Recovery instead of Palliation for the Mentally Ill
RECOVERY IN PERSPECTIVE
recovery paradigm is now widely accepted
known in the literature for over 30 years
US, UK, Aus have declared the importance of the recovery approach at a national level
US: New Freedom Commission on Mental Health
US: 70%+ of individuals with serious mental illnesses remain unemployed
about one quarter have a college degree
RECOVERY DEFINED
AACP def: a personal process of growth and change, which typically embraces hope, autonomy, and affiliation as elements of establishing satisfying and productive lives in spite of disabling conditions or experiences
"rediscovery and reconstruction of an enduring sense of the self as an active and responsible agent"
(even w ctd sx & dysfx)
*personal & unique development of new meaning & purpose as one grows beyond the catastrophe of mental illness*
reclaiming a meaningful life
a long-term journey with many dimensions
re-engaging in life
finding a niche or major role
developing secondary roles
reawakening hope
developing a sense of purpose
living despite having a disability
RECOVERY MARKERS
identity: gaining/regaining roles (and success, satisfaction) of student, worker, community member, tenant
empowerment: reduced sx, wellbeing
connectedness: more and better relationships, social inclusion
hope and optimism: better health, increased self-esteem
HOW TO GET PEOPLE THERE
fix the system: cultural shift in delivery system
work in true partnership with clients
include people lived experiences (peer specialists) in the delivery of services
NEED
vocational svcs
placement and support model of supported employment
access to healthy housing options
4 key domains of recovery-oriented practices:
1) socio-political environment: human rights (basic material needs, stigma and discrimination, advocacy), social inclusion (community participation, social networks), and daily occupations (meaningful activity, valued life roles)
2) workplace environment/organizational commitment to recovery, encompassing workplace support structures, quality improvement, care pathways, and workforce planning
3) practice-environment interaction, including working in partnership and inspiring hope; and
4) practice approach/an approach that supports a personally defined recovery, which includes informed choice, peer support, a strengths focus, and a holistic approach
STOP
1) organizing activities around diagnostic labels and using the role of "patient" in such activities
2) reserving medical charts primarily for the documentation of failures rather than strengths, accomplishments
3) segregating clinicians' and consumers' bathrooms, coat racks, and coffee services
4) utilizing a system in which only professionals conduct hiring interviews
START
1) involving clients in their team planning and review meetings
2) inviting program graduates to speak at activities
3) decorating facilities based on input from the individuals who are served
4) hiring in a way that considers lived experience as a "value added"
SOURCE
http://www.medscape.com/viewarticle/730233_4