Spirituality in the recovery from persistent mental disorders.

Mental health systems in this country are undergoing a quiet revolution. Former patients and other advocates are working with mental health providers and government agencies to incorporate spirituality into mental healthcare. While the significance of spirituality in substance abuse treatment has been acknowledged for many years due to widespread recognition of the therapeutic value of 12-step programs, this is a new development in the treatment of serious mental disorders such as bipolar disorder and schizophrenia. The incorporation of spirituality into treatment is part of the recovery model which has become widely accepted in the US and around the world. In 1999, the Surgeon General, in a landmark report on mental health, urged that all mental health systems adopt the recovery model. What distinguishes the recovery model from prior approaches in the mental health field is the perspective that people can fully recover from even the most severe forms of mental disorders. Services and research are being reoriented toward recovery from severe or long-term mental illnesses. This creates an orientation of hope rather than the “kiss of death” that diagnoses like schizophrenia once held. One hundred years ago, Emil Kraepelin identified the disorder now known as schizophrenia as dementia praecox, a chronic, unremitting, gradually deteriorating condition, having a progressive downhill course with an end state of dementia and incompetence. However, researchers have established that people diagnosed with schizophrenia and other serious mental disorders are capable of regaining significant roles in society and of running their own lives. There is strong evidence that most persons, even with long-term and disabling forms of schizophrenia, do “recover,” that is, enjoy lengthy periods of time free of psychotic symptoms and partake of community life as independent citizens. Daniel Fisher, a former patient, now a psychiatrist and internationally renowned advocate for the recovery model, maintains that “Believing you can recover is vital to recovery from mental illness. Recovery involves self-assessment and personal growth from a prior baseline, regardless of where that baseline was. Growth may take the overt form of skill development and resocialization, but it is essentially a spiritual revaluing of oneself, a gradually developed respect for one’s own worth as a human being. Often when people are healing from an episode of mental disorder, their hopeful beliefs about the future are intertwined with their spiritual lives, including praying, reading sacred texts, attending devotional services, and following a spiritual practice.”