Dr. Dean Brooks has spent his adult life advocating for persons with mental illnesses. And he has not slowed down even though he now is 94 years-old and is living in an assistant living facility not far from the Oregon State Hospital in Salem that he used to oversee. 
He first burst on the national stage when he appeared in the 1975 movie, One Flew Over The Cuckoo’s Nest, as the hospital’s chief psychiatrist, Dr. John Spivey, M.D. It was a clever irony because Dr. Brooks was actually in charge of the hospital at the time of filming. In the movie, he can be seen interviewing Jack Nicholson to determine if he has an actual mental disorder or is faking it.
I received an introductory telephone call from Dr. Brooks after my book was published and we have talked repeatedly ever since. He is a bundle of energy and someone whom I greatly admire.
His most recent advocacy effort is a short film called Asylum: An Empty Nest for the Mentally Ill. It is included in the 35th anniversary edition of the Cuckoo’s Nest movie that has been released in blu-ray.
In this short bonus feature, Dr. Brooks is interviewed along with his daughter Ulista J. Brooks, MD., and his granddaughter, Ulista Hoover, MD. All three talk about how jails and prisons have become our new asylums and how community care, especially inadequately funded community care, is failing to help people. They also discuss the need for what Dr. Ulista Brooks describes as “true asylums” — the construction of new modern mental hospitals.
Her comments run counter to the recovery model that preaches that everyone with a mental disorder needs to live in a community setting. In the film, Dr. Ulista Brooks argues that some patients have a much harder time recovering when they are forced to live in a community setting that often is hostile. She says many patients feel alienated from their neighbors, who neither understand nor sympathize with them. She also argues that while she and her father have always advocated for patients’ rights, giving someone who is severely sick and disorganized in their thinking the authority to refuse treatment and not take medication is counter-productive and harmful.
In one of my most recent conversations with Dean, as he likes to be called, we discussed how the Cuckoo’s Nest movie lead to an unfavorable image of hospital workers. The evil Nurse Ratched, brilliantly played by Louise Fletcher, came to symbolize the callous mental health professional. This upset Dean because he said the majority of his employees were kind and dedicated workers who were underpaid, yet showed up to work with patients who sometimes spit, hit, and kicked them.
Another irony about Cuckoo’s Nest is that Ken Kesey’s novel was about an autocratic force’s attempt to squash the individual — a popular theme during the 1960s. The fact that it was rooted in a mental institution gave Kesey an easy target. But Dr. Brooks, who played a key role in getting permission for the movie to be shot inside his hospital, never saw the story as an anti-mental hospital movie.
I don’t know how many of you remember the movie or have seen it recently. But one of the film’s most memorable scenes is when the rebellious patient, R.P. McMurphy, manages to escape with other patients into town on a school bus. He takes them on a fishing trip. In the movie, Dr. Brooks can be seen standing on the dock with an entourage of stern-faced employees ready to punish McMurphy and return the patients to locked wards.
In real life, Dr. Brooks was one of the first administrators to push for patients to participate in community therapeutic outings. Life magazine tagged along when he organized a rafting and mountain climbing expedition. Under his direction, 51 hospital patients, who had been diagnosed with chronic and severe mental disorders, were paired with hospital employees for a 16-day outing. Recalling the experience, Dr. Brooks told me that it was impossible to tell who was the patient and who was a staff member. He took special delight in remembering how a psychiatrist had to depend on the steady hands of a patient with schizophrenia who was holding the ropes while the doctor dropped down the face of a 110 foot tall cliff.
(I later learned the outing matched Dr. Brooks’ personality well. He was an avid rock climber. Sometimes he could be seen on hospital grounds carrying a backpack filled with stones to build up his endurance. He even rappelled once down the hospital’s exterior.)
The patient/staff outing reaffirmed Dr. Brooks belief that a human connection between people is essential to recovery. In fact, of the 51 patients on the trip, all but 8 were released from the hospital within a year. In the short film supplement, a historian talks about how one psychiatrist insisted that staff members live on the wards with patients in some hospitals so that they all could be part of a therapeutic society.
When Cuckoo’s Nest was being shot, Dr. Brooks insisted that patients be given jobs and, much to his credit, famed director Milos Forman, teamed actors with patients and had his movie stars locked in a ward for several days so that they could experience the isolation that patients often felt in state institutions at that time.
The release of the 35th anniversary edition of the movie on blu-ray disc will give a new generation a look at a classic movie that changed America.
