1. Wk. 12: M Health Yr. 2 SSW Recovery Model
‘Recovery is a process, not a place…it’s about recovering the roles of ‘healthy’ person, rather than a ‘sick’ person.’

2. Sources Text has only a few pages on Recovery Model
Key Articles: Mead & Copeland: ‘What Recovery Means to Us’: written by ‘consumers’ or ‘people with lived experience’
New Zealand Research from South Canterbury Mental Health Services
NASW Practice Snapshot: The Mental Health Recovery Model (posted online)

3. From NASW Article
‘The Recovery ‘movement’ refers to a grassroots initiative… and has the goal of recovery from mental illness…
…the concept of recovery originally began in the addictions field…the term has now been adopted in the mental health field as people realized that recovery from mental illness is also possible.’

4. What are people recovering from?*
Poverty
Dreams that never materialized
Loss of relationships
Loss of identity
Mental health problems
Isolation in community, stigma
Physical/sexual abuse
Addictions
Mental Health Systems
*Research Article:
S. Canterbury MH Services, N. Zealand

5. R & G: Traditional View p. 8
‘…dominant model of mental health focused on a deficit-based approach with clear assumptions about normality and pathology’
M Illnesses…
Chronic
Caused by family dysfunction, life skills deficits, poor social supports, non-compliance with treatment
Ignored experience of people living with mental health problems

6. Then… Then…up to 1990s Power divide Symptoms incurable
Medical Model
Power divide
Symptoms incurable
Likely get worse
Treatment =
meds for life
Forget dreams/goals
‘One size fits all’
Disabled
Disorder = identity
Brain disorder
Nothing about
-recovery
-hope
-how to help ourselves
-Clients helping each other
-wellness
-strengths

7. R & G: Recovery Model
Consumer choice/recovery now at forefront of mental health policy
Individuals can and do recover…hope plays an integral part
‘…a conspiracy of hope…a refusal to succumb to the images of despair associated with a diagnosis of mental illness’
Range of outcomes: ‘freedom from symptoms to living a satisfying life within the limitations caused by illness’

8. R & G: Key Components p. 9 Finding, maintaining hope, optimism, agency
Re-establish a positive identity, a core positive sense of self
Build a meaningful life
Take responsibility and control of one’s life

9. History: Early 20th Century
Eugenics Movement
= Survival of the Fittest
Derived from Darwin’s ideas on evolution
If dogs, horses, birds can be bred for certain traits…why not humans?

10. “The first task faced by eugenicists was to identify those
From Evolution: The Remarkable History of a Scientific Theory (Larson, 2004 p. 192)…
“The first task faced by eugenicists was to identify those
who should not reproduce. Hereditary forms of mental defect and deficiency became a main target…
…some eugenicists targeted repeat criminals, prostitutes, and others who regularly manifested certain supposedly hereditary undesirable social behaviours.”

11. Sterilization of ‘mentally unfit’
US:
“Nearly every American state maintained institutions for forcibly segregating those suffering from hereditary disabilities and…enacted compulsory sterilization laws.”

12. In Canada…
“The most damaging sterilization program in Canadian history was afforded via the passing of the Alberta Sexual Sterilization Act of From the years 1928 to 1972, sterilizations, both compulsory and optional, were performed on nearly 3000 "unfit" individuals of varying ages and ethnicities. In total, over 2800 procedures were performed.” (Wikipedia)

13. Roots of Consumer-Survivor Movement
1960s: Treatment models, philosophies challenged by Tzas, Laing and others
Deinstitutionalization
1970: Insane Liberation Movement founded in US
1971: Mental Patients’ Liberation groups form in Boston & New York
1971: Mental Patients’ Association, Self-help + Drop-in Centre, Vancouver
1972: Network Against Psychiatric Assault in San Francisco
1972: Madness Network News published in San Francisco

14. Roots…
1973: 1st Conference on Human Rights + Psychiatric Oppression in Detroit
Canadians attend
1978: Judi Chamberlain publishes ‘On Our Own: Patient Controlled Alternatives to the Mental Health System’
: ‘Pheonix Rising: The Voice of the Psychiatrized’, a magazine that is ‘anti-
psychiatry’ published in Toronto
1984: ‘Psychiatric Survivors’ used in US; reject term ‘patient’

15. Poster from Psychiatric Survivor Archives

16. Consumer Activism…
1989: Montreal hosts 1st national conference of psychiatric patients
Speakers resent being called ‘consumers’
1992: Queen Street Patients’ Council established
1990s: Ontario Council of Alternative Businesses founded
‘Raging Spoon, A-Way…’
Ryerson University: Mad Pride Student Club

