How Does the Public Understand Recovery From Severe Mental Illness Versus Substance Use Disorder?

• Published in: Psychiatric rehabilitation journal 2019-12, Vol.42 (4), p.341-349
• Main Authors: Corrigan, Patrick W., Qin, Sang, Davidson, Larry, Schomerus, Georg, Shuman, Valery, Smelson, David
• Format: Article
• Language: English
• Subjects: Addictions; Adult; Alcohol use; Drug use; Female; Goals; Human; Humans; Major Depression; Male; Mental depression; Mental Disorders; Mental Disorders - diagnosis; Mental Disorders - rehabilitation; Mental Illness (Attitudes Toward); Middle Aged; Opiates; Psychiatric Rehabilitation - methods; Psychiatric Rehabilitation - psychology; Public Opinion; Recovery (Disorders); Recovery (Medical); Recovery of Function; Schizophrenia; Serious Mental Illness; Severity (Disorders); Severity of Illness Index; Social Perception; Substance abuse treatment; Substance Use Disorder; Substance-Related Disorders - diagnosis; Substance-Related Disorders - rehabilitation; Treatment Outcome
• ISSN: 1095-158X; 1559-3126
• DOI: 10.1037/prj0000380

Objective: Recovery from severe mental illnesses (SMI) has been described as an outcome (end state where persons are symptom free) or as a process (despite symptoms, people can pursue life goals). Less clear is whether recovery as a process has credibility in the substance use disorders (SUD) community. We examined how public perceptions and expectations of outcome and process between SMI and SUD differed. A severity effect within SMI and SUD categories was also examined. Method: Participants (N = 195) read definitions of SMI and SUD and completed an online survey of their agreement on: perceptions of recovery from SMI and SUD as outcome and process, and expectations of recovery as outcome and process. Participants were then given more and less severe SMI (i.e., schizophrenia vs. depression) and SUD (opiate vs. alcohol use) definitions. They then responded to recovery items SMI and SUD conditions with low and high severity. Results: For SMI, perceptions and expectations of recovery as process were endorsed more than outcome. Severity effect led to greater increases in perceptions and expectations about recovery as process. Specifically, differences between outcome and process for schizophrenia were significantly larger than for depression. For SUD, expectations of process were significantly lower than outcome ratings. One negative interaction was found for SUD expectations; difference scores for opiate users were smaller than for alcohol. Conclusions and Implications for Practice: We discussed implications for interventions that enhance recovery for people with SMI and SUD. Impact and Implications This study shows that recovery as a process (symptom management) is more endorsed for persons with severe mental illnesses (SMI) whereas recovery as an outcome (symptom free) is more endorsed for people with substance use disorders (SUD). Distinction between process and outcome perspectives across two communities will shape individuals' recovery experience and inform good treatment practices.