This chapter traces the historical development, conceptual evolution, and ongoing debates surrounding the recovery model in community mental health, placing it within broader struggles for citizenship, social justice, and human rights. Starting with deinstitutionalization and the rise of community-based services, the authors explore how early service models often reinforced maintenance-focused practices and professional pessimism despite increased access to care. Using research, lived-experience narratives, and policy developments, the chapter documents the emergence of recovery as a counter-narrative to chronicity, as conceptualized by Bill Anthony’s influential reframing of recovery as a guiding vision rather than a specific clinical outcome. The chapter critically examines efforts to define, operationalize, and measure recovery, highlighting tensions between subjective lived experience and objective indicators such as symptom remission and social functioning. Special attention is given to critiques from psychiatric survivor movements, which argue that professionalized versions of recovery risk appropriating and diluting its emancipatory roots. The authors promote citizenship as a necessary extension of recovery, emphasizing participation, inclusion, agency, and social belonging as key outcomes of mental health services. Ultimately, the chapter contends that recovery-oriented practice must go beyond individual change to address structural barriers, coercive practices, and social inequalities. Re-centering lived experience, narrative authority, and rights-based frameworks is presented as essential to realizing recovery as both a personal and collective effort.


  1. How does the chapter define recovery differently from symptom remission?
  2. What historical forces shaped the recovery movement?
  3. How do agencies sometimes adopt recovery language without structural change?

Substance Abuse and Mental Health Services Administration. (2012). SAMHSA’s working definition of recovery: 10 guiding principles of recovery (HHS Publication No. PEP12-RECDEF). U.S. Department of Health and Human Services. This official document connects the Recovery Support Strategic Initiative with four dimensions of recovery—health, home, purpose, and community—and ten guiding principles.

National Association of Social Workers. (2021). Code of ethics of the National Association of Social Workers: Standard 1.02, Self-Determination. Standard 1.02 addresses clients’ right to identify and pursue their own goals, subject to limited exceptions involving serious, foreseeable, and imminent risk.

Cross-reference: Chapter 3 – Replacing Stigmatizing Beliefs and Behaviors


Davidson, L., Tondora, J., Lawless, M. S., O’Connell, M. J., & Rowe, M. (2009). A practical guide to recovery-oriented practice: Tools for transforming mental health care. Oxford University Press.

Mead, S., & MacNeil, C. (2006). Peer support: What makes it unique? International Journal of Psychosocial Rehabilitation, 10(2), 29–37. The Intentional Peer Support site provides access to the article and related writings by Shery Mead.

Medicaid and CHIP Payment and Access Commission. (2019). Recovery support services for Medicaid beneficiaries with a substance use disorder. This issue brief includes a 50-state policy review of Medicaid coverage and payment for peer support and other recovery-support services. Because Medicaid requirements vary by state and change over time, readers should also consult the current Medicaid provider manual and state plan for their jurisdiction.