From Surviving to Thriving: Redefining Mental Health Recovery Through a Public Health Lens

By, Alex Sheehan, One Mind Lived Experience Council Member

I wrote the following piece with the acknowledgment that not everyone subscribes to the term “recovery”, and if they do, that it is uniquely different for every person.

For decades, the dominant narrative of “recovery” in a mental health context has been shaped by the clinical world. It is often defined as the ability to manage one’s symptoms, to maintain stability in our lives and hopefully, to live independently and contribute meaningfully to society. 

Essentially, to survive. 

While these are important milestones, they fail – egregiously – to capture the full reality of what it means to live with a serious mental illness.

When recovery is viewed solely as an individual, symptom-focused process, we overlook the systems, structures, environments, and relationships that either support or undermine what it could become. THIS is why a public health lens is essential. It invites us to think bigger, by offering a complete cognitive reframe into what the real important question is. It’s not “How do we help people survive?”, but rather “How do we create the conditions that allow people to thrive?” 

Contrary to societal belief, thriving means much more than simply the absence of crisis. It means having access to safe and stable housing, purposeful work, peer support and connection, and opportunities to participate fully within our communities. It is not just about managing symptoms. It’s about reclaiming purpose, shaping identity, and living with a deep sense of belonging. 

The Problem with Narrow Definitions of Recovery

In many mental health spaces, “recovery” is measured in clinical terms: symptom reduction, reduced hospitalizations, decreased use of crisis systems, and improved medication adherence. While these measures are useful for tracking certain outcomes, they are incomplete. They frame recovery as something that happens within the individual, often in isolation from the systems and environments that shape their lives.

This narrow scope has major drawbacks: 

1. It ignores social determinants of health. Mental health is intertwined with social, communal, and environmental conditions. Without access to safe, stable housing, food security, peer support and economic opportunity, recovery is nigh impossible. 
2. It places undue burden on the individual. By focusing on personal symptom management, we risk implying that if someone is not “getting better”, it is THEIR personal failing, rather than a sign that systems and structures meant to support them are inadequate. 
3. It limits what we dare to imagine. Recovery is not about returning to a baseline. It’s about building a life that is connected and fulfilling. Clinical-only definitions of recovery unintentionally cap personal aspirations, narrowing the vision of what is possible. 

What Public Health Teaches Us About Recovery

Public health approaches focus not just on treatment; but prevention, and in creating environments where wellness is possible for all. This shift in perspective simply transforms how we think about recovery. 

A public health lens considers: 

1. Equity: Who has access to resources and opportunities, and who is systematically excluded?
2. Systems Change: What policies, procedures, and structures are needed to sustain recovery for both individuals and entire populations?
3. Prevention: How can we reduce risk factors (e.g. housing instability, unemployment, and economic imbalance) that make true recovery more difficult to achieve?
4. Peer Support & Social Connection: How can we strengthen the relationships and community ties that protect against loneliness, isolation, and stigma?

Instead of framing recovery as “getting back to where you were before”, a public health lens recognizes that for many, there is no going back. There is only moving forward, toward a new, more connected, and more fulfilling way of living.

My Personal Journey and Shift to Public Health & Healing

My public health journey has been anything but linear, its road paved with everything but concrete. In fact, I describe it as a mixture between a roller coaster and a house of carnival funhouse mirrors.

I spent ten years in a human services career that often felt like a revolving door.

But, it wasn’t always that way.

I came to this work because of both personal and familial history. When I was little, my birth father was diagnosed with paranoid schizophrenia. To him, the mark of a man was handling everything alone, regardless of whatever support he had in his corner. He refused help, turned to substances to cope, and spent years entangled in the vast webs of the criminal justice system. I did not know it then, but that single experience shaped my earliest view of what happens when stigma, mental illness, and injustice collide.

In high school, I began showing signs of major depression and severe anxiety. As it got worse, fear kept me quiet. Fear of being judged, of being taken away from my family, of ending up like my father. I tried to “beat it” by separating my mind from my body, staying busy, and pushing forward. But mental health doesn’t work that way. I just thought it did. Eventually, with the love and support of my family, I got the help I needed. This eventually laid the foundation that gave me the strength to pursue work where I could give back to others facing similar challenges.

When I began working with individuals living with mental illness who were returning to the community after incarceration, I thought my role was simple: connect them to services, follow protocols, and offer the same love and support that had been shown to me. Sounds simple, right? But the longer I did the job, the more I questioned why systems were built the way they were and why they seemed designed to set people up to fail.

