What is Mental Health Recovery?

A Guide to Mental Health Recovery

When it comes to mental illness, recovery can mean different things. For some people, it will mean no longer having symptoms of their mental health condition. For others, it will mean managing their symptoms, regaining control of their life and learning new ways to live the life they want.

Recovery is often described as a process that isn’t always straightforward. You might have days (or weeks, or months) where you feel well and times when your symptoms return. If you’ve discovered techniques and treatments that work for you, you’re likely to feel more confident and less overwhelmed by your symptoms.

When it comes to your recovery, think about what’s important for you and what a meaningful and healthy life would look like.

What might help with my recovery?

Different things may help and no right or wrong way to recover. Some research suggests that key factors on the road to recovery include:

• Good relationships
• Satisfying work, paid or voluntary
• Personal learning and growth
• The right living environment
• Setting goals to help with your recovery

Don’t be hard on yourself if you don’t reach a goal. Maybe you need more time to achieve it or maybe it isn’t right for you right now. Whatever it is that’s important to your recovery. Remember you don’t have to figure everything out on your own. Support from others – whether that’s your GP, friends, family or professionals involved in your care – can all make recovery easier.

Mental Health Recovery Planning

A Wellness Recovery Action Plan (WRAP) methodology is a popular tool that teaches you how to use some key concepts of recovery – hope, personal responsibility, education, self-advocacy and support in your daily life.

• Hope. The belief that we can get well, stay well, and go on to fulfil our dreams and goals. When we consider what hope means to us, we can also consider ways to increase hope in our lives.
• Personal responsibility. It’s up to each of us to take action and do what needs to be done to stay well. We get to decide what personal responsibility means to us and the steps we want to take to be responsible for ourselves and our wellness.
• Education. Learning all we can about what we are experiencing helps us make good decisions about all parts of our lives. We can each define education for ourselves and explore steps we want to take to learn more.
• Self-advocacy. Reaching out to others and expressing our needs helps us get what we need, want, and deserve to support our wellness and recovery. We can determine for ourselves how we want to self-advocate in different areas of our lives, including how we want to communicate our needs and preferences to others.
• Support. Receiving support from others, and giving support, will help us feel better and enhance our quality of life. We get to decide what support means to us, what we look for in supporters, and how we want to provide support as well as how we want to receive it.

A Wellness Toolbox

A Mental Health Recovery Plan (WRAP) can be referred to as your Wellness Toolbox. The toolbox is a space to put things you enjoy, are interested in, make you smile and look forward to. It is important to have these things written down as we can often find it difficult to think of them when we need them most.

Or how about an actual box? Try placing objects in this special box, for example: photos, tickets from concerts, pressed flowers from the garden, crossword puzzles, recipes, a cuddly toy, teabags, a DVD, a comfy t-shirt, phone numbers for friends, games, perfume, a magazine, a colouring book – whatever represents a happy place or time or an activity which will distract you and boost your mood.

We can also think about how we can reduce the steps it will take to ‘get going’ with our chosen activities by planning ahead. Maybe creating a calm/get going/dancing playlist on your phone so you don’t need to find the right music for your mood, writing a shopping list of the ingredients needed for your favourite recipe or even keeping your lists in a prominent place.

1. My Starting Point

This section is for you to set out what your normal is. Try to think how you feel, behave, think, and come across to others when your mood is more stable or lifted. Are you a naturally shy person? Do you like to make jokes? Do you have a short temper? Are you a worrier? Are you house-proud? It is useful to see how we are so we can see when things are changing – for better or worse.

You can make a note to yourself of all the things which have meaning for you – for example; having your own space, being well presented, spending time with family, learning new skills – whatever feels important and worthwhile to you.

It is also a good idea to make a note of the things which you find more difficult – answering the phone, going to busy supermarkets or getting up when your alarm goes off. By being aware of what can often be hard to do, we can encourage ourselves to be kinder when we do manage to get them done how we would like. It is not about letting ourselves off the hook and giving up on trying to improve our abilities. It’s about acknowledging that we are not perfect (none of us are!) and we all have things we have to try a little harder to do. It is also useful for others to see when a change in us is out of character and what our normal response is.

2. Maintenance Plans

Using a maintenance plan helps us break down everything we need to do to stay well. It can be helpful to break things down in this way so that we feel less stretched and busy and see exactly what we need to prioritise.

What do you need to do daily? Examples may be brushing your teeth, walking the dog, cooking a meal or doing a breathing exercise. Your weekly plan might involve meeting a friend, talking through your feelings with a therapist or taking a long bath. Your regular plan might include things like going out for a meal, taking a holiday or spending time in the garden. Some things on our lists are basic, others are indulgent, but all together they make a recipe keeping us as well as possible, and if one ingredient is missing, we do not feel the benefit.

3. Triggers & Action Plan

What are the things which make your mood worse? It could be things like having too many appointments at once; songs which remind you of a person, event, or place; TV programmes on certain subjects; unexpected bills; the move from summer into winter. Whatever it is for you, it is good to make sure you are aware of what them as triggers for you.

Once we are aware of our triggers, we can make an action plan to help us when we feel our mood slipping. It is important to remember that avoidance is a short-term coping mechanism for dealing with our triggers and over time avoidance will make our fears worse and encourage us to make our worlds smaller.

Instead, it is useful to think of actions we can take to boost our mood. For example, talking to someone you trust about how you feel, drinking a cup of hot sugary tea, writing poetry, scribbling doodles or using something from your wellness toolbox. For some of us, finding something which is both distracting and enjoyable is the best solution. For others, learning more about where our reactions come from is helpful. Being able to express the feelings our triggers can conjure up is also important.

