Recovery-oriented approaches can be implemented across the full spectrum of services, from community supports to primary health care and hospital-based care. Figure 3 depicts the relationship between recovery practice and service delivery, rehabilitation and other mental health interventions.
Commonwealth, state and territory policies stress the need for rehabilitation to commence at the earliest possible point in a person's recovery (Queensland Health 2005; Tasmanian Department of Health and Human Services 2009; NSW Health 2006; SA Health 2012).
Figure 3: Recovery practice along the continuum of mental health interventions
Source: NSW community mental health strategy 2007–12: from prevention and early intervention to recovery (2006)
Text version of Figure 3The continuum of mental health interventions is presented as a semi-circle, with each segment of the semi-circle representing a particular intervention. The spectrum is underpinned by mental health promotion.
The interventions that make up prevention are:
- care identification
- early treatment
- care identification
- early treatment
- standard treatment
- engagement with longer-term treatment (including relapse prevention)
- long-term care
A recovery approach in rehabilitation servicesIn Australia, rehabilitation services are provided by all mental health service sectors—public, private and non-government. Rehabilitation services work across service settings—inpatient to community based—and across the life span.
The Australian non-government mental health service sector is a significant provider of continuing care and rehabilitation and recovery services. This sector has defined their core service components as:
- accommodation support and outreach
- employment and education
- leisure and recreation
- family support and carer programs
- self-help and peer support
- helpline and counselling services
- information, advocacy and promotion (MHCC 2010).
A helpful definition of rehabilitation in the context of recoveryServices play a key role in supporting the recovery process for people with mental health issues by helping them to access the internal resources they need in their recovery (for example, hope, resilience, coping skills, self-acceptance and physical health) and the external services and supports that support recovery and independence (for example, stable accommodation, education and vocational support). Rehabilitation plays an important role in promoting hope, redefining identity, building personal control and finding meaning and purpose by using a strengths-based and wellness-oriented approach. The aim of recovery-focused rehabilitation is to enable people to live meaningful lives in the community and to achieve their fullest potential (NSW Health 2008; Russinova 1999). Top of page
Principles underpinning rehabilitation service provision
- Rehabilitation is not the same thing as recovery.
- Best-practice rehabilitation is recovery oriented.
- Rehabilitation services are not the only vehicle for recovery—they are one component of a service system that collectively works towards the recovery of individuals.
- Rehabilitation should be available in all settings and begin as soon as possible.
- Rehabilitation practices should always encompass purposeful best-practice interventions.
- Rehabilitation occurs on a continuum, and all workers need to understand rehabilitation, but not everyone needs to be an expert in providing all interventions.
- The process of establishing a positive therapeutic relationship is a part of the rehabilitation continuum, and it takes effort and time.
- Trauma-informed approaches are integral to a recovery-oriented approach and should be embedded in rehabilitation service culture, policy and practice.
- Rehabilitation techniques provide a range of tools that can be used to help an individual to gain or regain their independence and strive towards their recovery.
- Rehabilitation services that are shaped by the goals of promoting hope, healing and empowerment foster an underlying attitude that recovery is possible, offer opportunities for people to maximise their own experience of recovery and create a service environment that is flexible, responsive and accessible (SA Health 2012).