17. Recovery Model Philosophy: ‘People get better…’
“While m. health problems are often seen as a life-long affliction, the vast majority of people who get sick from mental illness recover.”
Dr. Kutcher, Chair, Adolescent Psychiatry, Dalhousie University

18. Recovery involves…
“…seeing symptoms on a continuum of the norm rather than an aberration…these are symptoms that everyone experiences in some form or other.”
Article: ‘What Recovery Means to Us,’ Mead, Copeland
“…the community is the source of mental health.”
Article: S. Canterbury MH Services

19. Changing Assumptions The Worker… Old Paradigm New Paradigm
How we see person
Disabled
Person with potential
How we define person’s needs
Deficiencies
Capacities
How we see the community
Obstacle: stigma, fear, prejudice, rejection
Resource: inclusion, acceptance
Who’s in charge?
Top down: policies to guide professionals
Self-determined
Circle of support
Our Role
Service Provider
Supporter

20. Recovery means…
“People who have experienced even the most severe psychiatric symptoms are doctors, lawyers, teachers, accountants…We are successfully maintaining intimate relationships.”
Mead, Copeland

21. ‘Normalize…’
Symptoms part of life: don’t we all ‘hear voices,’ get anxious, get depressed?
Client chooses which symptoms are a problem
Rejects sane-insane dichotomy
See symptoms on a continuum/spectrum
Most of us move around in the middle

22. Key Facets of Recovery Hope: …includes no limits
Each person responsible, accepts consequences of decisions made
Education is essential: people can grow and change
Not just a brain disorder-environmental issues key
Helping others with
m. illness can be key
Work as Peer Leaders
Recovery does not equal cure
Illness only one part of the self
‘Person with schizophrenia’
Therapeutic alliance: worker collaborates with client, relationship is key

23. Medications… One of many options and choices
Side effects, long term effects unknown
Can be combined with exercise, yoga,
therapy, diet, psycho-education, supporting others with M. Illness, herbal remedies…

24. Re: Helping Professionals
“Risk is inherent in life…it is up to us to make choices…it is not up to health care professionals to protect us from the real world…they need to believe we are capable of taking risks and supporting us…”
What key principles of the medical model does this reject?

25. Mead & Copeland: Best Practices
Treat person as competent
Focus on client’s experience, feelings
Listen to client’s unique experience
Share simple self-help skills
Break tasks into small pieces
Limit advice
Pay attention to individual needs
Be collaborative

26. Best Practices… Recognize strengths, acknowledge small gains
A person’s life path is up to them
Listen: are goals theirs or yours?
Decent housing is critical
Ask yourself: is there something getting in the way of a client making changes?
Ask: would this person benefit from helping other clients or by being in a group led by a consumer survivor?

27. From NASW article….
‘It is not our role to make decisions for consumers, but we do have a responsibility to provide education about the possible outcomes that may result from various decisions.’

28. Text: Recovery Model and Social Work
Both approaches stress:
Holistic emphasis
Positive relationships are key
Meaningful daily activity maximizes strength, promotes health
Spirituality helps mobilize capacity for inner healing
Personal growth means to overcome disability despite its continued presence
Medications are one tool among many
We can offer skill-building opportunities
Self-determination is a desired outcome

29. Toronto voices/language…
“My dream is a Mad-Positive Post-secondary culture”
David Reville, former Toronto City Counsellor, Advocate & ‘mad identified,’ speaks at GBC M Health Conference, 2012

30. CAMH Bill of Rights* Right to… Be treated with respect
Be free from harm
Dignity and independence
Quality services
Effective Communication
Be fully informed
Poole & Greaves, Becoming Trauma Informed
Make and informed choice
Give informed consent
Receive support
Right to complain
Have rights regards research and training

31. The late Diana Capponi Last hospitalization 1982
“School/work critical for recovery”
Got 300 people in recovery hired at CAMH from
Helped create 14 Peer Support positions at CAMH
Formerly Manager of Ontario Council of Alternative Businesses
Was developing national certification curriculum for peer support training
Unemployment rate for Consumers: 86%
For physically disabled: 67%

32. Capponi…
“Our culture sets low expectations and consumers internalize it…
…If employers set low expectations, it’s insulting and demeaning.”
Speech at GBC Conference on Mental Health, 2012

33. GBC Student Voice
“We need facilitators, not helpers. That’s paternalistic. We need support facilitating a path forward.”
Becky McFarlane, Consumer, speaking at GBC Mental Health Conference, 2012

34. The Last Word…
‘The person who experiences psychiatric symptoms should determine the course of his or her life. No one else, not even the most highly skilled worker can do it. We need to do it ourselves with your guidance and support.’
Mead & Copeland

35. Pairs: Critical Thinking...
In what situations does the recovery model not work?
2. How does it benefit/frustrate workers?
3. How does it benefit/frustrate families?