1. Recovery and Mental Health Promotion Margit Schmolke, Ph.D. German Academy for Psychoanalysis (DAP) Munich, Germany

2. Agenda Developments towards a philosophy of positive health Mental health promotion Empirical studies Recovery process Role of recovery in mental health promotion Implications for clinical practice

3. Towards a Philosophy of Positive Health (1) Morbidity rates and chronicity still high Prevention and health promotion necessary Knowledge and needs of users essential Shift from only minimizing risks and focusing on deficits and pathology towards strengthening positive health of a person

4. Towards a Philosophy of Positive Health (2) Positive (mental) health increasingly discussed in - Health psychology - Development psychopathology - Prevention and health promotion - Psychoneuroimmunology - Psychiatry and psychiatric nursing

5. Health Promotion (WHO Ottawa Charter, 1986) Positive health potential Strengthening individual and community resources Health to be actively produced in daily life Health promotion Health promotive policy, environments, community actions Developing personal competences Reorienting health services

6. Mental Health Promotion (WHO, 1999; Herrman et al., 2003) Mental health: Mental health: - Realizing ones own abilities - Coping with normal stresses of life - Working productively and fruitfully - Contributing to ones community Mental health promotion: Mental health promotion: - Improved physical health - Better educational performance of children - Better productivity of workers in business/industry - Improved relationships within families and broader community - Lower rates of some mental disorders

7. Empirical Studies (1) Victorian Health Promotion Foundation, Australia (VicHealth, 1999; Herrman et al., 2003) Some determinants of mental health, e.g. 1. 1. Social connection and inclusion 2. 2. Freedom from discrimination and violence 3. 3. Economic participation

8. Empirical Studies (2) Study on health protective resources of persons suffering from schizophrenia (Schmolke, 2001, 2003) 1. 1. Resources related to illness experience 2. 2. Personal resources 3. 3. Social resources 4. 4. Material resources

9. Recovery and Recovery Process No standard or universal characteristics Highly subjective and contextual Ongoing, dynamic, interactional process between strengths, vulnerabilities, resources and environment Actively self-managing psychiatric disorder Reclaiming, gaining, maintaining positive sense of self, roles and life beyond the mental health system

10. Role of Recovery in Mental Health Promotion Overlapping concepts in mental health promotion and recovery Authors in recovery are persons themselves recovering from a mental disorder Recovery as subjective experience has an eminent place in the spectrum Prevention Health Promotion Treatment Prevention Health Promotion Treatment Recovery Rehabilitation

11. Implications for Clinical Practice Researchers and clinicians benefit from learning about - individuals recovery processes - mental health strengthening factors - self-help and regulatory activities Risk of transforming autobiographical accounts by professionals Implementing knowledge in clinical interventions in mental and physical health care Claim expressed in WPA Consensus Statement on Psychiatric Prevention (Lecic-Tosevski et al.,2003)