Recovery Politics: Tensions and Opportunities Kate Storey &Tanya Shute The Centre for Building a...
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Recovery Politics: Tensions and Opportunities Kate Storey &Tanya Shute The Centre for Building a Culture of Recovery Making Gains: Toronto, November 2, 2009
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Transcript of Recovery Politics: Tensions and Opportunities Kate Storey &Tanya Shute The Centre for Building a...
Recovery Politics: Tensions and Opportunities
Kate Storey &Tanya ShuteThe Centre for Building a Culture of Recovery
Making Gains: Toronto, November 2, 2009
Fair Notice:
Our work is embedded in an understandingof recovery that seeks to educate and advocate for personal and system reformthat includes: equity, respect, and personalresponsibility.
Our message emerges from a critical perspective that requires deep questions aboutrelevance 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 ofchanging one’s attitudes , values , feelings, goals, skills and/or roles. It is a way of living a satisfying, hopeful, andcontributing life even with limitations causedby the illness.
Recovery involves the development of newmeaning and purpose in one’s life as one growsbeyond 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 moreRecovery is the personal process that people with mental illness go through in gaining control, meaning and purposein their lives . Recovery involves different things fordifferent people. For some, recovery means the complete absence of the symptoms of mental illness . For others, recovery means living a full life in thecommunity while learning to live with ongoing symptoms.
The goal of many mental health services and treatments isnow recovery. This wasn’t always the case. In thepast, mental health professionals told people with mentalillness and their families that most illnesses got worse overtime. 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. Thefreedom 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 reiterateexpected (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 supportswhen 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 aresult 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!
. Recovery
Self awarenessPersonal responsibilityStrengths & ResourcesChoiceAutonomyWellnessEducationLeadershipHOPE
Distress awareness, negotiation & support
Psychosocial/Rehab Model
Assessment & DiagnosisAssessment of skill and capacityAssessment of
StrengthsLong-term planning Intensive SupportCommunity oriented
Crisis planning
Medical/Clinical Model
AssessmentDiagnosis of illness or disorderTreatmentPrognosisChronicity
Example:Crisis intervention
Care & ControlExpert
Professional
“patient”
Autonomous choice &
leadership
“person”
Client-centred or oriented
Skill training/Building
“client”
POWER BALANCEPOWER BALANCE
