In their new chapter Reconsidering ‘Recovery,” Larry Davidson and Kim Jørgensen call for a paradigm shift toward personal recovery, emphasizing the pursuit of a meaningful, connected, and empowered life even in the presence of ongoing mental health challenges.
They respond to the persistent difficulty within mental health systems and local communities to define recovery, and the implications this ambiguity has for policy and practice.
As the opening chapter of The Path to Mental Health Recovery, the piece critically examines the evolution of the concept of recovery, situating it within both historical and contemporary frameworks. Through an integrative analysis of case-based reflections and historical perspectives, Davidson and Jørgensen demonstrate the impact and potential of changing definitions of recovery.
Approaching their work through a disability lens, the authors emphasize the value of person-centered care, peer support, and community-based participation.
The authors write:
“Real change requires systemic reforms, including policies that prioritize recovery-oriented care, funding for community-based support, and the integration of lived experience into decision-making. Training programs must equip professionals with a broader understanding of mental health beyond diagnosis and medication, while regulatory frameworks should move away from a narrow focus on symptom management. Without these deeper structural changes, education alone risks being a surface-level intervention that fails to challenge the entrenched systems shaping mental health services today.”
Davidson, a longtime recovery researcher at Yale, has helped shape recovery-oriented practice in the U.S. and internationally. Jørgensen, a Danish scholar whose work focuses on recovery-oriented practice and user perspectives across health systems, brings a European lens and a strong interest in how power works in “helping” institutions. They argue that the field has too often treated recovery as a clinical endpoint defined by fewer symptoms, fewer hospitalizations, and better scores on standardized measures. They call for a more ambitious definition, one rooted in disability studies, civil rights, and the knowledge produced by people who have lived through psychiatric systems.
The chapter is framed throughout by a clinical vignette depicting an encounter between a psychiatrist and a service user with depression. Rather than centering the interaction on symptom reduction, the psychiatrist supports the service user in identifying meaningful goals and aspirations, such as art and relationships, to cultivate hope, identity, and well-being. The vignette illustrates what can be possible when providers depart from traditional or dominant approaches to recovery and instead recognize individuals’ capacity to lead fulfilling lives, all while still experiencing ongoing mental health challenges.
Davidson and Jørgensen contextualize this approach through a historical analysis that challenges prevailing assumptions about recovery, emphasizing the dynamic nature of psychiatric thought through time. They demonstrate that the evolution of the concept of recovery was not a linear progression toward more compassionate care. In the late 18th century, Philippe Pinel advanced a more optimistic view, advocating for the dignity and respect of individuals experiencing severe mental illness and emphasizing their capacity for recovery.
This perspective shifted dramatically in the 20th century. Influenced by Kraepelin and institutionalized through diagnostic classification systems such as the DSM and ICD, psychiatry adopted a more pessimistic and reductionist framework. Conditions such as schizophrenia came to be framed as chronic, degenerative, and irreversible, profoundly shaping clinical practice, policy, and public perception through the dominance of the biomedical model.
The authors carefully examine the distinction between clinical recovery and personal recovery. Clinical recovery prioritizes symptom elimination and diagnostic outcomes. In contrast, the authors define personal recovery:
“Personal recovery is about reconnecting with who you are, setting meaningful goals, and building hope for the future. It’s not just about reducing symptoms, it’s about living a fulfilling life, even in the presence of ongoing challenges. Achieving this requires understanding and engaging with the social contexts and networks that shape daily life, as these can either support or hinder recovery. By shifting the focus beyond psychiatric institutions to strengths, hope, and inclusion, we can create meaningful pathways for recovery.”
Personal recovery is not framed as an end goal but rather as an ongoing process that entails navigating or transcending limitations or challenges.
To demonstrate how personal recovery can be supported and implemented in practice, Davidson and Jørgensen draw on the CHIME framework. CHIME identifies five interconnected dimensions of personal recovery: connectedness, hope, identity, meaning, and empowerment, which depend on relationships, social inclusion, and material conditions. The framework emphasizes the relational nature of recovery, and that empowerment emerges through participation and belonging.