I am glad that the package also contains Dr. Brooks’s warning that these changes have not fixed our badly broken system.
Sitting on a bench with his daughter and granddaughter, Dr. Brooks explains that patients need individualized care suited for their specific needs. Care means more than medication. It means jobs, education and especially a safe place to live. He adds that it is as easy for a society to abandon persons in a community settings as it is by warehousing them in under-funded hospitals.
Continuing, he reminds us that the location of care is not nearly as important as insuring that persons get care. And being accepted as a valued member of a society can happen in a suburban neighborhood and, based on his decades of experience, also on the grounds of a well-run hospital.
Do you agree? Are hospitals, by their very nature, an impediment to recovery or can persons who are very ill live on hospital grounds for long periods and be happier there than in a neighborhood?
About the author:
The state hospital and other community news, have questions regarding the fact that too many patients are remaining in wards for too long As there are factors that state that solitary confinement prooves to have shorter periods of stay. The question remains as to whether the patient is ready to be released into the community, and whether the community is ready for them. Many are accused of feelings of love that professional citizens forced them to say, for instance, “I love you”, and then become lost when they cant love them back and wish to be loved the same way that they were forced to give it. The difference is what is intended as the feeling, so if the person is heavily stressed, they dont understand why they cant give these feelings back, instead they are told that they are repulsive. What a terrible thing to be told, especially when they have given so much. By the way, thankyou Mr. Early for writing this, and I am happy to see that Dean is doing well. Give me a call sometime. You will have to use my landline as my cell phone isnt working well anymore. Take care, JLW
Dean Please note: you will have to use my landline
It all depends upon the setting (whether or not the hospital is an impediment or a solace). Having been inpatient on a “psych ward” I found my relatively brief stay to be like a much needed vacation. It would not have been possible for me to stabilize as quickly and to move towards an intensive outpatient treatment had I not been able to receive the care and treatment I did at a wonderful facility. That said, when it was time to be released, it was time. Staying longer in my case would have served no further purpose for treatment…my illness was such that my recovery was dependent upon reentering the community, but mine is one individual case, and we must remember that with mental illness, each patient and each case is different, just as each cancer patient is different and may require different treatments.
Thanks, Pete, for this insightful piece and for posing the question.
I am grateful that you were able to be prepared for, and be aware of how much time you needed. Many patients can not process within their minds and/ or have the ability to physically and mentally make a decision or know when it is time to live in their own communities. They may talk about it , however, preparing, scheduling and then physically leaving the facility is another story. They may not be well enough to make that decision. Making a decision that this would be a short term vacation, already indicated that somehow you knew yourself well enough to prepare yourself that you would find yourself back into the community soon. However, it would have been better if you could have taken your vacation in the mountains or camping I do understand that you wanted to be helped in a different way. A different kind of vacation.
On two occasions in the ’60s I was a parient at Middletown State Mental Hospital in Middletown, NY. All the staff I met there to varying degrees were kind individuals sincere in their attempts to aid the mentally ill. Patients and staff would regularly participate together in card games, bumper pool and ping pong. We had a patient government with elected officers that was monotored but not run by staff. Our function was to conduct meetings where patient issues were brought up, addressed and brought before staff where they were either delt with to our satisfaction or an explaination was given why they couldn’t be. I attended church services on site. On one occasion, I was included in a group of patients taken on an outing to the NYC World’s Fair. Looking back, I feel that the active, safe, accepted atmosphere of the institution was a significant aid in the healing process. I have no data on what kind of system results in the mentally ill returning to society as contributing members sooner. I do know that my experinece at Middletown was far more pleasent and less traumatic than an experience around 1980 in the Pima County Jail in Tucson, AZ.
He belongs in the Cuckoo’s Nest. The entire industry is as absurd as Jack Nicholson’s character reflected it to be–except that indeed things have gottten worse:the industry continues to insist upon expansion insofar as it possibly CAN. It is like a wounded bird knowing its days are numbered if enough people cannot come under its control, so it produces the new DSM Manual. Involuntary commitment is a joke–no law is EVER followed. EVER. Period–if anyone in the public out there thinks it is–I invite that person to talk to me. It means literally anyone can get in–and they’re very happy to let you in–big big bucks to be had.
