Chapter 10: Recovery, Paternalism, and Narrative Understanding in Mental Healthcare

In this first section, I introduce recovery as the goal of mental healthcare and sketch an abstract model for it. Recovery aims at a value-laden and person-specific conception of flourishing. In the second section, I show how the capabilities approach of Amartya Sen and Martha Nussbaum fits this abstract model but that the difference between Nussbaum’s and Sen’s versions reflects a corresponding difference between substantive and procedural accounts of personal autonomy. This difference is also present in Davidson and Hopper’s more specific claims about the possibilities for recovery from mental illness and leads to a challenge to the recovery model. If mental illness can compromise autonomy and calls for sensitive clinical intervention to recover it, does this not risk the paternalist imposition of others’ values? In the final two sections I argue that a narrative view of a sense of self can address this on either opposed broad view of recovery and autonomy.