Recovery & Serious Mental Illness

Serious Mental Illness (SMI) refers to conditions that can result in significant difficulties in functioning. Recovery oriented care can support individuals in moving towards greater life satisfaction.

Overview

Serious Mental Illness (SMI) refers to an American Psychiatric Association Diagnostic and Statistical Manual (DSM) Axis I disorder resulting in significant functional impairment and/or disruption in major activities of daily living. This typically includes schizophrenia and other psychotic disorders, bipolar disorder, major depression, and severe Posttraumatic Stress Disorder (PTSD). Veterans with other DSM Axis I diagnoses may also be included in this domain, usually in conjunction with a DSM Axis V Global Assessment of Functioning (GAF) Scale score of 50 or lower.

Recovery oriented care can help individuals living with Serious Mental Illness (SMI) move towards improved life satisfaction.

 

Veteran Voices

Supporting and encouraging a Veteran’s recovery

Tass met her husband, Anthony, after his service in the Marines. Whenever they left the house, she noticed he was on edge. He would jump up and talk while sleeping. Tass recognized how important it was to support her husband during his recovery and how effective treatment can be.

Video source: Make the Connection

Strength-Based Assessment

First Step in Recovery Planning - Understanding the Client's Strengths:

Taking a strengths-based approach to psychological assessment means identifying and prioritizing a client's positive abilities and resources within the assessment process. The assessment process is Veteran directed and he or she remains an active participant throughout. For example, the Veteran engages with the clinician in the process of identifying his or her strengths. Listed below are resources to support the integration of Veteran directed strengths-based assessment into one's practice.

  • Read about assessment of recovery, recovery attitudes, and recovery related areas such as hope, well-being, and community living in the PDFs Review of Recovery Measures and Compendium of Recovery Measures.

  • A list of assessment tools for measuring outcomes in psychosis compiled by the VA VISN 22 MIRECC, including tools for measuring life satisfaction and quality of life.

Action Planning

Treatment planning in the context of recovery oriented care means attending to whole health and wellness. This includes consideration of each Veteran's social engagement, spirituality, relationships, and community engagement.

Recovery action planning is goal oriented. The components of a recovery action plan include:

  • Collaborative assessment of each Veteran's strengths, resources, and goals

  • Veteran-directed planning: the goals are established and written in the language of the Veteran

  • Shared decision-making: collaboratively determining steps towards or actions directly relevant to each Veteran's client's goals and concerns

  • Crisis planning

Substance Abuse and Mental Health Services Administration (SAMHSA) Tools:

Peer Support:

Many Veterans find that that peer support is crucial to recovery. Peer support is important in conveying information, providing support, facilitating skills building, improving social networks, and empowering individuals to engage successfully in their recovery journey. Please see the following links for peer support information and resources:

Self-help Treatment & Recovery Resources for Clients:

  • The Wellness Self-Management (WSM) Manual was developed by the New York State Office of Mental Health to guide self-management of wellness and recovery for clients with serious mental illness.

  • About the Development of the WSM Manual: Please note, no person or agency may reproduce, reprint or distribute the WSM Workbook without the prior written approval of the New York State Office of Mental Health. Requests for approval should be directed to wsm@omh.state.ny.us.

Referring to VA

In order to support the rehabilitation and recovery of every Veteran with a mental illness, VA has identified recovery as a guiding principle for its entire mental health service delivery system. Recovery is a journey that involves developing hope, self-direction, empowerment, respect and peer support.

Mental Health Service Delivery at VA Medical Centers and Outpatient Clinics emphasizes recovery-oriented Psychosocial Rehabilitation. Such programs and services for Veterans with Serious Mental Illness (SMI) often include:

  • Resources for family involvement and engagement

  • Intensive Case Management

  • Peer Counseling

  • Social Skills Training

  • Wellness Management and Recovery

  • Evidence-based psychotherapies

Visit the VA Recovery Services in Mental Health website to learn more about these services

Connect to Services at Your Local VA Medical Center or Vet Center:

  • VA Program Locator: The program locator can help you find your local VA Medical Center.

  • Vet Center: Eligible Veterans can also find support and resources at Readjustment Counseling Centers. To learn more about the services provided at these centers please see their website.

Online Resources

Practitioner Resources:

Consumer Resources:

Additional Online Resources and Organizations:

Start Moving Forward:

Moving Forward is a free, on-line educational and life coaching program that teaches Problem Solving skills to help one to better handle life's challenges. It is designed to be especially helpful for Veterans, Military Service Members and their families. However, Moving Forward teaches skills that can be useful to anyone with stressful problems.

The Start Moving Forward website can be found at: https://www.veterantraining.va.gov/movingforward/