Celebrating The Art of RecoveryPRSANM Annual Conference

Albuquerque NM

June 13, 2013

Art- Merriam-Webster

A skill acquired by experience, study or observation

Recovery is a skill that can be learned through study, education, example, and experience

PSRANM Members As professionals you are central in the fight to

assure that these SMI achieve the recognition that they deserve in our civilization.

You are essential components and assets to those attempting to create their life art in spite of otherwise crippling illness

Psychosocial Rehabilitators You are the most important advocates for

those who suffer from the serious, frequently fatal brain conditions that we have coined “psychiatric” or “mental” illnesses

Without you as partners, hope is muted Your advocacy counts more than can be

measured

Recovery Re-finding of lost meaning in life after the

symptoms of mental illness have eroded hope, goals, future, happiness, and adaptive potential.

Survival and stability formerly the goal of treatment

Recovery transcends mere survival or stability

Roxanne’s Recovery

Roxanne 34 y/o woman who epitomizes the possibility, goals,

and prayers we have for achieving and sustaining recovery

40 years ago would have been a ward of the state and likely lived out her life in the relative safety and confines of a State Hospital

60years ago would have been lobotomized ( in 1955 55,000 men woman and children in the US alone undergo lobotomies)

75 years ago, if living in Europe, would have been exterminated in place or sent to “death camp” by Nazis

Roxanne 150 years ago would have been held in squalid

conditions in a prison or jail 300 years ago might well have been burned to

death as a witch in America 500 years ago the church published a text

describing the demons in the insane. Instructions were provided on how to torture and kill the “devil” in the soul of the mentally ill

Recovery The advent of Lithium and Thorazine in the

1950’s ushered in the “Modern Age” of treatment that provided hope for treatment of those with Schizophrenia and Manic Depression

Depressive illnesses were found to respond to Elavil and ECT in the early 60’s

New Hope- New Contract By the 1970’s a new, “revolutionary” movement

gained momentum in the US Community-based treatment seemed feasible and

more humane than “institutionalization” Community Mental Health Centers were born across

the nation For the first time in human history there was hope

that those with mental illness could lead productive, normal lives

New Hope- New Contract Community Mental Health Centers were

relatively well funded and though “modalities” were primitive, progress was made.

Centers prospered, “modalities” matured and improved

State Hospital Systems deteriorated and closed beds by the tens of thousands

Recovery Each person in the audience knows someone

who is achieving this goal. A process that is continuous

The challenges of “Recovery” are similar in some ways to that found in the venerable and successful substance abuse directed “12 Step” model

Central to “Recovery” is the concept that the “victim” assume a pivotal role in embracing the challenges of life with the illness

RECOVERY An expectation or goal beyond mere survival

with or without overt symptoms of illness A multifaceted goal that amounts to the

“restoration” of a meaningful, fulfilling life beyond survival

Many can now achieve this objective. For the first time in the history of mankind

What is “Recovery” Restoration of self esteem Restoration of dreams Restoration of self worth Restoration of pride Restoration of choice Restoration of dignity Restoration of MEANING

Recovery- Ten Components Self-Direction Individual and Person Centered Empowering Holistic Non-Linear Strengths Based

Recovery- Ten Components Peer Support Respect Responsibility Hope

Recovery Recovery from brain disorders such as Schizophrenia

and Bipolar Disorder is relatively rare without family, social, and professional partners in recovery

Taking medication is not the goal of recovery. It is however, for most, an essential foundation essential for recovery to be achieved for many with mental illness.

Treatment and often medications are essential to reduce or prevent relapse for those in recovery. Relapse prevention is an essential goal of treatment.

Recovery- Relapse Prevention Even brief periods of active illness may destroy

previous growth, relationships, goals, and trust on the part of all who are affected

Brief periods of relatively asymptomatic interludes can be “imposed” by coercion on the individual who is ill.

