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.

• Examines how recovery and significant improvement are possible if diagnosed with Schizophrenia and other psychoses
• Explains that innovative program designs from across the world are available to promote positive outcomes
• Discusses the need for the overhaul of funding, public policies, and program priorities in order to provide opportunities

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