Thirty years of recovery policy

Abstract

OBJECTIVE: Anthony (1993) proposed recovery as the organizing principle of the public mental health service system. This study examines the evolution of a recovery-oriented mental health system at the federal and state levels in the United States. METHODS: A rapid review of gray literature analyzed federal policy statements, state mental health policies, service reforms, mental health authority reports, websites, organizational records, and other public documents. The review compiled current recovery-oriented system features in the 50 states, the District of Columbia, and Puerto Rico. RESULTS: Findings highlight expansive but stalled transformation to a recovery-oriented system. Policy statements have made a pronounced shift toward recovery. More recovery-oriented services are being offered. According to the Substance Abuse and Mental Health Services Administration's uniform reporting system, many outcomes have improved modestly. However, many features of a recovery orientation have not been fully embraced, implemented, and sustained. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Official statements about recovery exist. Practices such as peer services are available in many states, yet the full actualization of a recovery approach remains unfulfilled. Most states would benefit from a concerted effort to fulfill their recovery visions by specifying the features of a recovery-oriented system that they currently lack and aspire to implement. Current implementation science can inform these efforts, including performance-focused, state-level evaluations using common measures tracked on a national dashboard. (PsycInfo Database Record (c) 2026 APA, all rights reserved).