Recovery Politics: Tensions and Opportunities Kate Storey &Tanya Shute The Centre for Building a Culture of Recovery Making Gains: Toronto, November 2, 2009

Fair Notice: Our work is embedded in an understanding of recovery that seeks to educate and advocate for personal and system reform that includes: equity, respect, and personal responsibility. Our message emerges from a critical perspective that requires deep questions about relevance and serious consideration of alternatives.

What about the word recovery? " a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and/or roles. It is a way of living a satisfying, hopeful, and contributing life even with limitations caused by the illness. Recovery involves the development of new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness.” Author deliberately obscured

hmmm " a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and/or roles. It is a way of living a satisfying, hopeful, and contributing life even with limitations caused by the illness. Recovery involves the development of new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness.”

How about… “…recovery principles and values describe the treatment services that our clients use to manage their symptoms and live independently in the community of their choice” Author deliberately obscured

One more Recovery is the personal process that people with mental illness go through in gaining control, meaning and purpose in their lives. Recovery involves different things for different people. For some, recovery means the complete absence of the symptoms of mental illness. For others, recovery means living a full life in the community while learning to live with ongoing symptoms. The goal of many mental health services and treatments is now recovery. This wasn’t always the case. In the past, mental health professionals told people with mental illness and their families that most illnesses got worse over time. People were told to lower their expectations.

Recovery is a process. Not a place. It is about recovering what was lost; rights, roles, responsibilities, decisions, potential and support. It is not about symptom elimination but about what an individual wants, how they can get there and how others can help/support them to get there. It is about rekindling hope for a productive present and a rewarding future – and believing one deserves it. Recovery involves people having a personal vision of the life they want to live, seeing and changing patterns, discovering symptoms can be managed and doing it, finding new ways and reasons, doing more of what works and less of what doesn’t. Recovery is about reclaiming the roles of a “healthy” person, rather than a “sick” person. Recovery is about getting there. ~ Laurie Curtis – CMHA Barrie/Simcoe

The Centre for Building a Culture of Recovery defines recovery as: …the hard work a person does him or herself, with the kindness and compassion of the people they choose to support them – in an environment that acknowledges and believes in their potential for wellness. ©

We use the language “person in recovery” or person with lived experience. Recovery is the person’s hard work. They realize recovery through relationships – with people they choose.

Our recovery perspective insists that people understand and choose the services and supports that they have experienced as, and/or believe to be, effective. This might include use of clinical/medical or rehabilitation services, or it may include peer support and self help, or people may choose to use or not use any formal services and supports.

understand and choose….. Equity requires that people are informed and free to question, challenge debate, then decide. Without equity – information provided to people will be filtered, cleansed or restricted Without equity people will not be free to risk - to make the same mistakes as everyone else Equity requires professionals to re-think their liabilities, policies and protocols

Appreciating equity requires clinicians to consider how they privilege knowledge and experience. Can one embrace equity while harboring doubts about competence and capacity? These reflective questions are essential to shifting to recovery- supporting practice and policy.

What about real choice….. What happens when people question? What are the real risks (let’s not be naïve) What are the effects of requesting a change to service – like a change of psychiatrist, case manager? What about declining medication? What about harm reduction? What about the hours of service…..the activities and programs?

Freedom to choose is complex The conventional system must invite, welcome and genuinely expect choice People in recovery must trust that their choice will be heard and respected.

Freedom to know, believe and choose requires self confidence and comfort…..empowerment Empowerment is frequently misunderstood. We use the word empowerment NOT empowered or empowering Empowerment correctly articulates the critical difference between the beneficent bestowal of power to have-nots from haves and what we think is more important: the personal realization of power.

Empowerment is the cornerstone to self-responsibility and self-advocacy It means the freedom to make real and true choice. The freedom to risk making mistakes. The responsibility for those decisions – and for our behaviours. Beware of “partnerships” that hold un-equal power; We must appreciate the impact of systemic power and oppression. People must be free to self advocate, not reiterate expected (conscious or unconscious) social expectations

Because recovery embraces the wisdom of lived experience, self-help and peer support is an essential component: Self-help and Peer Support acknowledge the value of personal lived experience as a demonstration of hope, recovery and ongoing personal growth and transformation. Self help and Peer Support respects choice & self-responsibility within an intentional relationship of negotiated risk. The self-help and Peer Support relationship supports the person to explore, question, challenge, decide and exercise his or her free choice. The self-help and peer support relationship supports the development and exercise of self-advocacy. The self-help and Peer Support is a distinct non-clinical relationship that is an alternate to, or compliment to, conventional services.

Leadership and Advocacy by people in recovery is required for system reform. Conventional providers and leaders must listen deeply and critically to the experiences of people in recovery. People told the Kirby commission that “the most devastating impact on their lives came not from the illness itself but from the way others, including clinicians treat them.”

We will all be supporting recovery when …. a person has the full information they require to legitimately question, challenge, debate and genuinely consider if they will accept or decline both conventional services or peer supports when our society tolerates personal difference and respects human rights …and when our system believes in the potential of people to be responsible for their health and wellness

Organizations, programs and clinicians can be/ must be: recovery supporting. This is not semantics – there is a critical difference in how we apply meaning to our work and our responsibilities as a result of our language. Clinicians have a valuable role to play serving people in recovery who choose their service – but this work is not “doing” recovery….. it is the work of supporting a person’s recovery

What would an equitable, just and truly recovery-supporting system look like? Multiple and Non-clinical points of access No requirement for screening, labeling, diagnosing, and illness/disability language Equal access to funded and autonomous self- help and peer support Inclusion – housing, education, employment – and factors that support them such as childcare and transportation Human rights

. Questions? Comments? Discussion!