4. Early Warning Signs & Action Plan

What small changes do you recognise when your mood begins to slip? Do you take longer to respond to texts? Does your sleep pattern start to shift? Do you skip breakfast? Do your underlying health conditions flare up? Do you find it harder to stay motivated? Anything from letting your nail varnish stay chipped when you would usually repaint your nails, to taking a longer time to do tasks can be a sign that things are beginning to change. Again, being aware is very important because the sooner we can spot these early warning signs, the sooner we can turn to our action plans and lift our moods.

What can you do to take the edge off how you are feeling and look after yourself? Breaking down your daily maintenance plan into smaller steps? Indulging in a couple of ideas from your wellness toolbox? Letting things out, whether on paper or to another person? Do you want to discuss your medication with your GP? Would taking a day or two off be beneficial – bearing in mind that sitting at home doing nothing may make things feel worse?

It is important to remember that while we may feel that we have less energy and motivation, pushing ourselves towards something achievable will affect our mood. We have control over what we can do to help ourselves feel better.

5. When Things Start Breaking Down & Action Plan

This tends to be a time when our mood is noticeably low, and our lifestyle is noticeably different. What has changed? What is worse? Have you called in sick a few days in a row? Are you skipping meals? Are you taking less care of your appearance? Have you turned off your phone? How do you feel?

Again, it is important to remember that we still have control over what we can do to help ourselves feel better, although it is worth noting that as things slip further, it will take longer and more effort will be needed to feel the benefit. If possible, it is worth asking for some help from others if we haven’t already. Maybe sharing this in your WRAP with them is a good place to start?

6. Crisis Planning

This section begins with a recap of our starting point. It can be useful to remember who we are when we are well (although it can be painful when it feels distant) so that we can see fully what has changed and what we want to work on. Your WRAP can also be useful to show anyone involved with your care this description of yourself, so they can see our affected you are by this current mood.

7. Crisis Indicators & Action Plan

Again, what is different and marks this episode out a crisis? What has changed? What is worse? How do you feel? What are you doing to help yourself, and what have you stopped doing?

What can you do to help things get back on an even keel? Who can help? What would you like them to do? What are the things you need to do to keep well (e.g. eating, sleeping, washing etc.)?

During a crisis we may turn down offers of help. This section is a useful reminder of what we really need. It is also helpful to others around you (should you chose to share it with them) as it lays out some ‘dos and don’ts’ they may never have considered before.

8. Medication & Treatments, & When Things Change

This section is useful for others around you and professionals you may have contact with during a crisis. It is a good way to make sure your wishes are heard and to show that any decisions you are making are based on thoughts from when you had a clearer view about your care.

It is important to point out that this is not a legal document and that any decisions health professionals make are ultimately up to them. However, this can be a useful tool to raise questions about those decisions if you feel that they go against your wishes for your care, and can help professionals explain why they feel it is necessary to make those decisions.

9. If I Am in Danger

If you have made a plan to end your life in the past, have used self-harm as a coping strategy, or struggle with intrusive thoughts, this section may be useful as a reminder of the things you should avoid, or limit your exposure to during this crisis and to let others know what is safe for you.

10. If I Have to Go into Hospital…

Hopefully by having this WRAP, by being self-aware and by following our own advised steps, you should never need to use this section. However, if things do become so difficult that hospitalisation is the best option, it is important to make a plan for what should happen. Our loved ones tend not to have considered this scenario until we are in it. Some details will depend on the length of time you will be away, but things like; who will feed any pets? does someone need to let family members, friends, or work colleagues know what is happening? Does the bank need to postpone any direct debits? Other than clothes and toiletries, what would you like brought from home? (It is worth saying that bags may be searched, and some items may be considered too risky to be allowed).

Should we find ourselves being offered a place on a hospital ward, it is important to remember that hospitals are places where sick people get better. Our stay may be uncomfortable, upsetting, confusing, unwanted – but we are where we need to be just now. With a little work and support we will be well enough to go home again. Hospitalisation does not mean we have failed in keeping ourselves well, it means that we are brave enough to keep fighting against something so difficult.

11. Post Crisis Planning

This section cannot be filled in unless we have come through a crisis. For that reason, some of us will never have a need for this section. If we do need them, there are important questions to consider based on the experience of the crisis. There is always a lot to learn and become more aware of after a crisis.

12. I Can Stop Using This Plan When…

We do not need to be fully ‘back to normal’ to stop using our crisis section.

Think back to previous sections – if your mood and actions now feel more like “when things start breaking down” then you are moving out of crisis. Are you well enough, in this mindset, to take back some responsibilities? Consider who you want around you, to support you, as well as anyone who may make things more difficult. Are there people who need to be updated on your situation? Are there things which have been delayed or stopped which can start up again? Is there anyone you want to thank or apologise to?

Thinking about what we have learned about ourselves; about what useful things we did and how we helped ourselves is a good exercise to try every now and then. We often take our abilities for granted, so a pat on the back is well deserved!

This also helps us figure out what did not work so well, and to make amendments to our WRAP. A WRAP is never finished as we are always learning more about ourselves and evolving as people.

Want to learn more about Mental Health First Aid?

The First Aid Training Co-operative runs a suite of private first aid courses that can be delivered at your choice of venue, at a time and date to suit you. We’ll come to you and tailor your course to suit your specific situation, based on one of the core course types that we have in our portfolio. We now have a range of courses available for those looking to become Mental Health First Responders in the workplace, raise awareness of mental health amongst their staff plus specialist mental health training for outdoor professionals. Check out our mental health first aid course suite.