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EDITORIAL |
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Year : 2022 | Volume
: 15
| Issue : 2 | Page : 105-106 |
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Recovery in severe mental illness: A utopian dream or a goal in need of will?
Bheemsain Tekkalaki, Punit Pradeep Mutalik
Department of Psychiatry, KAHER's Jawaharlal Nehru Medical College, Belagavi, Karnataka, India
Date of Submission | 12-Apr-2022 |
Date of Acceptance | 12-May-2022 |
Date of Web Publication | 24-May-2022 |
Correspondence Address: Dr. Punit Pradeep Mutalik Department of Psychiatry, KAHER's Jawaharlal Nehru Medical College, Belagavi - 590 010, Karnataka India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/kleuhsj.kleuhsj_398_22
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 |
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.
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