1 RECOVERY FROM MENTAL BREAKDOWN OR ILLNESS Jan Wallcraft Introduction People on the receiving end of mental health services have been organising for many years now to call for reform. Many have argued that psychiatric diagnoses and the negative predictions about the patient’s future which tend to go with diagnosis make them feel hopeless. Physical treatments in psychiatry, including ECT and many types of medication, have adverse effects which, along with the stigma and discrimination attached to mental illness diagnoses make it hard for people to get back into employment. As one ex- patient activist said: The psychiatric system far from being a sanctuary and a system of healing was…a system of fear and continuation of illness for me. Like so many others recovery was a process that I did not encounter within the system, indeed…it was not until I left the system that the recovery process really got underway in my life. It was as if the system had no expectation of me recovering, instead the emphasis was on maintenance. I am not saying that those who worked in the system did not care for me, they did. They clothed me, fed me, housed me and ensured that I took my medication. What they did not do was consider the possibility that I could return to being the person I once was..(Ron Coleman 1999) Because of pressure from service users and from mental health professionals and academics arguing the case for a more socially oriented approach, there are now signs of a paradigm shift that could change the underlying values in the psychiatric system. One concept in particular has wrought a powerful change in people’s views of what is possible in mental health, and that is ‘recovery’. Anthony (2000) says that the ‘recovery vision’ resulted from consumers writing their own stories of recovery from mental illness and from the empirical work of Harding and her associates (Harding 1994) who carried out long term outcome studies and reviewed a number of other long term studies. Harding found that a deteriorating course for severe mental illness is not the norm, and that it is likely that chronic illness has less to do with the disorder itself and more to do with complex interactions between the person and their social environment.