12 December 2010

mental health - "recovery"

Wither "recovery" today?
     The mental illness industry has once again glommed onto its treatment flavor of the month from those who are in the system. The clients argued during the 1990s that people can and do recover from prolonged bouts of psychic/spiritual/emotional disabling experiences (short version "mental illness") and, eventually, many service providers got the words but not the message.
     Some have partly gotten the message, going so far as to self-disclose during therapy sessions with "their" patients. But many just mouth the words without having any idea what they are talking about.
     As an academic or clinical concept, "Recovery" drew attention as far back as 1985 when researcher Courtney Harding and John Strauss conducted a long term follow-up study with people in Vermont [taking date gathered in the 1960s] to see what success they had (if any) at "recovering" from their travails.
     The findings of their work revealed that as many as 66% of the people once believed to be "forever ill" had gone on and left the mental health treatment system. A number of those interviewed said they recovered "in spite of" what the system proffered as care or services.
Photo to the left ~ typical of housing provided from the late 1800's until the end of the 20th century
     Now, more than 25 years later, the career bureaucrats have latched on to this and suddenly embrace the concept like a fuzzy toy, while further try to shoehorn the idea in with their own career objectives. Show "success" and maybe they will go on and get accolades at a national conference.
     But what they are still doing is riding the evident success of some who were once severely disabled without ever having done much more than fill out some grant applications from SAMHSA [that's the Substance Abuse & Mental Health Services Administration, an arm of the federal government].
     Alright, maybe that sound too cynical, but they are still slow on the uptake. And, by trying to make the process of recovery ~itself a very personal journey~ into some facet of the rehabilitation treatment model for mental health, they show how far they miss the point.
     What point is that, you ask? Point being that rather than create a new set of complex treatment plan curriculae and models and workshops to force non-comprehending staff to encourage or cajole "their clients" into following in hopes they get better (so as to allow the system to meet "measurable goals" and satisfy funding sources) how about providing people with:
• Affordable Housing
• Supportive, non-judgmental helpers
• An atmosphere of safety
• Chances to be treated as equals
• Combat the prejudices of a society that devalues people who don't appear to be "doing anything"
• Ask people what seems to work for them when in crisis ~and then make sure its available
• Make certain that basic needs of food, clothing, shelter, ability to get around are ensured
• LISTEN to people who suffer and/or experience disturbing discontinuities of thought
• Help provide people ways OUT OF the treatment system
     ...to name but a few things that could be accomplished ...or at least tried for.
     Finally, do things to help a person integrate back into the larger society at their pace and preference, rather than create a subordinate caste with "clubhouses," or programs and services that already duplicate what may exists out away from the mental health system funding and employment machine.
     Just wondering.
IMAGE SOURCES: "Tell Me..." face: International Journal of Psychosocial Rehabilitation; [left side] South wing of Weeks Hall, Middletown CT - destroyed in a fire October 2010; [right side] Gate in the Callan Park Mental Asylum, Sydney, AU - Frangipani's Flickr Photostream

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