This study reports on the relationship between stage of recovery and hope, meaning and responsibility for individuals diagnosed with severe mental illness. Methods: Seventy-seven people with a diagnosis of a psychotic disorder of at least 6 months' duration participated in the study. Participants completed the Self-Identified Stage of Recovery (SISR) scale, measures of component processes of recovery (Hope Scale; Positive Interpretation of Disease, SpREUK; Active Involvement, Personal Health Management Questionnaire (PHMQ) and the Recovery Assessment Scale-short (RAS). Results: Hope, meaning, Personal Confidence and Hope and Not Being Dominated by Symptoms varied significantly across stages of recovery; however, neither in a parallel nor linear fashion. Hopefulness and sense of meaning in relation to the experience of mental illness increase before personal confidence and resilience in the face of setbacks. Conclusions and implications: Symptoms appear to take less prominence in individuals' lives in later stages of recovery. Greater insight into the relationship between stage of recovery and component processes may allow for more targeted recovery-oriented support for individuals at different stages of recovery.

Aims – To review developments in recovery-focussed mental health services internationally. Methods – Two forms of ‘recovery’ which have been used in the literature are considered, and international examples of recovery-focussed initiatives reviews. A ‘litmus test’ for a recovery-focussed service is proposed. Results – ‘Clinical recovery’ has emerged from professional literature, focuses on sustained remission and restoration of functioning, is invariant across individuals, and has been used to establish rates of recovery. ‘Personal recovery’ has emerged from consumer narratives, focuses on living a satisfying, hopeful and contributing life even with limitations caused by the illness, varies across individuals, and the empirical evidence base relates to stages of change more than overall prevalence rates. Clinical and personal recovery are different. Two innovative, generalisable and empirically investigated examples are given of implementing a focus on personal recovery: the Collaborative Recovery Model in Australia, and Trialogues in German-speaking Europe. The role of medication is an indicator: services in which all service users are prescribed medication, in which the term ‘compliance’ is used, in which the reasoning bias is present of attributing improvement to medication and deterioration to the person, and in which contact with and discussion about the service user revolves around medication issues, are not personal recovery-focussed services. Conclusions – The term ‘Recovery’ has been used in different ways, so conceptual clarity is important. Developing a focus on personal recovery is more than a cosmetic change – it will entail fundamental shifts in the values of mental health services.

Declaration of Interest: None.