may have.
Most importantly, being unaware of, or choosing not to accept having, a behavioral health condition is to be viewed as a point of departure for treatment, rehabilitation, and support efforts as opposed to being viewed as cause for discharge from care. Based also on the input of people who are in recovery from addiction and/or psychiatric disorder, this model places central emphasis on the role of peer-delivered services and supports at each point along the continuum of care.
Recovery Support
Services
Recovery Coach / Guides
Outreach and Engagements
Intensive Outpatient Services
Acute Care
Supported Community Living
Medication Assesments,
Administration / Monitoring
Risk Assessment / Management
Table of Common Characteristics
