Recovery from Schizophrenia: Evidence, History, and Hope

Evidence from two highly regarded three-decade NIMH follow-up studies of schizophrenia and other psychoses, conducted by Courtenay Harding and her research team, have revealed that one half to two-thirds of even the most disabled schizophrenia patients achieved significant improvement, and even recovery, over time. These findings are consistent with those from nine other decades'-long studies from across the world, as well as many shorter-term investigations as well. But the field of psychiatry has nevertheless largely failed to accept that recovery is possible for most psychotic patients. Recovery from Schizophrenia provides numerous examples of patients becoming productive citizens, overcoming difficult starts in early life, alongside exciting program strategies and additional research evidence - evidence that provides a blueprint for both how to build new and successful mental health systems, and how to significantly improve clinical training programs. Unfortunately, most service systems still provide primarily stabilization, maintenance, medications, and entitlements under the new guise of rehabilitation. Critical changes need to occur in public policy, funding mechanisms, program design, and new clinical expectations to improve patient care-all of which will promote much more significant improvement and recovery. Discussion of these critical issues is presented here in accessible prose, allowing readers from a range of backgrounds - families, clinicians, and researchers alike - to experience the ups and downs of an entire field trying to solve the puzzle of recovery from schizophrenia in the usual settings. Recovery from Schizophrenia is the remarkable story of these patients and the scientists and caring professionals who refused to let go of hope for better outcomes.

Table of Contents:
Foreword Introduction PART ONE: EVOLUTION OF A REVOLUTION Chapter 1 Shocking Treatment in Colonial Vermont Chapter 2 The Evolution of a Vermont Country Doctor Chapter 3 A Puzzled Psychiatrist Became a Revolutionary with the Help of His Patients Chapter 4 More Ingredients in the Early Vermont Program Chapter 5 Phase II: The Five-Year Follow-Up in 1965 and the Demise of Vermont State Hospital PART TWO: NEW TEAM, NEW STUDY, SAME SAMPLE, YEARS LATER Chapter 6 The Implausibility of a Housewife Who Became a NIMH Principal Investigator Chapter 7 Learning about Research, the Generosity of the Field, and Politics in Science Chapter 8 How We Measured a Life Lived: Preparation Is Worth all The Effort Chapter 9 Tough Questions from The Chief of Medical Biostatistics PART THREE: SURPRISES Chapter 10 Surprise Discoveries Out in the Field Chapter 11 "A Whole Bunch of People Got Better" Chapter 12 "I Don't Believe a Word She Just Said!" Chapter 13 Did Rediagnosis for Contemporary Schizophrenia Make a Difference in the Rates of Improvement and Recovery? Chapter 14 Vermont Data Supported the DSM-5 Deletion of Subtypes in Schizophrenia Chapter 15 The Role of Rehabilitation, Neural Plasticity, and Public Policy in Long-term Outcome--The Maine-Vermont Comparison Study Chapter 16 Northern New England: Perfect Environments for Longitudinal Research PART FOUR: NINE OTHER VERY LONG-TERM STUDIES FROM ACROSS THE WORLD AND THEIR IMPLICATIONS Chapter 17 World Wide Evidence of Recovery Chapter 18 Eating Humble Pie PART FIVE: SAMPLE OF REHABILITATION PROGRAMS HELPING PEOPLE IMPROVE AND RECOVER Chapter 19 World Programs Chapter 20 US Programs ACKNOWLEDGMENTS NOTES INDEX

About the Author :
Courtenay Harding has spent nearly 40 years as a professor of psychiatry. She has presented this evidence at least 550 times at international and national meetings, academic Grand Rounds, providers, families, patients, and government entities. She has received 47 awards and honors for her work.

Review :
As a psychiatrist, I have dedicated my entire professional life to accompany people diagnosed with schizophrenia, encouraging them to become the leaders of their recovery process, always trying to find new ways to recover their own self through what we call Accompanied Self-rehabilitation. For us nothing would have been possible without the ideas, the energy, and the accompaniment we received from Professor Courtenay Harding. Anyone who studies this book carefully will understand why. Harding's book leads us on a heartwarming journey into recovery from schizophrenia, once thought to always deteriorate, infused with the author's empathic heart and scientific mind. It shares stories of resilience and overcoming challenges, providing new hope. This book reshapes our understanding of psychiatric rehabilitation, offering fresh perspectives on what is possible in mental health care. A must-read for anyone touched by mental illness, crafted with compassion and dedication. Harding is first and foremost a storyteller and this illuminating volume contains many such compelling stories. First and foremost are the stories of persons experiencing serious mental illnesses over the previous two centuries, going through a variety of circumstances, treatments, and their own efforts to gain recovery. Secondarily is the recovery of the field of psychiatry, which has led to the current climate in which we have come to accept nothing less. Dr. Harding tells the story of a lifetime of research that demonstrates that persons living with the most severe mental illnesses can and do recover. Along with other long-term outcome studies, her research has helped produce a revolution in global imagining of mental health services based in genuine hope for recovery and humane care for persons whose lives have been shattered by psychosis. A profound contribution to mental health scholarship and activism! Sometimes a book is delightful and engrossing. Occasionally, one is profound. Dr. Harding's new work is all of the above. It weaves together the stories and results of all the long-term follow-up studies on people diagnosed with schizophrenia-the most feared and misunderstood mental illness. The heart of the book is descriptions of the studies that Dr. Harding led and participated in. All of the studies find that the long-term prognosis for people diagnosed with schizophrenia is good. The results are even better when rehabilitation is emphasized. Society and medicine must recover from their pessimistic views about people with these mental health problems, just as most people recover. Dr. Harding's book will help. Dr. Harding's incredible book asks a question that state leadership, especially mental health commissioners, will find critical to system redesign. 'What do you need to get out of the hospital?' Many patients are being custodialized in the community as well as the hospital with the stabilization, maintenance, meds, and entitlements model that represents little hope for getting better but staying chronic. They need to see a pathway out of community care into a real life for themselves from the time they arrive until they go. All of them need support and graduation to have a successful life in the community. So it is 'What do you need to get on the road to having a full life?' We are here to walk this path with you.