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Missouri's recovery experience

November 1, 2007
by Joseph Parks, MD
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The Show-Me State liked the results of its Procovery pilot so much that it is implementing the program statewide

Change agent. Peter M. Senge has written that "[often] new insights fail to get put into practice because they conflict with deeply held internal images of how the world works, images that limit us to familiar ways of thinking and acting."5 Recovery implementation cannot be designed as the back end, hoping to ride on some other transformation initiative. It must have the substance and form to serve as a change agent to lead agencies, providers, and stakeholders to do business differently.

The Procovery program encompasses each of these components, offering a concrete set of principles and skills that cross services, diagnoses, and cultural barriers. Procovery is a unified program identical for staffs, clients, families, and communities (trainings are typically for mixed audiences), and it provides clear fidelity requirements and licensing structures to maintain accountability across all stakeholders and agencies. Procovery Circles, the group training and support system, operate identically in an inpatient forensic setting as in a residential care facility, homeless shelter, jail, community setting, or school, which enables development of system-wide referral and builds integration, collaboration, and access to care. We found that Procovery offers succinct recovery principles and strategies that both providers and consumers are able to operationalize regardless of setting.

At its heart, Procovery is about hope, moving forward, and change. To close, I offer a few comments from individuals in Missouri.

Comment from the Missouri Institute of Mental Health pilot evaluation3:

Procovery has helped me become more independent.... I was living in a group home and now I have a room of my own.... I live on my own, by myself now. I feed myself, I bathe, I shower...I go shopping and I do a lot of other things.... all on my own. I am even looking for a job...I am able to take care of myself.

Post on the Missouri Department of Mental Health blog in June:

Procovery has given me a sense of control, where previously I felt I had none; I felt as though I would be battered around by my illness for the rest of my life. A disheartening, discouraging, depressing way to live. I've had NO psychotic events since I got on board with Procovery because by applying the ideas in the book, I know myself and my fluctuations better. I've put together strategies for dealing quickly with changes before they become real problems, and best of all, although my illness continues to frustrate me, I no longer beat myself up when things aren't as stable as I'd like them to be (yes, I have some really tough times—Procovery can't prevent that, it just enables me to deal with them more effectively). Bottom line: By applying what I'm learning in Procovery (I've been through the book countless times) my quality of life has improved dramatically.

Mickie McDowell, NAMI SW Missouri, Procovery Circle Facilitator:

I always believed that I could maintain a happy, productive life with my mental illness. It took someone else believing in me as well to make that become a reality. That is what Procovery does for people.... It believes in them.

Joseph Parks, MD, is the Chief Clinical Officer for Missouri's Department of Mental Health, as well as the Director of the department's Division of Comprehensive Psychiatric Services. He is President of the Medical Directors Council of the National Association of State Mental Health Program Directors. Dr. Parks is a Clinical Assistant Professor of Psychiatry at the Missouri Institute of Mental Health and University of Missouri—Columbia. He practices psychiatry on an outpatient basis at Family Health Center, a community health center in the Columbia area. Dr. Parks received the 2006 American Psychiatric Association Bronze Achievement Award for a program controlling pharmacy costs by improving prescribing practices.

Procovery is a program and a registered trademark of the Procovery Institute. For more information on Procovery, visit http://www.procovery.com.


  1. Implementing Recovery-based Care: Tangible Guidance for SMHAs. NASMHPD/NTAC e-Report on Recovery. Fall 2004. http://www.nasmhpd.org/spec_e-report_fall04intro.cfm.
  2. Crowley K. The Power of Procovery in Healing Mental Illness. Los Angeles:Procovery Institute; 2000.
  3. Campbell J, Lama G. Final Report: Missouri Procovery Demonstration Evaluation: Quantitative Findings. Jefferson City, Mo.:Comprehensive Psychiatric Services, Missouri Department of Mental Health; 2006.
  4. Parks J, Svendsen D, Singer P, Foti ME (eds). Morbidity and Mortality in People with Serious Mental Illness. Alexandria, Va.:NASMHPD Medical Directors Council; 2006.
  5. Senge PM. Mental models. Planning Review (a publication of the Planning Forum); 20 ( 2 ): 4. 1992