10/6/2017. The Recovery Conversation. Benjamin Rush. What significant challenge or task have you overcome and benefited from?

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1 The Recovery Conversation A process for achieving unity among mental health care consumers, their families, and mental health care professionals. Benjamin Rush First American physician to view mental illness as having a physical cause, published Diseases of the Mind in What significant challenge or task have you overcome and benefited from? Does thinking about one challenge affect the way you think about new challenges? What skills and values does coping develop? How does one person s coping affect others in a group? How does your role shape your response? 1

2 Dorothea Dix mid-eighteenth century A tireless activist for the rights of those with mental illness, she was responsible for providing food and shelter in the first generation of asylums. Eugenics From the early 20th century to WW II, in a movement to improve the quality of the gene pool, those with mental illness and other deficient traits were sterilized. Is courage based on hope? What does courage mean? Where does hopelessness come from? What are the differences between courage and hope? What are the sources, origins, and triggers of your hope? 2

3 The Great Depression & World War II With the focus of the nation on other pressures, mental health care languished. After the war, conditions in asylums were compared to those in concentration camps. Lobotomy The first treatment that had any effect on symptoms. From a modern perspective it is hard to conceive how this practice could have won the 1949 Nobel Prize. Are your finances under control? Someone I know keeps all his receipts and analyzes them every night. The numbers of his finances are his life s passion. Another person I know gives away all the monies from their monthly check and, when hungry, eats their room-mate s food. Most people are between these two poles. Where do you fit in? How do you maintain your finances? How would/do you feel if or when a third party intervenes? 3

4 Insulin & Electrical Shock therapy Shock therapy, first using insulin and now electricity, induces seizures similar to epilepsy. Still used in limited conditions, EST is usually replaced by medications. When someone says the word Recovery to you, what do you think of? What relationships and resources does a person with lived experience want and need on a recovery journey? Do those with lived experience, their families and other colleagues, as well as their service providers, all view recovery similarly? Thorazine and Haldol 1950 s The first anti-psychotic medications had harsh side effects, but provided hope for the future. Newer anti-psychotics and mood stabilizers, such as the highly effective clozaril, are now in common use. 4

5 What does it mean to have insight into a chronic illness? Acceptance of an illness comes with trusting and being trusted. It is social; it means utilizing strengths and accepting challenges. Do you and/or others in your life realize and accept this insight? What does it mean to accept your chronic illness or the illness of another? Deinstitutionalization 1950 s - present With the advent of drugs and the rising costs of hospitalization, an effort was made to empty large mental health institutions. Community Mental Health Centers 1960 s President John Kennedy gave federal grants to the states to provide centers for the care of those with mental illness. This accelerated deinstitutionalization, bringing on new problems as well as new ideas. 5

6 What role does hope hold in your life? A goal is a dream with a deadline. A wish is a dream you want to see happen in your life. What is the difference between your dreams and your wishes? Which are more important? Why do you keep your dreams and wishes? What are those dreams and wishes? Medicaid Medicare SSI & SSDI With roots in the Truman administration, federal responsibility for community care and health insurance of the disabled was established in the 1960 s and early 1970 s. Subsidized Housing At the same time as medical care and other universal needs were provided for, programs for subsidized individual and aggregate housing for those with mental illness became law. 6

7 Who is in charge of your medical & psychiatric care? Who is the author of the medical & psychiatric story? Do you trust your medical relationships? Why or why not? What happens when you disagree with someone about a medical decision? What part do those in differing roles play in a medical & psychiatric story? Program for Assertive Community Treatment This research project of a Wisconsin State Hospital proved the best way to care for someone experiencing a severe and persistent mental illness is to provide needed supports so they can live in the natural community Clubhouse movement With it s unique Transition Employment Program, Clubhouse has provided socialization and employment for people with mental illness globally starting in

8 Has anybody ever cared for you in a way that stigmatized you? Usually caring is a good thing. However, sometimes one person cares for another in a way that makes that person more into a dependent. Has anybody ever become involved in your life to deal with their own issues? How would this affect you in the long run? How does this affect your dignity and your concept of trust? NAMI This grass roots group was formed in 1979 in Madison, Wisconsin. It is now the most powerful support and advocacy group of the mental health care community world wide. What do you do to cope with the drugs you take? All drugs, from vitamins to narcotics, have side effects. Alcohol has been consumed for thousands of years, and there is still no way to avoid the morning after... or it s far more destructive effects. What side effects do you deal with? How do you deal with these side effects? 8

9 Lessard Case 1971 Institutionalized on the basis of doctors opinions she was dangerous, the US Supreme Court ruled Alberta Lessard was entitled to Due Process before being hospitalized. Donaldson Case 1976 Kenneth Donaldson, kept against his will for 15 years and rescued by attorneys and advocates, helped establish legal status of least restrictive environment for care. To which groups have you gone for strength, guidance, or a sense of belonging? What groups of people have you belonged to in the past, do you belong to now, and hope to belong to in the future? Family? Colleagues & coworkers? Spiritual groups? A military unit? 9

10 Howard Howie the Harp Geld Co-founder of Insane Liberation Front (Portland, Oregon) and Mental Patient Liberation Front (New York, New York), both seminal mental health activist groups Have you ever felt completely isolated? When have you most known the burden stigma causes? A man by the name of Sartre said that when someone is labeled they become nothing but a word. That word freezes in time, cancels, the person s past achievements and future hopes. What did Sartre mean? When someone learns of a person's challenge before meeting that person, what does it take away? Have you ever been treated in a way that took away your achievements and hopes? Americans with Disabilities Act (ADA) The disabilities equivalent of the 1964 Civil Rights Act, it established federal protection for the rights of those with disabilities. It was passed in

11 How do you gain dignity from risk? In what way are you able to include your own judgment in decision-making? People develop dignity by working with others to make their own decisions. Risk, blame, and accountability are key. How does stigma deny a person the right to learn about risk? Can it lead to blame, or a lacking of accountability & responsibility? How do people get dignity in their decision-making processes? Mental Health Parity Act Federal law drafted in 2008 requiring insurers to give coverage to psychiatric illnesses equivalent to that of other medical issues Whom do you admire? Who is it you appreciate? What values do you see in others that are admirable? What values do others admire and appreciate in you? 11

12 The End Compiled, Written and Presented by Ed Erwin Slide Presentation Created by Ed Erwin, Joseph Männchen, Trevor Murray The Version First Presented on June 18th, 2010 Copyright 2010 E. Erwin All Rights Reserved. 12