From recovery to resilience via health activation

Very rapidly, we are entering the early stages of a very significant new social movement. In fact, it is so new that we do not yet have a very good way to describe it. Several concepts are competing, such as “self management”, “engagement”, and “health-activation”. Yet, none of these labels adequately describes the full range of skills being practiced by those who have developed this capacity. Actually, such people are able to implement their own recovery and wellness so effectively that they learn and hone specific skills that increase their subsequent resiliency. 

The skills we are attempting to describe have been learned by people of lived experience to promote their own recovery and wellness, and to protect their own resiliency when confronted with stress, trauma, and symptom re-occurrence. Persons with these skills are very actively engaged in the pursuit of their own good health; very knowledgeable about personal best practices for promoting good health; and fully engaged as active participants in all aspects of their own health care, whenever such care is needed.

These persons represent a whole new approach to health-seeking and to caring for personal well-being. Traditionally, most people are very passive about their own health and care. This passivity is reflected in a general unconcern about personal health. It also is reflected in the very passive approach that most people take to their own health care and to their providers, many of whom assume a paternalistic stance toward care seekers. Thus, such traditional persons do not really own their own health or care. Rather, they are very dependent, and “health inactive” in the language of the new social movement.

Such passivity does have negative consequences. When people are so passive about their own health and care, then it is very unlikely that they will have a strong sense of personal well-being (positive thoughts and feelings about one’s own health) or of personal health-related quality of life (positive thoughts and feelings about one’s relationship to other persons and events in one’s own environment), Thus, passivity actually can harm one’s own health. The reverse is true for those persons who elect to play a determined and active role in their own health and care.

What types of skills are being developed by these people? They may be as simple as paying close attention to the need for adequate sleep each night, eating appropriately, or engaging in exercise, such as participation in a yoga class. Or they may be as complex as newly acquired cognitive and emotional skills to mitigate the effects of stress and trauma. Or they may be developing and maintaining of a supportive network of friends. For each person, the particular mix of these skills will vary. 

What changes can we expect to ensue from this important new social movement?

Most importantly, persons who actively pursue good health will develop important cognitive and emotional skills that will permit them to become and to remain healthy. They know what to pursue and what to avoid. They develop a stronger sense of well-being, and they foster a more positive relationship with friends and their broader social context. They actually are “health activated”.

Similarly, such persons are “care activated.” They participate actively in the planning, the implementation, and the evaluation of their own care. They engage in a personal search and appropriate reflection about their own health concerns, and they come to care encounters fully prepared with necessary information and questions.

This new approach to health and care also will foster major changes in the behavior of care providers. Through necessity, providers will become less paternalistic and more equalitarian in their care encounters. They will come to recognize that the goal of care delivery is “health activation” to remove dependency and to promote a high level of personal resiliency.

People of lived experience are pioneering health activation day-by-day through personal trial and error. Clearly, these skills have broader applicability to everyone. The advent of the Affordable Care Act gives us an exceptional opportunity to share these skills with others through health homes and integrated peer support.

This new social movement is a key harbinger of better health and better care for all of us. How wonderful! How very wonderful!