They say the ornery lead long lives while the righteous die young. I think this man proves this fact. I don’t give a flying kite how many mountains he has climbed nor expeditions of patients he has lead–the system remains entirely corrupt. The entire notion that it is all about caring for people is 100% bogus. Well, check that:the bogus “professionals” do care for themselves, and they have circled the wagons mightily to protect their ethically corrupt industry and the basically bankrupt notion that they actually perform any good function for society. I invite anyone wishing to study Psychiatry and what it believes to read the “ethical standards” supplied by the American Psychiatric Association, with special note to the contradictions one might find all over the place. Psychiatrists control what the FDA passes as acceptable medicine–that carries so much risk of misery and early death that if there were an unbiased panel looking into them most of them would be BANNED.
I speak from experience too begun in childhood and likely based on the fact of undiagnosed severe medical(ie, REAL) illness, and it is in my opinion a wholly corrupt system from top to bottom, based on nothing but “professional opinion”(which it turns out is based upon nothing other than itself in an endless circular reasoning). I got caught up in the system for economic reasons as a result and have continually and consistently observed the underbelly of the system and believe you me, it is not pleasant and has nothing to do with anyone making ANY attempt to follow correct procedures or legal ones.
The bottom line:happiness is not guaranteed to anyone. Nor is the notion of sanity and lack thereof in a free society validly the sole domain of Psychiatry–yet all the fearmongering has made it so. Especially since the 1960’s, folks have looked to substances of various kinds to find escape from stress and unhappiness to something better. Such is only a temporary reprieve therefrom:life is filled with ups and downs, Psychiatry is filled with notions of itself, and itself has created a great deal of sickness, which has been exported from America to the rest of the world and in addition to War, is a valid reason America has earned mistrust from other cultures which does not take its broad definition of deviance and cause for war to heart as The United States of America does.
And for people who seem to hear voices and admit to same, the remainder of us DO to these people WHAT we do for one simple reason:FEAR. FDR famously stated “The only thing we have to FEAR–is FEAR itself!! Nameless faceless fear….” How true that was. All the Kendra’s laws and all that are passed, and if someone commits a high profile crime of violence the media immediately goes into a frenzy of connecting same with “mental illness”.
Szasz claims that the entire concept of “mental illness” is a myth–and he is a Psychiatrist. The couragous ones –those few who dare–speak out on the topic. The others simply go along because to not go along would be to admit that the entire basis of their careers and possibly their lives is based on a lie. Someone famously said “all men are frauds–only a few will admit it.” Especially applicable to Psychiatry–and no, I’m not a “Scientologist”–never heard the term connected with activism against involuntary commitment until recently, yet glad there is good Hollywood money behind that effort because there is surely good money behind the status quo of abject coercion, repression, and indeed tyranny by Psychiatry. It is not satisfied now with Involuntary INpatient Commitment–it has expanded itself to Involuntary Outpatient Commitment and Involuntary Drugging. The notion is these patients just don’t know what’s good for them and here we are doing them a favor–what they really mean is “we’re protecting society from harm and danger–sort of like the notion that unless we remain in Afghanistan we are then subjecting ourselves to genocide at the hands of the Taliban, Al-Queda, Muslim Terrorists, and in fact must take pre-emptive action to save humanity(not that anyone can ever in any sense prove that happened–but the fear is sufficient for the pre-emptive act to be somehow justified).
Let me say to JM Bowers as well that I am glad you found a positive experience;obviously I don’t know your circumstances but I grew up in a locale where we heard about your institution and to us it was an ongoing joke–glad to hear the joke was based on an untrue stereotype, but such was not the case further upstate in my experience. Nor can I personally imagine that any such institution could possibly be an aid to any healing process–but then again I was thrown into a situation which as a child was completely inappropriate and uncalled for and have been victimized since so I roundly hate the system and I think for good reason.
I went to the World’s Fair too, although I would reflect that the Monsanto display in the rotating predicted “home of the future” has yet to include people who genuinely understand the ruinous coercion of mental health system from personal experience, and that instead of having picture phones, we have Skype etc. I just wish it were truly as the Disney ride suggested, a “small world after all” in that folks really knew the prison mentality and actual prison system in this country is not limited to any single jail or prison but resides also in the mental wards and hospitals–in some ways moreso, because there, the criminal rules of evidence simply don’t apply–the patient is presumed guilty until proven innocent–and under the rules–simply cannot be “proven innocent”. And, by the way, never is proven innocent. E. Fuller Torrey is someone I consider one of the most dangerous individuals in America.
To ChildPsychiatryVictim:
While you made some valid points in your comments there were other comments that I found very disturbing. Opinions that are based on the premise that something is all good or all bad are unrealistic, and some of the things that you say are hurtful to those of us who have been to hell and back and damaging to those of us who work very hard to provide ethical treatment to the people that we serve.