They advocate for approaching recovery through a disability lens, stating:
“Acknowledging severe mental illness through a disability model is crucial for identifying opportunities and resources, ensuring that individuals with mental conditions can access and participate in society without hindrance. The imperative for community inclusion as a prerequisite for recovery, rather than a reward for overcoming mental illness, challenges the prevailing narrative. Stigma and discrimination present formidable barriers to community participation for individuals with mental illness, perpetuating negative perceptions and hindering self-identity as capable individuals.”
Additionally, the authors highlight a range of interventions and movements that demonstrate progress and possibility within a disability- and person-centered framework, many of which have emerged from service user and survivor movements. For example, Hearing Voices Groups, peer support workers, and recognizing lived experience as legitimate knowledge, as well as the Housing First initiative and Individual Placement and Support.
By integrating clinical and personal recovery, the authors argue that mental health services can move toward a more holistic and humane model of care. The chapter concludes that actual recovery-oriented practice requires not only reform within mental health systems, but a collective commitment to inclusion, dignity, and shared responsibility, redefining what and who mental health care is for.
In conclusion, Davidson and Jørgensen call for a transformation of psychiatric and mental health systems, moving away from authoritative, practitioner-driven decision-making toward collaborative environments in which individuals with diverse mental health experiences are recognized as partners in recovery.
“Despite facing numerous challenges, individuals with mental health conditions offer unique and critical perspectives on the effects of their conditions on their lives, including the effectiveness of different interventions… Ultimately, it is the individual with a mental illness who bears the primary consequences, both positive and negative, of decisions concerning their well-being and lifestyle. Consequently, the focal points of the Recovery movement center on person-centered planning and the active participation of individuals in the process. This approach, encapsulated in identifying and leveraging a person’s strengths, opportunities, and community resources, fosters hope and supports their pursuit of aspirations.”
Davidson and Jørgensen argue that “recovery” cannot be reduced to symptom control without betraying the very people the recovery movement emerged to serve. Their chapter presses mental health systems toward a rights-based, disability-informed model in which belonging and participation are not rewards for getting better, but prerequisites for living.
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Davidson, L., & Jørgensen, K. (2025). Reconsidering “Recovery.” In K. Jørgensen, The Path to Mental Health Recovery (1st ed., pp. 1–16). Routledge. https://doi.org/10.4324/9781003489030-1 (Link)
The amount of lying and manipulation that goes on in the mental health system is insane. There are too many people who have had complete lies written into their notes and charts by people in the mental health and medical fields. We can’t continue to allow such unethical behavior. People’s lives have been ruined and they have been denied the care they actually need because of what was written in their notes and charts. The use of clinical language only dehumanizes people further and pathologizes emotion. Lying about a person’s condition in order to bill insurance, to control them, or for any other reason is never acceptable. This type of behavior has been going on for far too long. People’s narrative and their lives have been rewritten by those who clearly don’t have their best interests in mind. I feel disturbed every day knowing that this is the current way people are operating within the mental and medical systems. This type of unethical behavior never should have been tolerated to begin with. I realized a long time ago we have no medical system in this country. What we have is one group of people labeling and categorizing another group of people who have different thoughts, behaviors, and emotions than they do. This society is obviously controlled by immature people and not by people who care about intelligence, compassion, and empathy.
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This is so well stated Matthew and so true:
“There are too many people who have had complete lies written into their notes and charts by people in the mental health and medical fields. We can’t continue to allow such unethical behavior. People’s lives have been ruined and they have been denied the care they actually need because of what was written in their notes and charts.”
Psychiatry is the wild west in regards to patients rights and informed consent. Psychiatrists can write whatever they want and defame someone’s character. The get to do this with total impunity even when what they wrote are lies, fabrications and were written out of spite or total incompetence. The patient is defenseless as there appears to be no way to get the lies and fabrications corrected.
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It’s infuriating how they are allowed to violate our human and constitutional rights and are never held accountable for doing so. Meanwhile if we try to stand up for ourselves we are punished and threatened with force and violence. The constitution which is the law of the land in the US needs to be upheld.
