December 7, 2009

People with severe mental illness can get well and stay well.  It’s an idea the “patients” taught the professionals, not the other way around.  At first, the professionals ignored us; then they fought us.

Now, recovery-based mental health services are national policy, and recovery is widely acceptable as an achievable goal by governments, agencies, “consumers” and mental health professionals.

New Hampshire used to have the most recovery-friendly mental health system in the country, but other states have caught up.  New Hampshire has either stalled or slipped into reverse.

My bipolar disorder has been in my rearview mirror for 30 years, thanks to medicine, psychotherapy, support from friends and fellow survivors, and lifestyle adjustments.  Medicine stopped me from being sick, but I learned to make myself well.  Except for a lucky few, medicine alone is not enough.

Until 1995, I just took medicine, and that allowed me to pull my weight at a daily newspaper.  I thought that was as good as it gets:  symptom-free, stable on medication, being what I always wanted to be when I grew up.

But that was not recovery the way I understand it today.  That was a medical description of someone who is not sick.   Recovery is about being well:  being satisfied with the person you are and the quality and balance of your life, relationships, and connections to the community.  It does not mean you no longer need medicine, but people with high blood pressure need medicine too.

Everybody has a different definition of a better life, so recovery has a different meaning for everyone.  As you achieve your goals, you acquire new goals, and that changes your definition of recovery as well.

At the newspaper, I was 110 pounds overweight, smoked cigarettes, was crippled by anger and shame, isolated, and cursed with a nasty, inappropriate sense of humor that got me in trouble at work.  My life consisted of going to work, doing the work, and getting ready to go back to work.  News reporter was what I was, not what I did.  When I got downsized in the mid-1990s, I had to find a new person to be. not just a new job.

When I entered the NH public mental health system in 1996, we were still very recovery oriented.  I recognized that right away, at my intake interview at the Center for Life Management Community Mental Health Center in Derry.  Instead of talking about what was wrong with me, the two professionals asked about my “recovery assets.”  Nomental health professional had eveTr talked to me that way.   Professionals call it “strength based treatment,” building on a person’s strengths, as opposed to trying to compensate for a client’s deficits.

Then, the professionals sent me to a seminar to learn recovery skills, and to a consumer-run peer support center. There people could truthfully say to me, “I’ve been there and know how you feel.  Here’s what helped me get better.”

The state sent me to a “train-the-trainer” seminar with Mary Ellen Copeland, the creator of the recovery curriculum I’d just started practicing.  I’ve been teaching it since 1997, most recently to inpatients at NH Hospital.

Those were the good old days.  The system was becoming more and more recovery-based, but system change has three speeds:  slow, stop, and reverse.   Recovery education and other mental health treaments are better now than they’ve ever been, but they are harder to get than ever.  The state Supreme Court has already decided that mental health services in prison are so bad they violate inmates’ rights, and I believe community-based treatment is so hard to get, because of years of underfunding, that it violates the rights of all consumers and their families, and costs taxpayers and businesses a fortune.

The system could save itself a lot of money in these days of shrinking government funding by adding to their recovery-based services instead of cutting them.  It is far less expensive to help people recover than it is to maintain people who will always be sick and dependent.

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