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Cover page of the Journal of Health Sciences

 Table of Contents  
Year : 2022  |  Volume : 15  |  Issue : 2  |  Page : 105-106

Recovery in severe mental illness: A utopian dream or a goal in need of will?

Department of Psychiatry, KAHER's Jawaharlal Nehru Medical College, Belagavi, Karnataka, India

Date of Submission12-Apr-2022
Date of Acceptance12-May-2022
Date of Web Publication24-May-2022

Correspondence Address:
Dr. Punit Pradeep Mutalik
Department of Psychiatry, KAHER's Jawaharlal Nehru Medical College, Belagavi - 590 010, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/kleuhsj.kleuhsj_398_22

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How to cite this article:
Tekkalaki B, Mutalik PP. Recovery in severe mental illness: A utopian dream or a goal in need of will?. Indian J Health Sci Biomed Res 2022;15:105-6

How to cite this URL:
Tekkalaki B, Mutalik PP. Recovery in severe mental illness: A utopian dream or a goal in need of will?. Indian J Health Sci Biomed Res [serial online] 2022 [cited 2023 Mar 21];15:105-6. Available from: https://www.ijournalhs.org/text.asp?2022/15/2/105/345832

Historically, severe mental illnesses (SMIs) have been viewed with much skepticism as morbid diagnoses with poor prognostic outcomes. This pessimistic view has found a place in modern understanding and practice of psychiatry among researchers, clinicians, and consumers alike, and may be credited with the stigma, discrimination, and stereotyping associated with SMIs. However, with the emergence of evidence for heterogeneity of outcomes in the past couple of decades, the morbidity associated with the diagnoses of SMI needs to be reviewed. Demonstration of the possibility of heterogeneity of outcomes has opened the doors to the concept of recovery in SMIs.[1],[2],[3],[4],[5]

The understanding of the recovery concept by the clinicians and the patients/caretakers appears to be divergent. Where clinicians tend to assume the absence of signs and symptoms of illness as a logical endpoint, the journey toward the recovery for patient/caretakers has just begun. Recovery for the consumers is the return to a life of productivity that contributes to a meaningful existence in the society, in addition to the absence of any significant signs and symptoms of illness. This discrepancy was taken into account when formulating the current understanding of recovery, i.e., the existence of symptomatic remission as well as functional remission.[6],[7]

When this concept of recovery was applied in Schizophrenia Research, the results indicated a significant chunk of patients with schizophrenia achieving recovery. This finding has also been observed to be fairly consistent across various races and ethnicities around the world. Long-term follow-up studies exploring the outcomes in schizophrenia have shown that between 10% and 35% of patients of schizophrenia achieve recovery. A systematic review and meta-analysis of recovery conducted in 2012 encompassed data from 50 studies. The study resulted in 13.5% of individuals found meeting recovery criteria.[8],[9],[10],[11],[12]

The first step toward achieving recovery is to believe in its existence and direct efforts in the right direction. While evidence on recovery in SMIs needs to be further unearthed, there is enough evidence to support the existence of heterogeneity of outcomes. The significance of this heterogeneity must not be undermined by practitioners and caregivers. Pessimism surrounding the prognosis of SMI needs to be shunned, and investment into achieving congruence with the consumers expectations should be focused upon.Interventions consistent with the biopsychosocial model of illnesses need to be devised. Early intervention with rational and judicious use of medications, enhancing family support, curtailing stigma and discrimination via spread of awareness, and promoting reintegration of the individual into the society are the management cornerstones on the road toward recovery in SMIs. So, is recovery in SMI a utopian dream? It appears so because of the lack of hope and dismissive attitudes on part of the clinicians and the society. We believe it's a Goal in need of Willingness to act.

  References Top

Harrison G, Hopper K, Craig T, Laska E, Siegel C, Wanderling J, et al. Recovery from psychotic illness: A 15- and 25-year international follow-up study. Br J Psychiatry 2001;178:506-17.  Back to cited text no. 1
Liberman RP, Kopelowicz A. Recovery from schizophrenia: A challenge for the 21st century. Int Rev Psychiatry 2002;14:245-55.  Back to cited text no. 2
Bleuler E. Dementia Praecox or the Group of Schizophrenias; 1950. Available from: https://psycnet.apa.org/record/1951-03305-000. [Last accessed on 2019 Jan 23].  Back to cited text no. 3
Tooth B, Kalyanasundaram V, Glover H, Momenzadah S. Factors consumers identify as important to recovery from schizophrenia. Australas Psychiatry 2003;11 suppl 1:10.1046/j.1440-1665.11.s1.1.x.  Back to cited text no. 4
McGlashan TH. A selective review of recent North American long-term followup studies of schizophrenia. Schizophr Bull 1988;14:515-42.  Back to cited text no. 5
Cohen P, Cohen J. The clinician's illusion. Arch Gen Psychiatry 1984;41:1178-82. Available from: http://www.ncbi.nlm.nih.gov/pubmed/6334503. [Last accessed on 2019 Jan 23].  Back to cited text no. 6
Barton R. The rehabilitation-recovery paradigm: A statement of philosophy for a public mental health system. Psychiatry Rehabil Ski 1998;2:171-87.  Back to cited text no. 7
Harrow M, Grossman LS, Jobe TH, Herbener ES. Do patients with schizophrenia ever show periods of recovery? A 15-year multi-follow-up study. Schizophr Bull 2005;31:723-34.  Back to cited text no. 8
Novick D, Haro JM, Suarez D, Vieta E, Naber D. Recovery in the outpatient setting: 36-month results from the schizophrenia outpatients health outcomes (SOHO) study. Schizophr Res 2009;108:223-30.  Back to cited text no. 9
Whitehorn D, Brown J, Richard J, Rui Q, Kopala L. Multiple dimensions of recovery in early psychosis. Int Rev Psychiatry 2002;14:273-83.  Back to cited text no. 10
Prikryl R, Kholova M, Kucerova HP, Ceskova E. Prevalence of remission and recovery in schizophrenia in the Czech republic. Compr Psychiatry 2013;54:1111-6.  Back to cited text no. 11
Jääskeläinen E, Juola P, Hirvonen N, McGrath JJ, Saha S, Isohanni M, et al. A systematic review and meta-analysis of recovery in schizophrenia. Schizophr Bull 2013;39:1296-306.  Back to cited text no. 12


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