I am a psych nurse with over a decade of experience, as well as a consumer who has been inpatient. Several hospitalizations were voluntary but one was not. I know what it’s like to have the keys, but also have the experience of not having the keys. My opinions are based on the reality of a person who experienced the negative AND positive effects of treatment, as well as someone who has dedicated a large chunk of their life to providing ethical and effective care, as well as advocating for the people who I treat. I don’t appreciate it when someone who has had a bad experience tries to negate everything that is good and all of the people who DO work so hard and genuinely care for people who often times cannot speak for themselves.
What happened to you as a child was traumatizing and unacceptable. It also sounds like it could have been avoided if you had been properly diagnosed with the medical problem that was the cause of the symptoms you had. This still happens far too often. It is getting better, but some people out there haven’t gotten it into their heads that many medical issues cause or present as psychiatric symptoms. Drug interactions and adverse reactions do the same- probably more often than a specific illness, from what I’ve seen.
I agree that involuntary inpatient hospitalization causes so many problems, but would like to add that voluntary inpatient hospitalization also has many devastating effects in many areas of ones life. Once you are inpatient you are labeled “crazy” for life. If your boss finds out, you run the risk of losing your job. No, they cannot supposedly do that, you should be covered under the ADA, but if someone is put under scrutiny they can always find something, because we are human and will make a mistake at some point. All they have to do is wait, and the pressure from trying to be perfect is more than most people can handle.
Your friends and family will see you differently. Even the most informed will aways wonder if your judgement is intact and will question your decisions. If you are happy you are manic, If you are sad or grumpy then you must be depressed. If they don’t agree with you, then you must be psychotic. To sum it up- People who didn’t know you are not going to give you a chance. The people who do know you will see you in a different light and you will have to prove yourself all over again. I would be wrong to say that this is universal. There are many people out there who will respect you for getting help and once you are better will not judge or dismiss you. The ones who don’t can severely limit your quality of life and rob you of your right to succeed based on hard work and intelligence.
I also believe that inpatient psych units do not help a person to recover after a certain point. People should not be inpatient unless there is a specific reason- such as safety. I am talking about the person’s own safety- if someone is suicidal they need to be in an environment where they are monitored. It doesn’t always prevent harm, some will find a way to hurt or kill themselves no matter what, but the vast majority do not. And recovery is not possible if someone is dead. They deserve a chance to be safe and have a right to live through their hell and continue their lives.
The other comments that you made are appalling and many of them them are not true. I will address the ones that are obvious to me.
You say “I speak from experience too begun in childhood and likely based on the fact of undiagnosed severe medical(ie, REAL) illness”
To me that statement implies that psychiatric disorders are not real. Yes, it is not possible to be 100% sure that a diagnosis is totally on target. The human brain is not something that is easily assessed. We are at the beginning of a time that is promising- we are learning new things every day about the way the brain works. Until then, we have to group symptoms under a diagnosis because people who are suffering these symptoms predictably respond to the therapies that are standard practice and based on evidence. Sometimes we can only treat the symptoms because the presentation of the patient doesn’t fit any specific diagnosis. The main issue here is that you are saying that neurochemical and neurobiological disorders do not exist, and are dismissing the distress and devastation that so many people experience. How dare you! If you could live in my head and have the feelings, the experiences which can only be described as hellish, for even 5 min, you would not say that again. You are invalidating the suffering of a large group of people. We do not need your help with that. We deal with people who tell us that our experiences are fake and not worth addressing all the time.
You say “The bottom line:happiness is not guaranteed to anyone. Nor
is the notion of sanity and lack thereof in a free society validly the sole domain of Psychiatry–yet all the fearmongering has made it so.”
Are you implying that because life is not fair and that bad things do happen to every person who lives, it is inappropriate to treat the diseases that cause unhappiness- the ones that are possible to treat? If that is what you believe then you are also saying that your medical problems should not have been addressed. After all we all feel rundown and we all get the flu at some point. How would it make you feel if someone told you that because some people get headaches for example, you do not have the right to be treated for the medical problem that has caused you suffering. It is simply not valid, I’ve had headaches and they went away, so you need to suck it up and wait for you illness to get better. My headache got better. Stop whining and get on with your life already!
