Pathways of recovery. Report of the national consultation on preventing further episodes of mental illness

This report, and the national consultation that it describes, has heightened awareness of the core role of prevention in continuing care for people who have experienced mental illness. The consultation was based around the Discussion Paper developed for the National Mental Health Promotion and Prevention Working Group on the role of relapse prevention in the recovery process for people seriously affected by mental illness. Through the consultation process, it was made very clear that preventing further episodes of illness is a fundamental concern of consumers and carers, although many consumers preferred the more wellnessfocussed term “staying well” to the more illness-focussed term “relapse prevention”. Prevention is also a high priority of many service providers, particularly psychosocial and rehabilitation service providers, yet the fragmentation of the current mental health system works against this longer-term approach to wellness and continuing care. This report summarises the national consultation and highlights the concerns of consumers, carers and service providers regarding the capacity of the current mental health system to deliver continuing care. There must be a fundamental reorientation from a crisis focus to a more proactive approach that can intervene early to prevent the development of crisis situations. While there is a lot of activity in the area of recovery-oriented services, it is evident that these approaches must be incorporated as part of routine practice in all mental health service delivery. It is hoped that raising these issues through the consultation will encourage all jurisdictions to focus on better approaches to continuing care; approaches that operate with a recovery orientation and that incorporate ongoing prevention and psychiatric rehabilitation as part of core business within the mental health system. The national consultation reported strong support for the implementation of the 4As Framework presented in the Discussion Paper to ensure that jurisdictions develop the mental health service system to provide appropriate follow-up and continuity of care for people who have been seriously affected by mental illness.- Keith Wilson (Chair, Mental Health Council of Australia)