Abstract
Recovery is a key concept driving system transformation in both the addiction and mental health sectors, with shared roots in advocacy and a shared focus on hope in the face of stigma, self-determination and meaningful lives. Nevertheless, while mental health recovery is possible even with on-going symptoms, addiction recovery generally starts with or leads to abstinence. This disconnection undermines coherence at the policy level and exacerbates fragmentation between services and supports in the mental health and addiction sectors in Canada and internationally. At the same time, harm reduction, which does not require abstinence, has been gaining ground in the Canadian addiction sector. This qualitative policy study explores the potential for harm reduction to bridge the gap between mental health recovery and addiction recovery in the Canadian context, drawing on diverse experiences from the mental health and addiction sectors. The findings could be adapted internationally to address similar policy challenges.
Highlights
Recovery is a key concept driving system transformation in both the addiction and mental health sectors, with shared roots in advocacy and a shared focus on hope in the face of stigma, self-determination and meaningful lives
The wariness expressed regarding integration suggest that harm reduction may be too controversial and too distinct to be of much use in the development of a unifying vision, are both mental health recovery and addiction recovery are controversial and distinct
While parallel mental health recovery and addiction recovery movements are gaining strength in Canada and internationally and share considerable common ground, important conceptual differences regarding the necessity of cure and abstinence undermine coherence at the policy level and exacerbate fragmentation in services and supports
Summary
Recovery is a key concept driving system transformation in both the addiction and mental health sectors, with shared roots in advocacy and a shared focus on hope in the face of stigma, self-determination and meaningful lives. While mental health recovery is possible even with on-going symptoms, addiction recovery generally starts with or leads to abstinence This disconnection undermines coherence at the policy level and exacerbates fragmentation between services and supports in the mental health and addiction sectors in Canada and internationally. International Journal of Mental Health and Addiction conceptual disconnection: while mental health recovery is possible even with on-going symptoms, addiction recovery generally starts with or leads to abstinence This disconnection undermines coherence at the policy level and exacerbates fragmentation between services and supports in the mental health and addiction sectors, which is problematic given shared risk and protective factors and high rates of concurrent mental health and substance use disorders. The Substance Abuse and Mental Health Services Administration’s integrated definition simultaneously introduces flexibility while invoking abstinence: “Overcoming or managing one’s disease(s) or symptoms—for example, abstaining ... if one has an addiction problem—and for everyone in recovery, making informed, healthy choices that support physical and emotional well-being” (2012, p. 3)
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