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Yes, exactly! I especially like your observation about “one group of people labeling and categorizing another group of people who have different thoughts, behaviors,and emotions than they do.” I would just note that the privileged few who do invidious labeling and categorizing of others are undoubtedly from a more affluent background and thus not as exposed to the economic hardships, poor healthcare, fewer educational opportunities, and similar challenges experienced by people barely surviving on the lowest rungs of society.
I find this smug, condescending attitude reflected in several recent articles on the MIA website, whose authors expatiate on the “mental health symptoms” allegedly prevalent among members of the impoverished urban and rural underclass (frequently minorities), while pointedly ignoring the psychological traits and motivations of political and economic elites who create, maintain, and profit from the system that gives rise to such “pathology.”
One doesn’t need a degree in sociology to realize that this differential approach can be no accident.
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That is true that the people who are categorizing others are usually from a more privileged background. Unfortunately this type of labeling has affected my life in a terrible way. I was labeled years ago with depression and now doctors are not helping me with a serious illness that I’ve had for years. My life has become a complete nightmare because of this label that is being used to define me. I can’t believe that I have been denied medical care because of this. My condition has worsened because my physical health is not being taken seriously. I am one of those people who is barely surviving on the fringes of society. I haven’t been able to work in years because of how severe my illnesses are. There is no real help offered to me. I am expected to deal with severe chronic pain for the rest of my life. I am yet another person who has been failed and mistreated by the medical system. This entire ordeal has nearly ruined my life and made it much harder for me to live.
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I think I agree with all of your legitimate disgust, regarding today’s scientifically “invalid” “mental health professions,” Matthew, well stated.
The entirety of today’s DSM “bible” believing and billing humans promote stigma and discrimination. “Stigma and discrimination present formidable barriers to community participation for individuals with mental illness [which includes everyone they defame with their “invalid” “DSM disorders”], perpetuating negative perceptions and hindering self-identity as capable individuals.”
“Ultimately, it is the individual with a mental illness who bears the primary consequences, both positive and negative, of decisions concerning their well-being and lifestyle.”
And even all of us normal humans, who systemically have had the common symptoms of antidepressant discontinuation syndrome, like brain zaps, misdiagnosed as “bipolar.” Since none of the “mental health professionals” even knew brain zaps were a common symptom of antidepressant withdrawal, until 2005. (Please see my previous links on this website pointing this out, since all the internet censorship is getting truly disgusting.)
But what’s “professional” about not knowing anything about the common withdrawal and adverse effects of the drug one gives, coerces, or forces another to take … when the entirety of the “mental health professions” and mainstream doctors were supposedly still ignorant of those common adverse effects, around twenty or so years ago? And these misdiagnoses are still occurring.
“Consequently, the focal points of the Recovery movement center on person-centered planning and the active participation of individuals in the process. This approach, encapsulated in identifying and leveraging a person’s strengths, opportunities, and community resources, fosters hope and supports their pursuit of aspirations.”
Yet the current “invalid” DSM “medical model” does the opposite.
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That’s what’s so frustrating about all of this. How little say people have in the way they are being treated. How human and constitutional rights are violated the second someone is labeled with a mental illness. The mental health system never should have been allowed to become like this to begin with. It’s painful to think about how mental health practices reached this terrible level and why immoral and unethical behavior has been permitted by so many in society. It saddens me that so few people are willing to take a stand against not having a say in their own treatment. It’s clearly wrong that people are being abused and mistreated yet so many remain silent about this.
I have faced discrimination and mistreatment myself for standing up for what I believe in. I have been ignored numerous times and left to suffer from serious medical conditions because I want a say in my own treatment. Sometimes it hard to believe this is happening to me. We live in such an inverted world. It couldn’t be more obvious. I have felt severe arthritis pain throughout my body for years now but I am just left to suffer because all this system does is abuse people like me who have serious health conditions. I want the constitutional and human rights of anyone seeking medical care to be upheld. I have been denied proper medical care and instead people have repeatedly tried to coerce and intimidate me into accepting mental health “services”. When I make it obvious I don’t want to interact with a system that is going to abuse me I get ignored as one would expect when dealing with a system that has continuously allowed unethical and immoral behavior.
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Matthew,
“The mental health system never should have been allowed to become like this to begin with.”
Indeed.
