In Recovery: The Making of Mental Health Policy

Traditionally, Nora Jacobson notes, recovery was defined as symptom abatement or a return to a normal state of health, but as activists, mental health professionals, and policymakers sought to develop "recovery-oriented" systems, other meanings emerged. Jacobson's analysis describes the complexes of ideas that have defined recovery in various contexts over time. The first meaning, "recovery-as-evidence," involves the theories, statistics, therapies, legislation, and myriad other factors that constituted the first one hundred years of mental health services provision in the United States. "Recovery-as-experience" brought the voices of patients into the conversation, while "recovery-as-ideology" drew on both recovery-as-evidence and recovery-as-experience to rally support for specific approaches and service-delivery models. This in turn became the basis for "recovery-as-policy," which developed as assorted representative bodies, such as commissions and task forces, planned reforms of the mental health system. Finally, "recovery-as-politics" emerged as reformers confronted harsh economic realities and entrenched ideas about evidence, experience, and ideology.

Throughout, Jacobson draws on her research in Wisconsin, a state with a long history of innovation in mental health services. Her study there included several years of fieldwork and interviews with the government-appointed groups charged with making recovery policy. Thus, "In Recovery" also provides an inside account of the process of policy development and implementation.