recovery for all
TRANSCRIPT
R
Recovery for all
six word short stories
‘He didn't. She did. Big mistake.’
AL Kennedy
‘For sale: baby shoes, never worn’
Ernest Hemmingway‘A&E IOU’
Toby Litt
‘Womb. Bloom. Groom. Gloom. Rheum. Tomb.’Blake Morrison
‘Purse found. "No notes," she said.’Andrew O'Hagan
‘Mother's-milk. Ribena. Tetley's. Chibuku-Shake-Shake. Complan. Morphine.’Marina Lewycka
‘Defenestrated baby, methamphetamine, prison, rehab, relapse.’Jeffrey Eugenides
Overview What is recovery?
Why is recovery important?
Social movement to policy goal
Recovery focused mental health services
Recovery?
• How confident do you feel working in a recovery focussed way?
Scale of 1-10?
What is recovery?
Personal RecoveryMental Illness &
Medical Model
Social movement
• "revolutions begin when people who are defined as problems achieve the power to redefine the problem” McKnight (1992)
• Recovery involves people living with addictions and mental health problems
Defining 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 illness. Recovery involves the development of new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness.”
Anthony, 1993
Recovery Timeline
Recovery Model
Anti-
depr
essa
nts,
195
7
Dem
entia
Pra
ecox
188
3
Anti-
psyc
hotic
s, 1
960De-institutionalisation
Psychosocial Rehabilitation, 1940’s - 70’s
Disability Rights Movement
Self
Hel
p, 1
930’
s
Survivor Narratives
Bill
Anth
ony,
199
3
Reco
very
Ass
essm
ent S
cale
, 19
96
Policy, 2006…
Prac
tice
The
Div
ided
Sel
f, 19
60
1959
Men
tal H
ealth
Act
The
Wat
er T
ower
Spe
ech,
19
61
Inte
rnati
onal
Pilo
t Stu
dyO
f Sch
izoph
reni
a, 1
967
Reco
very
Con
fere
nce,
200
4
SRN
, 200
3
WWII: 1939-45
Chlo
rpro
maz
ine,
195
2
Anti-psychiatry
Italia
n Ps
ychi
atric
Ref
orm
, 197
8
1960’s & 70’s
“People need to recover from the system, not their mental health problem.” Ron Coleman
“We have the right to be heard and listened to. We…need not be passive victims of an illness.” (Deegan, 1993)
Foundations of Recovery
Medical Recovery
Maintenance
Personal Recovery
What is Recovery?
People of all ages living with mental health problems and illnesses are actively engaged and supported in their journey of recovery and well-being.
“Mental health service providers should operate within a framework that supports recovery.”
“Rights”
“Best Practice”
“Social Inclusion”
“Active participation & empowerment strategies.”
“Focus on Outcomes”
“Rights, Relationships & Recovery: review of
mental health nursing (SGHD 2006, 2010)
Recovery Policies
Recovery in Scotland Devolution (1999) Recovery conference, Ron Coleman (2004)
Mental Health Care & Treatment Act (2003) Scottish Recovery Network (2004) Rights, relationships and recovery: review of mental health nursing
(2006) (refreshed, 2010) Delivering for mental health plan, 2006 Mental health strategy (2012) New Mental Health Act (2012)
Future: – Personalisation & SDS– Practice & Measurement
Recovery key themes
Being Supported by Others Renewing Hope & Commitment Engaging in Meaningful Activities Redefining Self Incorporating Illness Overcoming Stigma Assuming Control Managing Symptoms Becoming Empowered & Exercising Citizenship
What is recovery?
• A reality (it happens)• A process rather than an event• Processes have fluctuations• Built on growth and learning• Unique experience with common themes
CHIME (Leamy et al. 2011)
What helps recovery?
• Telling your story and being listened to• Developing awareness and skills• Taking part in life • Supportive relationships• The positive role of work• Recovery leadership / champions• Identity , hope and creativity
Recovery-focused nursing
Why is recovery important to nursing?
How can you work in a recovery focused way?
What is holding back recovery?
What it’s not
• A fad, buzz word or new phenomenon• A service model but they do need to
change• All about mental health services
‘I know everyone talks about hope, as if it’s the jargon and the latest fad. The thing is, it’s not jargon. It’s the light in the darkness which kept me going; the wish and yearning for change.’Personal narrative: www.scottishrecovery.net
What it’s not
• Something you can do to people• Necessarily easy or quick
‘Recovery is a personal journey and is different for everyone, and the way is not always easy... My journey to recovery took several years and much time was spent finding out what helped and what didn’t.’ Personal narrative: www.scottishrecovery.net
Implications of recovery
• People in recovery are the evidence• Different knowledge, skills and values• Shared roles - walking alongside• A shift in power
‘I feel that it’s vital that professionals are open to letting people take control, but I know that it’s hard to get it right. Ultimately, it’s about treating people as individuals.’Personal narrative: www.scottishrecovery.net
How do we know this?
• Narrative research projects• Local recovery networks• Promoting WRAP• Influencing services – SRI 2• Encouraging Peer Working• Listening to ‘experts by experience’• Research
The vision (your preferred future)
Let’s imagine a (recovery) miracle takes place…
What do you see yourself and others do?From staff, service user and carer perspectivesWhat’s different about it?
Achieving our vision
What is the first very small step you will take that will let you know that you are moving towards you vision?DiscussAcknowledging powerSMART objectivesRecovery is action oriented
Recovery = Journey
WALK IT!
References• Anthony W. A., (1993) Guiding vision of the mental health service system
in the 1990s. Psychosocial rahabilitation journal, 16(4), 11-23.• Cowan S, Guise J, (2012) Revisiting the narrative research project: a
follow up study of mental health recovery. Available at: http://www.scottishrecovery.net/Non-SRN/View-category.html . Last accessed: 12/01/14.
• Katalova-O’ Docherty Y, Stevenson, C, Higgins, A (2012) Reconnecting with life: a grounded theory study of mental health recovery in Ireland Journal of mental health 21 (2) 136 – 144.
• Leamy M, Bird V, Le Boutillier C, Williams J, Slade M, (2011) A conceptual framework for personal recovery in mental health: systematic review and narrative synthesis, British Journal of Psychiatry: 199:445-52.
References• Stickley, T., Wright, N. (2011) The British research evidence for recovery,
papers published between 2006 and 2009. Part two: a review of the grey literature including book chapters and policy documents. Journal of psychiatric and mental health nursing, (18), 297-307.
• Stickley, T., Wright N. (2011) The British evidence for recovery, papers published between 2006 and 2009. Part one: a review of the peer reviewed literature using a systematic approach. Journal of psychiatric and mental health nursing, (18) 247-256.
• Smith– Merry J, Freeman R, Sturdy S, (2010). Recovering mental health in Scotland: Recovery from social movement to policy goal Louvian-la-Neuve: Universite Catholique de louvian.
• Scottish Government Health department (2006) Rights, relationships and recovery: The review of mental health nursing in Scotland
• Scottish government (2012) The mental health strategy.