Pathways of recovery: 4As framework for preventing further episodes of mental illness

Overview of the framework - the 4As

Page last updated: 2006

The basic elements of the Framework are the 4As, which are adapted from work in crisis prevention.6 Briefly, the 4As are:

  1. Awareness – awareness of mental health status and understanding of the factors that affect mental health and mental illness, including potential vulnerability to further episodes of illness.

  2. Anticipation – planning for future mental health in terms of self-management, recovery, continuity of care, and crisis planning.

  3. Alternatives – availability of self-management and service alternatives that address all the risk and protective factors for mental health according to a holistic approach.

  4. Access – early, easy and equitable access to services that meet all the changing care needs of people who have been seriously affected by mental illness and their families and carers.
The 4As are not a linear or sequential process—the 4As support each other and together they comprise the basic elements that promote the future mental health of people who have experienced mental illness.

To implement this Framework, actions need to be undertaken at a number of levels.

Figure 2 shows the possible array of people and services that may need to be involved:
  • At the individual level are the person who has experienced mental illness and their carers, family and friends.

  • At the next level are service providers, and the nature and number of service providers varies from person to person. Some people will have little service response and manage their ongoing mental health through self-management and the support of their general practitioner (GP) or other primary care provider. For people with complex conditions, there can be numerous and diverse service responses comprising both clinical and non-clinical services including: GP, care coordinator, specialist mental health services, drug and alcohol services, peer support, allied health, rehabilitation and employment services, housing services and the justice system.

  • There is also a macro level of influence for all people that reflects the broader community, other human services (such as transport), the media and the impact of government at all levels. Top of page

Figure 2. Supports for people who have experienced mental illness

Refer to the previous text for a text equivalent of Figure 2. Supports for people who have experienced mental illness