The Ten Principles are right on, however, a truly holistic approach to recovery must take into consideration the ecological and political dimensions that so deeply affect individuals, families, communities and entire nations. “Recovery” ultimately connects us with some of the most important issues of social and environmental justice affecting humanity right now.

We are closely bonded with every other human being in the planet, and with the very complex living systems that support our existence. We cannot speak of individual recovery while at the same time ignore the conditions that contextualize the war, oppression and subjugation currently fostering trauma and social disintegration world-wide, including here in the US. Our belief that recovery is possible is anchored in the assumption that we live in healthy environments and social communities, but we don’t.

At the base of the spiritual life so central to recovery, lies a commitment to respect and compassion towards every living being, the planet and the whole universe, the recognition that we are, that each of us is, much more than we could possibly fathom. Recoveries means regaining that sense of the preciousness of life and imbue it, not only in every aspect of our personal and immediate community life, but in the wider levels of our culture. It means assuming the ecological and political dimensions of every action we make.

Recovery is about consumers learning how to manage their illness in order to ultimately manage their lives. Recovery is an individualized process that can be measured via domains that reflect life outcomes (finding and maintaining a job, keeping a home, feeling connected to the community) as well as through equally valuable measures about an individual’s perception of their self-confidence & self-esteem, how empowered the individual feels, and how hopeful the individual is or is becoming