“if someone commits a high profile crime of violence the media immediately goes into a frenzy of connecting same with “mental illness”. That is so totally true and is something that angers me. It is probably the main reason that I advocate passionately and do everything that is possible to educate and reduce stigma such as the one that you mention. I have yet to come across a news stories that reads “So and so, who has absolutely no history mental illness and is perfectly sane was arrested today for (name a violent crime, any crime really)”.
Most people who have a psychiatric problem do not engage in violent behavior. Although the risk for violence is increased for some mentally ill people it is the exception and not the norm. And it is not their fault. The first month I worked in psych I was assaulted by a patient and I do not feel she was responsible for her actions, they were caused by her illness. She attacked several staff because she was black and thought that we were members of the KKK and were about to lynch her. If I were in her shoes I would’ve defended myself vigorously, which she did. I would want her on my side if I was ever threatened…. Her strength was admirable and I respected her courage and tenacity even though it hurt like hell when she tackled me.
My dad has a disorder that caused him to have 7 psychotic breaks and he was very delusional but would not hurt a fly. He ran for that reason. I had to pull him out from under a car where he had hidden the first time it happened. He was terrified but never considered violence an option, as sick as he was.
We agree on that. And I think we are on the same page when it comes to the stigma related to mentally ill people and the amount of danger they cause. The stigma related to mental illness, whether it be the risk of violence or inability to function is what causes so many to suffer and sometimes die due to lack of treatment. Many do not get help even when they are aware that they have a disease that needs treatment and have access to help. Society not only judges those who have a history of psych treatment, it can downright ruin them. In CA, a person who has been on an inpatient psych unit, voluntary or not, loses their right to own a firearm. I may be off on the time frame, but I believe that they are deprived of this right for 5 years. Sometimes that saves lives, but a police officer who was a patient at the hospital where I worked lost his career and ultimately this made his life so hard that he did end up committing suicide. If people were able to see the issue clearly this would be a rule that could be individualized and it is probable that he would not have been in that position. It is illegal for me to be a nurse in TX because I have received treatment for a mental illness in the past 5 yrs. So that tells me that if I want to work and I live in TX I should stop treatment. I shudder when I consider the kind of care I would provide if I stopped taking my meds for 5 yrs. Not that I would be alive. I already have a 15% risk of dying by suicide simply because I have bipolar disorder. I am fortunate that my particular form of my illness responds to medication and as long as I take my meds and tell my provider if they aren’t working well I am able to lead a relatively normal life. But only if I keep my mouth shut and don’t disclose anything. There are so many people who would lose everything that matters to them if they asked for help that many people do not get the help that they deserve. There are some very brave people who are in positions of authority who have disclosed without losing their respect and careers, and I am so grateful to them for having the courage to take the chance. I am not that brave. So, I suppose in my own way I am perpetuating that stigma, but I don’t see any other option for myself.
This stigma that makes it impossible for many to seek treatment, leads to involuntary treatment in many cases, because the sicker someone gets the less insight they have and a lot of people who are very sick do not believe that they have a mental illness. Pardon my language, but that just sucks. Big time.
Involuntary outpatient treatment is necessary for some patients. I live in AZ, where they do have court ordered treatment. Since the budget cuts this population has lost many of the resources that they had before- the follow up and loss of case management has allowed some of the court ordered patients to fall through the cracks. In one tragic case (not the recent one) one of my patients did get court ordered but did not recieve the outpatient treatment required by law. He killed his nephews in a brutal manner, something he wouldn’t have done on meds. He was a gentle man who only was violent when he went off his meds, and if he had received his involuntary treatment those boys would be alive and he would not be charged with murder. That is an example that is not representative of the big picture re: the need for court ordered outpatient treatment though. I work with involuntary patients in the position I hold. None are willing to be treated so they are mandated. They would be dead if they weren’t. The order is only good for a year, and a large percentage of the patient that I see on my inpatient unit are there because the year is up and they are no longer required to take their meds. I know of at least 4 patients who lost their case managers due to budget cuts in July and stopped treatment- they have died by suicide- one set themselves on fire.
Involuntary outpatient treatment is a last resort, but it is the only way to keep some people alive. They have the right to be alive and benefit from the treatment that saves their lives, even if they are so ill that they cannot access it.
