Dave's Progress. Chapter 100: The Road to Recovery.

Yesterday, together with another member of the Pathways Group, I was invited to sit in on the meeting of a steering group brought together to discuss the treatment of psychosis in our local area. The group brought together everyone from a consultant psychiatrist to an outreach worker to a representative from the North Staffs Users Group (an organisation run by service users, i.e patients, which aims to improve mental health services and get the voice of service users heard).
As preparation for the meeting, we were sent a document about making mental health services "recovery" oriented. The document, written by a group of psychiatrists from South London and Maudsley and South West London and St.George's NHS trusts, I felt, contained many good ideas about essentially changing mental health services from a strictly clinical practice defined by symptoms, treatment and cure, to a more recovery based one, being about the "social recovery" as well as the clinical recovery of the service user and building a life beyond illness without necessarily achieving the elimination of all the symptoms of illness.
The concept of recovery, then, was much discussed within the document and it was suggested that there were three core ideas pertaining to the process: Hope- for this is essential in sustaining motivation and supporting expectations of an individually fulfilled life. Agency- which refers to people gaining a sense of control, having jurisdiction over their own problems, the services they use and their lives. It is concerned with self-management, self-determination, choice and responsibility. Opportunity- which links recovery to social inclusion and people's participation in wider society.
The change to a recovery oriented practice, then, would have many implications and would represent something of a paradigm shift in mental health practice. In terms of hope, there is now evidence to suggest that recovery from the most severe of illnesses, including schizophrenia, is not only possible, but statistically becoming more probable. Old models which traditionally saw schizophrenia as having quite a poor prognosis now seem to be a little outdated and I think it is essential that a message of hope is given to a patient right from the outset of treatment, for without the promise of becoming well and achieving, there seems to be little motivation for the service user to even try. In terms of agency, this would perhaps mean a radical shift in the existing power structures involved in mental health practice, with service users being placed on a more equal footing with their carers and even, when well enough, becoming involved in paid positions within mental health services as "peer professionals" who could encourage and help others in their own journeys through the recovery process. Lastly, in terms of opportunity, this would mean mental health professionals perhaps becoming involved in helping people achieve a life beyond mental health services by, for example, aiding them in gaining some form of employment or just engaging them in some form of meaningful activity. This may also have implications in terms of stigma and discrimination, a major barrier to opportunity, as service users would, perhaps, be able to rely on psychiatrists and others of professional capacity to join the fight against stigma.
At the meeting I attended it was discussed how professionals could measure the outcomes of their interventions, and which tools would be appropriate in measuring how well or how badly mental health services were performing in providing such new approaches. If I'm honest, I was a little overcome with all the professional jargon that was used in the meeting, and one wondered whether our presence there was simply tokenistic. I also expected there to be more discussion of how recovery principles were going to be put into practice, and I think only one person, the outreach worker, mentioned something about getting users more involved in choices about their treatment. However, the very fact that we were at the meeting and the fact that many recovery principles seem to be already in operation at the Pathways Group is heartening. There was even a tacit promise made that some of us could, in the near future, take on the role of a paid "peer professional".
All in all, then, the future of mental health treatment looks promising. We are no longer, it seems, and in the words of the great Talking Heads song, on a "road to nowhere". We are, most reassuringly, finally on the road to recovery.     

Comments

dcrelief said…
Dear David,

Congratulations on your one hundredth chapter! Well done and well shared.
Hope is the big issue we all want to know is there for us. Support from others in keeping hope alive has been largely overlooked. I choose to stay positive, and hope the changes the groups presented begin soon.
Medical language/terminology, becomes second nature with usage. (Once I discussed 'string theory' it became easier to understand. Haha) Take apart those terms, David; kick the tires; learn what they mean. Besides, you're one of the smartest people I know. I have great hope and faith in you. Keep them challenged.
In peace,
Dixie
klahanie said…
Dear David,
This time, I shall leave my comment, succinct.
No jargon from me. I just want to let you know that, overall, this was a most encouraging posting. I think our 'little red wagons', are doing rather well.
Congratulations on reaching 'Chapter 100'.
All the very best and hopefully, shall talk to you soon.
Gary.
bazza said…
Greetings Centurion!
You may remember that I previously mentioned a close family member who suffered a nervous breakdown some years ago. My impression, at that time, was that he became a 'product' to be processed through a system. In fact I have experienced this myself at A&E.
Therefore this new outlook is certainly hopeful. Let's pray that the words are translated into action soon. Good luck with that!
Bazza’s Blog ‘To Discover Ice’
David said…
Dear Dixie,
Thanks for your most enthusiastic and encouraging comment.
I will, of course, attempt to learn as much as I can and I do hope I can "keep them challenged", even though I know some of them (that is professionals) don't like it!
Thanks for all your support Dixie, and I'm glad you're staying positive.
With Very Best Wishes,
David.
David said…
Dear Gary,
Your comment may be succinct, but it is, all the same, good to hear from you and to have your continued interest and support. It seems a while since we've spoken. In fact, I do apologise for not getting in touch sooner.
Keep riding that wagon, though, Gare. I'm sure all of us are applauding you on your way.
Yours with All The Best,
David.
David said…
Dear bazza,
I suppose it is unfortunate, but in both physical and mental health practice we can be made to feel a little less than human. I know this has certainly happened to me on my way through the system.
But, things do seem to be getting better and if practice does indeed become more about social, as well as clinical, recovery, then it is all to the good.
Like you say though, our words have to be translated into actions, and the consultant psychiatrist said at the meeting we attended that this may all just be "beautiful ideas". But, one lives in hope.
Hope that all is a well as can be with you, bazza and wishing you all the best,
David.
The Manic Chef said…
Interesting article, and I do hope 'they' are sincere concerning what 'they' feel are the issues. I'm trying to get a 'diagnosis' for what I sense, according to a number of 'self-assessments' is Manic/Bi-polar symptoms, I could be wrong, but what I experience fits all the 'scenarios'. My first experience with the 'professionals' concerning this issue was not good, but I feel I must take charge over the outcome of my life. I do not fully trust the 'professionals' my past history with them has not been encouraging, so I must do all the leg work, otherwise to fully cast myself into 'their' hands is not an option. I've always been a fighter, going against the 'norm' I won't settle for second or third best. If the system is going to get better, it is up to US, to make sure it does! Thanks good info. Take care, later....
David said…
Dear Manic Chef,
Thanks for your comment and I can relate very much to what you say.
I, too, have had bad experiences with the so-called "them", the mental health professionals.
I do feel, though, that things are getting better and if you feel you have symptoms of a certain illness, I think it is preferable to seek treatment for it rather than just leave it to the hands of fate.
As I try to say in my post, living a fulfilled life is possible, even with the most severe of mental health conditions, and at least you seem to have enough insight to know that you may be a little unwell. That, in itself, is a great attribute.
But it is a very vexed question. I know some who prefer to live without medication and outside mental health services, but, on the other hand, knowing and identifying your own issues can, in fact, in the end, be liberating.
You may fimd my post "To Disclose or not to Disclose, That is the Question", a help. I forget which chapter it is, so you may have to poke around a little.
Anyway, I sincerely hope that you continue to "go against the norm", and realise that that in itself is most emphatically not a mental helath problem.
Good Luck and Very Best Wishes,
David.

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