Rarely will these efforts lead to “recovery” until the individual has reached bottom, or experienced an epiphany that allows the realization that the illness is one of the major challenges that they must transcend if they are to lead a fruitful life.

Recovery Those assisting individuals with recovery

may face similar challenges to those loved ones and others attempting to assist a person with addictions

“Helping” versus “Enabling” Recovery is a lifelong process Continuous challenge that will “rule the lives

of the affected if they do not rule it”

Recovery

Family and loved ones

Judiciary, city and county, prosecutors, relief organizations, faith based groups, neighbors

Mental health providers, advocacy groups, support groups, therapists, social workers, case managers, doctors, CPS, attorneys, peers, many others

Recovery Happens Early Diagnosis and Treatment is essential to

maximize potential Avoidance of substance abuse essential Partners are critical to success Access to care paramount

Recovery Can and Does Happen You can give hope and the means Few can succeed alone with or without major

mental illness We can and must work to provide hope and

access to humane and effective treatment for ours, our children, and their children.

The economic and societal effects of failure are unaffordable and inhumane

The “true” measure of a civilization is not the people or territory that it has conquered, controlled, dominated, or influenced, but how it provides for it’s most vulnerable citizens

The Criminalization of Mental Illness We, as a society, have reverted, by default, to mental

health management approaches that were clearly inhumane in the middle of the 1800’s.

We have closed the refuges, created refugees, and imprisoned tens of thousands of people who could be effectively treated without danger to the community

We have a failed mental health system in much of the United States. There is no light at the end of the tunnel that hasn’t been “spun” to satisfy other agenda.

Roxanne 1500 years ago thousands of “insane” were

murdered to get rid of the “evil” souls that possessed them. The spirits that possessed them were allegedly dedicated to “deceiving” and “confusing” the opposite sex

2000 years ago and as far back as human recorded history her illness, schizophrenia, mania and melancholia accurately described and essentially unchanged from modern descriptions

Roxanne ten thousand or so years ago she and her

children would have likely been eaten by a predator or starved as she abandoned her tribe in a deluded attempt to protect her children from those who she felt intended to victimize them.

No Hope- No Contract In the 1980’s state and national subsidization of

Centers began to erode Year after year budgets were cut and cut and cut Policy makers abandoned those with mental illness Programs deteriorated Access to, and quality of care continues to backslide

The Criminalization of Mental Illness County Jails and TDCJ have become the “de facto”

mental hospitals of the modern age. Dorthea Dix, a nurse in the late 1800’s was reviled

by the fact that most mentally ill were incarcerated in inhumane conditions our jails and prisons

Dorthea Dix campaigned tirelessly to establish humane treatment for the mentally ill

New Jersey, followed by 30 other states established hospitals for the “insane” near the turn of the century

The Criminalization of Mental Illness In 1861 10,000 of 30 million Americans

resided in mental hospitals The population of the US has reached over

300 million. Over 500,000 persons were detained and

protected in asylums in the US when modern treatment became available in the late 1950’s

Roxanne 500 years ago 1000,000 mentally ill were

tortured, burned and killed in France alone over a thirty year period

In Geneva 500 people burned at the stake publicly in three months

600 years ago she may have been allowed to live in relative freedom if her family could care for her

The Criminalization of Mental Illness The State Prison System and County Jails are the

Asylums of the new millennium They provide, routinely, and with few exceptions,

inadequate, substandard, and often inhumane treatment

We, as a people, have accepted “Out of sight, out of mind.”

We, as a people, should be ashamed as we are capable of responding more effectively and humanely to this issue

No Hope- No Contract Seriously Mentally Ill become homeless, exposed to

drugs, crime, victimization With no access to community treatment, increasingly

they are incarcerated Incarceration to protect “law abiding citizens” and

more recently “for their own good” Twenty percent of many jail and penitentiary

populations across the country are composed of severely mentally ill.

Some are indeed dangerous, most not if afforded, or directed into, appropriate treatment