Why do so many people with mental illness end up in jail or prison?

Why aren’t mental health crises met with mental health responses?

Why are jails and prisons treated as de facto psychiatric facilities in the U.S.?

The list of questions went on.

The more questions I asked, the clearer it became: nothing about this work was black and white. It was all shades of gray, and policies rarely reflected the messy realities of life after incarceration, especially when compounded by mental illness. What I could offer, compassion, support, and empathy, did feel small at times. But slowly, I saw that those human connections were often the most powerful, sometimes the only lifelines people had.

Even with that knowledge, after ten years in the field, I left feeling depleted and defeated, as if I hadn’t made any real change at all. This was extremely disheartening. What I also didn’t recognize was the toll of ten years of vicarious trauma and the weight I carried by trying to help others without tending to my own mental health needs. Everything just went out the window. I still cannot tell when it started but I’d started living a misguided notion that taking care of others was also taking care of me. It filled my cup. The pressure had silently built for years, and eventually it was like a dam breaking. Hidden cracks giving way under the weight, everything spilling out at once. I was left trying to pick up the pieces of rubble of who I once was.

At that point, I didn’t even know what “public health” was. Honestly, I didn’t care. I was exhausted and sick, physically, mentally, and morally. Turning back to an already failed strategy of separating mind from body until I had finally collapsed…again. But with guidance from my psychiatrist and mentors, I began to see my work and my life through a new lens.

It took a while, but I realized that everything I had been doing all along was public health. Compassion, community, and connection weren’t just nice gestures. They were lifelines that transform surviving into thriving. That shift in mindset remains my greatest AHA moment, opening my eyes to public health as community, connection, dignity, and hope. It is life-altering and life-saving, and I am living proof of that. Just as my lived experiences first drew me into human services, public health has renewed my sense of justice and purpose. 

As I write this four years after that experience, I can honestly say I feel like the best version of myself, and it all stems from that public health reframe. Learning to anchor my life in compassion, community, and connection gave me not only the strength to heal but also the courage to lead. Today, I am fortunate enough to channel that energy into my role as a member of the One Mind Lived Experience Council and call my fellow members family, where I also have the privilege of telling my story and using it to build bridges for others. It’s not just about sharing experiences. It’s about creating pathways for healing, equity, and systemic change. The same lifelines that once pulled me through my darkest moments are now the tools I use to lift others. And that is the kind of full-circle transformation that fuels me to keep pushing forward, with the stalwart conviction that lived experience is not only valid, but vital.

Shifting from Individual Resilience to Collective Responsibility

One of the most important cognitive reframes that a public health lens offers is the idea that recovery isn’t just about personal resilience, but collective responsibility. Generally, recovery narratives celebrate individual strength without acknowledging that resilience is built in relationship to those we connect with and supported (or undermined) by systems. This is not to downplay personal effort, because that is important. But it’s simply not enough when structural barriers remain intact. 

Public health reframes the question from “Why can’t this person recover?” to “What can we change in their environment and within the system, so that recovery is possible?”

The Role of Policy and Systems-Level Change

Equitable and sustainable recovery requires systems-level change in how mental health services are funded, delivered, and evaluated. Public health pushes us to advocate for: 

1. Increased investment and funding for employment, housing, and peer support services as integrated, essential components and mechanisms within mental health systems. 
2. Integration of mental health care into primary care to break down silos and make services low-barrier and easier to access. 
3. Policies that protect against discrimination and stigma in employment, housing and health care. 
4. Evaluation metrics that measure individual quality of life, not just clinical outcomes, as indicators of success. 

When centering these priorities, we begin to shift time and resources towards the conditions that make thriving go from being a dream to a reality.

Going from Surviving to Thriving

Recovery should NEVER be about simply meeting the bare minimum requirements for living. People are not checkboxes, yet systems treat us that way. True recovery is about building a life full of life, love, meaning, empathy, connection, and opportunity. 

When we reframe “recovery” through a public health lens, we see VERY CLEARLY that mental health is completely inseparable from social conditions and systemic structures. Thriving should be the floor, not the ceiling, and with this perspective, recovery can become less about surviving and more about creating the conditions necessary for people with mental illness to live fully and completely, with dignity, passion, and purpose, just as we all deserve. 

It is there, in that space, that true healing and recovery begins.