Mental health: Six steps to sustainable recovery

Written by: Dr Pooky Knightsmith | Published:
Image: Adobe Stock

We can sometimes be too quick to think that a young person is recovered from a mental health problem. Dr Pooky Knightsmith offers six steps to supporting sustainable recovery from mental health issues

One of the easiest mistakes to make when supporting a young person who has been struggling with mental ill health, is to take our foot off the pedal too soon.

When weight is restored, scars are healed or dependence on drugs or alcohol has ceased, we can be forgiven for thinking our work here is done. In truth though, this can be the hardest time of all; in the early stages of recovery we are often having to learn new ways of thinking and behaving, we’re fighting the urge to return to unhealthy coping mechanisms and our sense of self can be pretty fragile if we’ve been labelled by our illness for some time.

To support sustainable recovery and prevent relapse, there are some simple steps we can take.

Recognise that the body and brain recover at different rates

If a young person lost or gained a lot of weight during the course of their mental illness or have, for example, visible injuries or hair loss, the return to the norm of their physical appearance can lull us into thinking everything is okay. It’s not. The body can heal relatively quickly but it can take far longer to address the underlying emotional wellbeing or mental health issues and it’s vital that we recognise this and continue to support pupils long after they appear more healthy.

Have realistic expectations

Ideally we should work with the pupil, their parents and their teachers to ensure that we are setting shared realistic expectations. These expectations will vary from child to child but might be around academic attainment, attendance, sporting performance or participation in class. A transition phase can often be helpful with clear short and medium-term goals being set, supported and revisited by a team around the child.

Accept that recovery is never perfect

Our expectations around recovery also need to be realistic. No matter how mentally well they are, nobody has a good day every day, and the same is true for those of us in recovery from a mental illness.

There will be bumps in the road. We need to acknowledge and prepare for this likelihood and recognise blips in recovery for what they are – small hurdles to overcome along the journey rather than a return to the start line.

Understand the importance of blips

Not only are blips inevitable, they’re important. Being able to prepare for and overcome setbacks in the recovery process while in a supportive environment can help the pupil become more self-aware and more able to manage subsequent difficulties. In future they may face similar struggles when they no longer have the immediate support of school, family or friends and it’s important that they can recognise warning signs early and learn to respond positively in order to maintain their wellbeing long-term.

Plan ahead in times of calm

Don’t wait for blips to happen – actively plan for them. When we are in a heightened state of anxiety, or our motivation is lacking as depression takes grip, it can be very difficult to think our way out of the current situation. This can lead to blips taking hold and developing into full blown relapse. If, instead, we plan ahead with the pupil and any relevant others about what to do if they hit a difficult patch, this removes the need to troubleshoot on the hop and results in better, quicker decision-making that can be enacted quickly.

It is also helpful to specifically plan ahead and consider times that are likely to prove more difficult for the pupil – for example loss of routine in the holidays, transition between year groups, or exams are the types of typical life event that can pose difficulties for all pupils and should be specifically planned for with pupils with a known history of ill mental health or who are considered otherwise vulnerable.

Be aware of warning signs

Working with the young person to identify the warning signs that might indicate that their recovery is slipping is a hugely helpful thing to do – again this should be done at a time when things are going relatively well and the pupil is motivated in their recovery.

By working together we can identify signs, specific to them, that can act as an early warning system. The easiest way to do this is to look backwards – you might all have missed the warning signs in the past, but retrospectively they can be fairly easy to identify and this can be a simple way to help safeguard against future difficulties.

Typical warning signs might include a change in academic performance, absenteeism or lateness, becoming more isolated or changes in eating and sleeping patterns.

Wellbeing Action Plan

If you’re working with a pupil who is in the early stages of recovery, a positive exercise can be to complete a wellbeing action plan with them. Inspired by an evidence-based practice developed by Dr Mary Ellen Copeland for adults in the US, wellbeing action plans (see below) are a simple way for you and your pupil to walk through warning signs, triggers, healthy coping strategies and sources of support.
This approach can be used either as a preventative or a supportive tool and provides a tangible framework in a physical booklet that the pupil can keep for future reference.

  • Dr Pooky Knightsmith directs the children, young people and schools programme at the Charlie Waller Memorial Trust, a charity that provides fully funded mental health training to schools. Visit and email For more information on the charity, visit

Wellbeing Action Plan

You can download copies of a Wellbeing Action Plan free resource at or order free physical copies from the Charlie Waller Memorial Trust via

Mental health advice

Dr Pooky Knightsmith provides regular support and advice in SecEd. To read her previous articles, go to If there are specific issues you would like to see addressed, email or tweet @PookyH


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