Developing a definition of recovery and establishing guiding principles enable both individuals and systems to measure progress toward realizing levels of successful recovery or facilitating that achievement in the lives of others.
In recognition of the importance of hope and the benefits of a solid support system, Magellan Health Services recommends the following revisions to the guiding principles:
Recovery emerges from hope: The belief that recovery is real provides the essential and motivating message of a better future – that people can and do overcome the internal and external challenges, barriers, and obstacles that confront them. Hope is internalized and can be fostered by peers, families, providers, allies, and others. Hope is the catalyst of the recovery process.
Recovery involves making choices: Self-determination and self-direction are the foundations for recovery as individuals define their own life goals and design their unique path(s) towards those goals. Individuals optimize their autonomy and independence to the greatest extent possible by leading, controlling, and exercising choice over the services and supports that assist their recovery and resilience. In so doing, they are empowered and provided the resources to determine appropriate coping mechanisms, make informed decisions, initiate recovery, build on their strengths, learn how to manage chronic conditions, and gain or regain control over their lives. For children, youth, and adults, families, caregivers and friends play a key and sometimes primary role in shaping and supporting their path to recovery.
Recovery occurs via many pathways: Individuals are unique with distinct needs, strengths, preferences, goals, culture, and backgrounds  including trauma experiences  that affect and impact their pathway(s) to recovery. Recovery is built on the multiple capacities, strengths, talents, coping abilities, resources, and inherent value of each individual and the family and community context in which they live. Recovery pathways are highly personalized and non-linear in that they are characterized by continual growth and improved functioning that may involve setbacks along the journey of progress. Because setbacks are a natural, though not inevitable, part of the recovery process, it is essential to foster resilience for all individuals and families. Abstinence is an important choice for individuals with addictions. In some cases, these pathways can be enabled by creating a supportive environment; this is especially true for children, who may not have the legal or developmental capacity to set their own course.
Recovery is all-encompassing: Recovery encompasses an individual’s whole life, including mind, body, spirit, and community. This includes addressing: self-care practices, family, housing, employment, education, addiction and mental illness treatment, services and supports, primary healthcare, dental care, complementary and alternative services, spirituality, creativity, social networks, recreation, and community participation. The array of services and supports available should be integrated and coordinated.
Recovery is supported by peers and allies: Recognition and acceptance of the need for support is an important consideration. Mutual support and mutual aid groups, including the sharing of experiential knowledge and skills, as well as social learning, play an invaluable role in recovery. Peers encourage and engage other peers and provide each other with a vital sense of belonging, supportive relationships, valued roles, and community. Through helping others and giving back to the community, one helps one’s self. Peer-operated supports and services provide important resources to assist people along their journeys of recovery and wellness. One of the fundamental tenets of peer support is that it is grounded in choice – enabling an individual to determine who can best assist them based on any number of individualized factors. Professionals can also play an important role in the recovery process by providing clinical treatment and other services that support individuals in their chosen recovery paths. While peers and allies play an important role for many in recovery, their role for children and youth may be slightly different. Peer parent supports for families are very important for children with behavioral health problems and can also play a supportive role for youth in recovery, into their journey to adulthood and as their ongoing support system as an adult.
Recovery is supported through relationships and social networks: An important factor in the recovery process is the presence and involvement of people who believe in the person’s ability to recover; who offer hope, support, and encouragement; and who also suggest strategies and resources for change. Peers, family members, providers, faith groups, community members, and other allies form vital support networks. Through these relationships, people leave unhealthy and/or unfulfilling life roles behind and engage in new roles (e.g., partner, caregiver, friend, student, employee) that lead to a greater sense of belonging, personhood, empowerment, autonomy, social inclusion, and community participation.
Recovery is culturally-based and influenced: Culture and cultural background in all of its diverse representations – including values, traditions, and beliefs – are keys in determining a person’s journey and unique pathway to recovery. Services and supports should be culturally grounded, attuned, sensitive, congruent, and competent, as well as personalized to meet each individual’s unique needs. Engagement should occur in a culturally responsive way in order to help facilitate increased *********** and access to the services and supports to meet the identified needs.
Recovery is supported by addressing trauma: The experience of trauma (such as physical or ****** abuse, domestic violence, war, disaster, and others) can sometimes act as a precursor to or become associated with alcohol and drug use, mental health problems, and related issues. Services and supports should be trauma-informed to foster safety (physical and emotional) and trust, as well as promote choice, empowerment, and collaboration.
Recovery involves individual, family, and community strengths and responsibility: Individuals, families, and communities have strengths and resources that serve as a foundation for recovery. In addition, individuals have a personal responsibility for their own self-care and journeys of recovery. Individuals should be supported in speaking for themselves. Families and significant others have responsibilities to support their loved ones, of all ages in recovery. Communities have responsibilities to provide opportunities and resources to address discrimination and to foster social inclusion and recovery. Individuals in recovery also have a social responsibility and should be afforded the opportunity to practice the ability to join with peers to speak collectively about their strengths, needs, wants, desires, and aspirations. The role of peers, professionals, and informal supports are critical in coaching and mentoring individuals to build their voice and participation into action and leadership which fosters their journey to recovery.
Recovery is based on respect: Community, systems, and societal acceptance and appreciation for people affected by mental health and substance use problems – including protecting their rights and eliminating discrimination – are crucial in achieving recovery. There is a need to acknowledge that taking steps towards recovery may require great courage. Self-acceptance, developing a positive and meaningful sense of identity, and regaining belief in one’s self are particularly important.

While I think the idea behind most of the listed guiding principles is sound, I do take issue when it states that “Recovery is Person-Centered”, instead I think it would be more appropriate to state that “Ideally, recovery is person-centered,” since that is not always possible.

I apologize for the long response, but many people on this site have called people’s statements into question based on lack of evidence.

There is a small, but very important, population being ignored throughout these various threads, those who are the most severely ill and lack the insight that they are indeed ill. This is not a made-up disease, or something cured by simple nutrition. Anosognosia is real. Most of the comments I've read from "consumers" who have bipolar or schizophrenia and have been able to lead to normal lives, or from those who amount assisted outpatient treatment to torture, don't understand that this does not apply to most people. Not all those who have a severe mental illness have anosognosia or a need for intervention.

I am not here to represent any organization or to try to use propaganda to sway this discussion. I am trying to provide a more thorough understanding of the real issue.

