Abstract
Recovery among people living with schizophrenia continues to pose challenges for mental
health systems, particularly where care remains centered on hospital-based treatment. In
Thailand, advances in psychiatric services have not fully addressed persistent relapse and social
disconnection after discharge, highlighting gaps in continuity of care and community-based
rehabilitation. This study investigates recovery-oriented mental health care at the community
level by exploring local recovery systems, the perspectives of service providers and family
caregivers, and the recovery experiences of people living with schizophrenia, with the aim of
informing the development of an integrated recovery system compatible with the Thai context.
The study employed a multiple-case qualitative design. Data were collected through
stakeholder meetings and in-depth interviews with health professionals, community practitioners,
family caregivers, and people living with schizophrenia in five provinces—Nonthaburi, Sukhothai,
Chanthaburi, Loei, and Phang Nga—resulting in 141 participants. System-level dynamics were
examined using a Power–Interest Matrix, while recovery-oriented practices and experiences were
analyzed using SAMHSA’s 10 Principles of Recovery and the CHIME framework.
The findings show variation in community-based recovery systems across provinces. Areas
with strong involvement from civil society organizations and local administrative bodies tended
to demonstrate more continuous and adaptive post-discharge support, whereas health-sectorled networks showed stronger clinical coordination but more limited attention to social and
vocational recovery. Analysis suggests that recovery-oriented practice in Thailand is largely
relational and family-centered, emphasizing stability and everyday functioning rather than
individual autonomy. Peer support and strengths-based approaches remain largely informal.
From the perspective of people living with schizophrenia, recovery is shaped by everyday
relationships, community belonging, and, in some settings, religious or spiritual life. Hope is
expressed through attainable goals embedded in daily routines, while empowerment is
understood as gaining practical control over everyday life rather than achieving full independence.
These findings support the development of community-based recovery systems grounded in
human dignity and human rights, sustained through coordination across health services, local
authorities, families, and civil society.
