The adoption of recovery by behavioral health systems in recent years has signaled a dramatic shift in the expectation for positive outcomes for individuals who experience mental and/or substance use conditions. Today, when individuals with mental and/or substance use disorders seek help, they are met with the knowledge and belief that anyone can recover and/or manage their conditions successfully. The value of recovery and recovery-oriented behavioral health systems is widely accepted by states, communities, health care providers, peers, families, researchers, and advocates including the U.S. Surgeon General, the Institute of Medicine, and others.
SAMHSA has established a working definition of recovery that defines recovery as a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential. Recovery is built on access to evidence-based clinical treatment and recovery support services for all populations. Learn more about SAMHSA’s Working Definition of Recovery — 2012.
SAMHSA has delineated four major dimensions that support a life in recovery:
- Health—overcoming or managing one’s disease(s) or symptoms—for example, abstaining from use of alcohol, illicit drugs, and non-prescribed medications if one has an addiction problem—and, for everyone in recovery, making informed, healthy choices that support physical and emotional well-being
- Home—having a stable and safe place to live
- Purpose—conducting meaningful daily activities, such as a job, school volunteerism, family caretaking, or creative endeavors, and the independence, income, and resources to participate in society
- Community—having relationships and social networks that provide support, friendship, love, and hope
Hope, the belief that these challenges and conditions can be overcome, is the foundation of recovery. A person’s recovery is built on his or her strengths, talents, coping abilities, resources, and inherent values. It is holistic, addresses the whole person and their community, and is supported by peers, friends, and family members.
The process of recovery is highly personal and occurs via many pathways. It may include clinical treatment, medications, faith-based approaches, peer support, family support, self-care, and other approaches. Recovery is characterized by continual growth and improvement in one’s health and wellness that may involve setbacks. Because setbacks are a natural part of life, resilience becomes a key component of recovery.
Resilience refers to an individual’s ability to cope with adversity and adapt to challenges or change. Resilience develops over time and gives an individual the capacity not only to cope with life’s challenges but also to be better prepared for the next stressful situation. Optimism and the ability to remain hopeful are essential to resilience and the process of recovery. Visit SAMHSA’s Partners for Recovery Initiative’s Resilience Annotated Bibliography – 2013 (PDF | 531 KB).
Because recovery is a highly individualized process, recovery services and supports must be flexible to ensure cultural relevancy. What may work for adults in recovery may be very different for youth or older adults in recovery. For example, the promotion of resiliency in young people, and the nature of social supports, peer mentors, and recovery coaching for adolescents and transitional age youth are different than recovery support services for adults and older adults. Learn more about Cultural Awareness and Competency.
The process of recovery is supported through relationships and social networks. This often involves family members who become the champions of their loved one’s recovery. They provide essential support to their family member’s journey of recovery and similarly experience the moments of positive healing as well as the difficult challenges. Families of people in recovery may experience adversities in their social, occupational, and financial lives, as well as in their overall quality of family life. These experiences can lead to increased family stress, guilt, shame, anger, fear, anxiety, loss, grief, and isolation. The concept of resilience in recovery is also vital for family members who need access to intentional supports that promote their health and well-being. The support of peers and friends is also crucial in engaging and supporting individuals in recovery.
SAMHSA established the Recovery Support Strategic Initiative to promote partnering with people in recovery from mental and substance use disorders and their family members to guide the behavioral health system and promote individual, program, and system-level approaches that foster health and resilience (including helping individuals with behavioral health needs be well, manage symptoms, and achieve and maintain abstinence); increase housing to support recovery; reduce barriers to employment, education, and other life goals; and secure necessary social supports in their chosen community.
Recovery support is provided through treatment, services, and community-based programs by behavioral health care providers, peer providers, family members, friends and social networks, the faith community, and people with experience in recovery. Recovery support services help people enter into and navigate systems of care, remove barriers to recovery, stay engaged in the recovery process, and live full lives in communities of their choice.
Recovery support services include culturally and linguistically appropriate services that assist individuals and families working toward recovery from mental and/or substance use problems. They incorporate a full range of social, legal, and other services that facilitate recovery, wellness, and linkage to and coordination among service providers, and other supports shown to improve quality of life for people in and seeking recovery and their families.
Recovery support services also include access to evidence-based practices such as supported employment, education, and housing; assertive community treatment; illness management; and peer-operated services. Recovery support services may be provided before, during, or after clinical treatment or may be provided to individuals who are not in treatment but seek support services. These services, provided by professionals and peers, are delivered through a variety of community and faith-based groups, treatment providers, schools, and other specialized services. For example, in the United States there are 22 recovery high schools that help reduce the risk environment for youth with substance use disorders. These schools typically have high retention rates and low relapse rates. The broad range of service delivery options ensures the life experiences of all people are valued and represented.
Supporting recovery requires that mental health and addiction services:
- Be responsive and respectful to the health beliefs, practices, and cultural and linguistic needs of diverse people and groups
- Actively address diversity in the delivery of services
- Seek to reduce health disparities in access and outcomes
Cultural competence describes the ability of an individual or organization to interact effectively with people of different cultures. To produce positive change, practitioners must understand the cultural context of the community they serve, and have the willingness and skills to work within this context. This means drawing on community-based values, traditions, and customs, and working with knowledgeable people from the community to plan, implement, and evaluate prevention activities.
Individuals, families, and communities that have experienced social and economic disadvantages are more likely to face greater obstacles to overall health. Characteristics such as race or ethnicity, religion, low socioeconomic status, gender, age, mental health, disability, sexual orientation or gender identity, geographic location, or other characteristics historically linked to exclusion or discrimination are known to influence health status.
SAMHSA is committed to addressing these health disparities by providing culturally and linguistically appropriate prevention, treatment, and recovery support programs. This commitment is reinforced through the agency’s disparity impact strategy that monitors programs and activities to ensure that access, use, and outcomes are equitable across racial and ethnic minority groups.
The SAMHSA Office of Behavioral Health Equity (OBHE) works to reduce mental health and substance use disparities among diverse racial and ethnic populations, as well as lesbian, gay, bisexual, and transgender (LGBT) populations. OBHE was established to improve access to quality care and in accordance with section 10334(b) of the Affordable Care Act of 2010, which requires six agencies under the Department of Health and Human Services (HHS) to establish an office of minority affairs.
Through the State Peer and Family Network Grant Programs, the Recovery Community Services Program, the National Consumer Supporter Technical Assistance Center and the Targeted Capacity Expansion Peer-to-Peer grant program, SAMHSA is gathering data to assess the effectiveness of recovery supports delivered by peers with specific populations, and to identify program models that best address the needs of individuals in recovery. For example, SAMHSA works with tribal groups to develop culturally focused and person-centered health and wellness initiatives and housing supports – 2014 (PDF | 1.2 MB). Also see the SAMHSA’s Bringing Recovery Supports to Scale Technical Assistance Center Strategy (BRSS TACS) webinar Supports and Services for LGBT Youth in Recovery.
A recovery focus is also a preventive approach that simultaneously supports building resiliency, wellness, measureable recovery and quality of life. Visit SAMHSA’s Center for the Application of Prevention Technologies (CAPT) training and technical assistance (TTA) tools for Trauma and Resilience Resources.
Learn more about:
- SAMHSA’s Recovery Support Efforts
- Peer Support and Social Inclusion
- Grants Related to Recovery and Recovery Support
- Publications and Resources on Recovery and Recovery Support