Although psychiatrists may face barriers such as limited time or lack of
training about recovery principles in their quest to help patients recover
from serious mental illness, they can empower themselves—much in the
same way they empower their patients—to overcome these barriers.
This was the hopeful message from a consensus conference held in
Philadelphia in January 2006, the outcome of which appeared in a report in the
August Psychiatric Services.
At the meeting, 24 community psychiatrists convened to discuss the barriers
to recovery they have encountered in practice and consider ways to promote
recovery in their patients.
Three major consensus points they reached involved the need to enhance
psychiatrists' knowledge of recovery, the need to redefine their roles in ways
that support their efforts to promote recovery, and the need to invest in
recovery-oriented training throughout their careers.
One of the problems identified by psychiatrists at the meeting was that
they had only a vague sense of the principles of recovery and that"
those providing clinical supervisions or working day to day with
patients had little training and too few opportunities to learn about recovery
and its implications for their work," their report stated.
The meeting participants also believed that too few public mental health
programs emphasize the tenets of recovery—empowerment, employment, and
education—so that psychiatrists do not always know where to refer
patients for help in these areas.
According to Mark Salzer, Ph.D., one of the article authors and an
assistant professor of psychiatry at the University of Pennsylvania,
psychiatrists at the meeting had a sense that there were few recovery
guidelines available for them to use in their daily work with patients.
Another problem identified was that they have limited time to work with
patients and perceive little opportunity for more in-depth interactions with
patients. According to Salzer, they remarked that psychiatry's leaders have
not done enough to "promote the importance of recovery within the
field," and he noted that current reimbursement systems do not support
In addition, participants noted that there were no standardized methods of
assessing the effectiveness in achievement of recovery-oriented goals.
Some of the problems identified stem from a lack of funding in the public
mental health system and from injustices such as stigma toward people with
Psychiatrists at the meeting voiced a need for "more substantial
funding for a wide range of rehabilitation programs that respond to
They suggested a number of ways to overcome the problems they identified
and thus help patients lead more meaningful lives. They recommended that
psychiatrists be systematically educated on the principles of recovery, for
instance, and that the field develop best-practice guidelines that emphasize a
range of approaches to support patients' progress toward recovery (see"
Promoting Recovery: Recommendations for Psychiatrists").
Psychiatrist Anita Everett, M.D., helped organize the meeting and
participated in the discussions. "It is critical that all psychiatrists
in community practice fully understand the value of working with consumers
from a recovery paradigm," she told Psychiatric News."
Preparing psychiatrists to be well-equipped to work in contemporary
mental health centers is essential for our profession to thrive."
Everett is section director for community and general psychiatry at Johns
Hopkins School of Medicine in Baltimore.
She noted that psychiatrists have moved from a more "custodial-care
era" to one in which there is increased emphasis on community
integration and consumers' participation in their own wellness and
The tools already available to psychiatrists include new medications that
are better tolerated than medications in decades past and a more sophisticated
knowledge of effective psychosocial rehabilitation and support services,
"My favorite shorthand for recovery," she said, "is the
Home Depot tag line, 'You can do it. We can help!' "
An abstract of "Barriers to Recovery and Recommendations for
Change: The Pennsylvania Consensus Conference on Psychiatry's Role" is