Recognizing a role for structure and agency: Integrating sociological perspectives into the study of recovery from severe mental illness

Mental health practitioners have traditionally regarded the long-term prognosis for severe mental illness1 to be poor, with a steady deterioration of functioning over the lifespan (Harding, Zubin, & Strauss, 1987). Influenced by findings from long-term outcome studies that called this view into question (for a review, see Calabrese & Corrigan, 2005), prominent researchers of the 1980's (e.g., Cohen & Cohen, 1984; Harding et al., 1987) called for the field to adopt a more optimistic outlook with regard to potential outcome for severe mental illness. In an influential paper, Anthony (1993) discussed the concept of "recovery" from severe mental illness as an idea with important implications for mental health services and policy. Drawing heavily from descriptions of recovery in the personal accounts of mental health consumers (e.g., Deegan, 1988; Lovejoy, 1984), he stressed that achieving or being in recovery does not require that one be completely free of symptoms, but rather that one has found "a way of living a satisfying, hopeful, and contributing life even with the limitations caused by illness."