Adult Mental Health in a Changing International Context: The Relevance to Social Work

Mental ill health and mental health have been—and remain—contested categories, not only in terms of definitions and meanings, but also in terms of effectiveness of policies and interventions, as well as the associated human rights aspect. In the last thirty years, we have witnessed a sea change in most Western societies concerning the way we think about these issues, the key stakeholders and what we are aiming to achieve through mental health interventions. These changes impact on social workers, too; moreover, some of them have been initiated by mental health social workers, such as the strengths approach (Rapp, 1998) and the involvement of service users in policy making (Ramon, 2006b). The major shift has been the move in the direction of the new meaning of recovery. This has entailed a shift from a deficit, chronicity and a hegemonic medicalised perspective of mental illness into a perspective that focuses on the ability of those experiencing mental ill health to lead a meaningful life with the illness and beyond it (Anthony, 1993; Davidson, 2003) as well as increasing the degree of being in control over one's life (Deegan, 1988). International longitudinal research has convincingly demonstrated a considerably higher rate of recovery than traditionally predicted among people with schizophrenia who have been resettled in the community (DeSisto, 1995; Harding, 2005).