Please hear me out on this. I am consumer who has successfully lived both medicated and not medicated during different points in my life; my mother has bipolar and has decided that she can't function without medication (I completely agree with her--medication ALONG WITH appropriate care from competent mental health care professionals is how she is able to take care of herself); my father has late-onset paranoid schizophrenia and tried to commit suicide three times, had three involuntary hospitalizations, has ANOSOGNOSIA, and has been HOMELESS for the last 10 years where he's been taken advantage of, had his nose broken after being attacked, and was treated for frostbite from sleeping on the cold streets; my sister has severe anxiety/depression and without her medication I would worry for the safety of her and her children; my friend has bipolar and without medication was completely unable to work, leave her house, or function; and my son has something that nobody can correctly label yet, has been misdiagnosed over a dozen times by nearly 20 different mental healthcare doctors, mistreated by medication which caused ulcers, stunted growth, and then weight gain, and who is currently doing much better WITHOUT any medications. Not everyone needs nor responds to medication. In fact the medications of the 1970s and 1980s did my mom more harm than good. Finally science has advanced enough to provide her with appropriate and effective medication.

I can see all sides of this issue.

The issue of anosognosia and the recognition that some of the most vulnerable people need others to help them to get treatment does not apply to all individuals who have bipolar or schizophrenia, but only the MOST severe, like my father. It seems to be easy for many here to dismiss this idea as a family's desperation (yes, many families don't have enough information to help their loved ones effectively and it is a very painful position to be in when you have to watch your loved one deteriorate), or an overzealous pharmaceutical industry (yes, there are definitely abuses there), or incorrect diagnosis (YES, we need more research dollars to be spent on understanding and "mapping" the human brain's chemical functions, to eventually be able to provide reliable evidence of all mental illnesses) or even torture (yes, the psychiatric hospitals have committed many deplorable abuses in the name of medicine), but do these same individuals here not recognize that ALL human beings deserve the decency to be able to live healthy, productive lives, free from a severe disabling condition?

What about Andrew Goldstein and Kendra Webdale? What about Scottt Harlan Thorpe and Laura Wilcox? What about Jared Loughner and Rep. Gabrielle Giffords and the six who died? What about Seung-Hui Cho and the 32 people at Virginia Tech? What about Kelly Thomas and the police department? The list goes on and on. What do all of these tragedies have in common? A person who was severely mentally ill who was not being adequately treated, and whose family knew there was a mental illness that needed to be treated. I am not saying all violence is attributed to mental illness, nor am I claiming that all those with severe mental illness will become violent. Neither could be further from the truth.

However, definition of recovery aside, how in good conscious could the SAMHSA ignore these people in this discussion? While they make up a very small minority, we are still talking about human life and mental illnesses that must be addressed.

Money will always be an issue, but it’s far less costly to provide sufficient care—be it inpatient or outpatient—than to sit by, pretend there isn’t a problem, and allow things to continue as they have been, with people being incarcerated or left to fend for themselves on the streets, which only results in more money being spent and more preventable tragedies.

Let’s look at the facts. According to SAMHSA, homelessness is frequently a mental health issue. Their National Mental Health Information Center lists the following statistics: over the course of 1996, 2.1 million adults were homeless; 39 % of the homeless population in America report having a mental illness, and 20-25% meet the criteria for a severe mental illness. There are also several individual factors that may increase a person's risk for becoming homeless and remaining homeless for a longer period of time, one of which is an untreated mental illness which can cause individuals to become paranoid, anxious, or depressed, making it difficult or impossible to maintain employment, pay bills, or keep supportive social relationships. Homeless individuals with severe mental illness are twice as likely as other homeless people to be arrested or jailed. SAMHSA also reports: “Homelessness among people with serious mental illnesses can be prevented. Discharge planning that helps people who are leaving institutions to access housing, mental health, and other necessary community services can prevent homelessness during such transitions. Ideally, such planning begins upon entry into an institution, is ready to be implemented upon discharge, and involves consumer input. Providing short-term intensive support services immediately after discharge from hospitals, shelters, or jails has proven effective in further preventing recurrent homelessness during the transition back into the community.”

And , according to the U.S. Department of Justice, Bureau of Justice Statistics’s study “Mental Health and Treatment of Inmates and Probationers” by Paula M. Ditton, BJS Statistician: “At midyear 1998 an estimated 283,800 offenders with mental illness were incarcerated in the Nation's prisons and jails.

I don’t pretend to have the answer to everything, but I do know that we must recognize this subset of the population before and after they are incarcerated or homeless, and include them in this discussion.