Home > ‘Understanding the whole person’: the first in a series of literature reviews on severe and multiple disadvantage.

Terry, Lucy and Cardwell, Vicki (2015) ‘Understanding the whole person’: the first in a series of literature reviews on severe and multiple disadvantage. London: Revolving Doors Agency.

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Because many people experience multiple and complex needs, it is important to understand the cross-cutting and distinct themes across the journeys of recovery from mental illness, recovery from substance misuse, and desistance from crime. The key themes highlighted in our paper are based on a review of the literature within three separate disciplinary fields: mental health, criminology and substance misuse.
Common themes emerging from the literature

• The three areas are processes, not events, involving setbacks, lapses, and trying again. While they are difficult many people eventually achieve lasting success - we should all be optimistic about people’s potential.
• These journeys are about moving towards something positive: this is as if not more important than rejecting or moving away from bad experiences. These are inherently hopeful journeys looking towards the future.
• The journeys are highly subjective and about the reality of people’s lives, not top-down interventions or treatments. A person must perceive an opportunity or event as meaningful for it to make a positive impact.

• Success is associated with developing a strong, positive identity. This means overcoming labels like ‘offender’ and ‘patient’ and believing in one’s own agency and capability.
• Healthy relationships are crucial. They give emotional and practical support as well as providing meaningful roles and opportunities to give back. But social networks are unhelpful in some cases, and often positive relationships are rare for certain groups such as drug-using offenders and other people facing multiple needs.
• It is key to believe in one’s role in the wider community and society, and internalised stigma can be a big barrier to recovery and desistance.

Distinctive themes:
• Recovery in mental health focuses on recovery from institutions and the effects of being a mental health patient; whereas the other two domains focus more on processes of behaviour and motivational change taking place in a social context.
• Recovery in mental health also emphasises the need for socially inclusive policies and adaptations that allow people with an ongoing severe mental illness to still participate on their own terms.
• Some of the variation in themes is partly due to the particular research methods used by each domain.

The review concludes that some of the themes distinctive to mental health recovery have potential relevance to all three domains. It also highlights the literature’s relevance to multiple needs policy and reiterates that there are many ways to support people on their complex but often successful journeys towards change.

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