“It’s painful to think about how mental health practices reached this terrible level and why immoral and unethical behavior has been permitted by so many in society.”
It is shameful, but is due to us all living within way too paternalistic societies.
Western civilization needs to learn to respect the women and children, not just the men.
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Sadly I now see the whole concept of the recovery model sitting firmly with the medical model paradigm. It seems to only see ones life challenges as symptoms of illness rather than exactly what they are, simply someone responding to the c**p that life throws at them in a way that maybe others see as “abnormal” and therefore a sign of an illness within them requiring treatment.
The recovery model sits within this as well, the quotes and understanding i read about simply state that recovery means living your best life within the limitations or maybe parameters of the illness. And it’s that last bit, only seeing ones different emotional response to the life they are experiencing as an illness that they need help to live the best they can in spite of it.
Well maybe we need to actually help and address people to work through their difficulties and empower them to forge ahead rather than tell them they are dysfunctional, need help, disable them, tell them the way they are is not normal. Who is to say what normal is anyway.? Similarly with anyone who declares they are atypical, well who decides what typical is and anyway I’m not sure, I, for one would want to be ever considered the same as anyone else, I don’t want to be “typical” to whom exactly?? Neoodivergent? Isn’t everyone on the f××××ing planet neurodivergent in the sense that every single one of us is completely different. It’s what makes humans the rich and wonderous beings that we are.
Stop boxing us up, labelling us and telling us because you don’t see us responding in what you consider a “normal” way there is something that requires recovery from, or to live in recovery from the box you have deposited us in and thrown away after being regarded as different from the norms you suggest are correct.
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I agree that labels don’t help any of us at all. I was labeled over a decade ago with depression. I never thought in a million years that being labeled with depression would prevent me from receiving medical care in the future. My life has become a nightmare all because people won’t see past something that I was labeled with. They don’t care that I’ve had multiple serious illnesses for years. They just see the word depression in my notes and they somehow think that chronic pain, inflammation, muscle pain and weakness, and arthritis are caused by depression and not by Lyme disease which I am constant exposed to. The medical industry is such a joke. Because of it I have been left to suffer instead of receiving any real help. And because they labeled me with depression now I get the added benefit of being threatened with antidepressants and ECT if I try to seek help for my medical conditions. What a messed up world we live in. I get threatened with brain destroying drugs and harmful shocks to my brain because I’ve been labeled. This society is so unreal sometimes.
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My entire human identity was replaced by a fictitious psychoquackical chart narrative of fabricated behaviors and “symptoms” resulting in over a dozen years of incarceration in a nightmarish psychoprison. I have never regarded those advocating “improving” that enterprise as being my advocates. My liberation eventually resulted from purely political interventions which I engineered myself. I have thrived for the last 21 years. It is easy to “recover” from nonexistent illness. The only ethical solution is abolishment of the entire institution of coercive and excusive psychoquackery. This is a political endeavor requiring the will and resolve of honest citizens. You college boys and girls need to go back to the drawing board.
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We’re going to need many honest citizens to step forward. Millions of people are suffering because of this corrupt system. Human and constitutional rights are being violated on an hourly basis. Children, the elderly, and people with serious health conditions are constantly being abused and neglected thanks to the efforts of the mental health system. Anyone who has a conscience needs to stand against the mental health system which is nothing but a fraudulent system based on lies and manipulation. Anyone who cares about freedom and liberty needs to stand against this unethical and immoral system. We can’t sit idly by and remain silent about these abuses anymore.
People need to stand together and demand an end to this abuse. It has gone on for too long and psychiatry needs to be abolished. How many more people are going to get harmed before this madness comes to an end? How far back into the dark ages are we going to let these liars and manipulators take us? We can’t allow any of this to continue if we want to build a society based on the values of fairness and equality. We can’t ignore the corruption of the human soul and spirit. The degeneration of the human condition must be addressed.
If we do not address these barbaric and torturous practices now they will follow us into the future instead of being abolished and remembered as part of a systematic horror which destroyed the innocence and well being of many in the past. Future generations shouldn’t be subjected to this system of judgement, abuse, neglect, and psychological torture. They deserve better as we all do.
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Well said, Matthew.
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