You say that mental health professionals are in it for the money- at least the ones that you disagree with. If I was in this for the money I would work in the ICU. I make $10/hr less than a critical care medical nurse. I work to earn a living, so I am in it for the money in some respects, but I chose my specialty, before I had psych issues, because I love treating this population and find it tremendously rewarding. The rewards are not as immediate as they are in other specialties, but they are huge, and make me very happy. There is no better feeling than the one I get when I help a patient who has just experienced their first episode of an illness that is severe, chronic, and can take away so much of the future they had planned for themselves. The hope and empowerment that a young person who has just had their first episode of mania or any psychosis can regain is powerful. I help my patients regain this feeling by education and understanding. The things that I teach- mood and symptom charting, things to be aware of that can cause relapse, and that they can live their life the way they planned, with a few modifications, are simple. I also make it a point to get them involved with NAMI- the best resource I have found. I have lived here for just under a year and am not aware of many of the resources in this state, but NAMI covers all of the ground and once a person is hooked up to them I don’t have to worry about lack of help available after they leave the hospital. I am not the only one that is this passionate about providing good ethical care, and I do question authority when it comes to rights and plain old common sense. Yes, I piss off my superiors and peers at times, but I will not stand by and see someones rights violated or know that they are not receiving what they need to live up to their potential. My approaches are tailored to each individual- I don’t presume to know what makes another person tick. An assessment is useless if it doesn’t include the needs and desires of each patient personally. I take pride in the fact that patients have given feedback stating that it made a difference and removed some barriers to treatment. I am currently trying to develop some sort of alliance with a group that can help care for the pets of a patient if they need inpatient services, because many people live for their pets and will not leave them if they aren’t sure that they will be ok while they are away. A lot of the staff think I am being ridiculous, but it’s not that hard to arrange a pet visit either- just need a MD order and someone to bring the pet to the facility. It is so rewarding for me and the patients say that it is the one factor that they worried about most in some cases. And that they will be able to get voluntary treatment if they need it in the future.
There are so many more like me- I feel that I am doing them a disservice in not mentioning their personal accomplishments but that is something that they deserve credit for, and I couldn’t do them justice if I tried.
So don’t ever assume that just because you have had bad experiences with some of the people in my field that every single one of us is selfish and raking in the all this money (what money?) but not caring. You have to care- we get spit on, called names, and have to navigate a complex system that is beyond frustrating to make a difference.
When I read stuff like the misinformation you put in your post I get very angry. How many people will not get help if they believe you?
I just got called into work, and will not be eating out with friends as planned. But I’m only in it for money, right?
Since we’re talking about the benefits of different kinds of treatment, I’d like to put in a word for mental health self-help organizations, like Recovery, International (formerly called Recovery, Incorporated), Emotions anonymous, and Grow. Here’s some advantages of self-help as a mental health resource: 1) it can expand to accommodate an unlimited number of patients without overcrowding; 2) it costs nothing for the taxpayers and little or nothing for the patients (what expenses these organizations have are usually paid for mainly by voluntary contributions at the meetings); and 3) what little research has been done supports the effectivelness of self-help groups in dramatically reducing hospitalizations and symptoms.
My personal knowledge of self-help comes from the fact that I have been helped greatly with my own illness by attending Recovery, In’l meetings and practicing the methods that are taught there. I know many other people who have also benefitted from Recovery. I found out about Recovery from my wife, otherwise I would never have heard of it. I can’t help thinking that there are others who are suffering that could be helped by Recovery, Int’l but who will suffer for the rest of their lives because they never hear of it or are never cncouraged to go to meetings, as I was.
It seems to me it would be worthwhile for a journalist interested in mental health to do an article on self-help organizations. Articles in major newspapers and magazines in the 1950’s were an important factor in the early growth of Recovery, Int’l. Anne Landers often recommended Recovery in her column. But there have been few such articles in recent years. A current article in a newspaper or magazine might help people find resources that could do for them what Recovery, Int’l has done for me. It might also stimulate the kind of research that could identify the capabillities and limitations of the various groups, so that professionals would have the information they need to help people with nervous or mental illness find resources that might benefit them.
I agree, it is really is about recovery in the end. If people are given their power back- the real power of understanding that they are the experts on their own particular illness (because no person or illness is the same) they can do amazing things.
It’s something that you can’t give someone… But education is key, and the knowledge that someone has done it before you, they build a very powerful force- we still have the will to live, and live well. We just need assistance from the right professionals and have to be able to trust our own instincts, once we have dusted ourselves off and claimed a few victories. I won’t lie… just because I know what I need does not make me an easy patient. If I didn’t have a provider who respected my feelings and wishes (I’ve had to back them up with double blind placebo controlled facts at times) I would be giving the credit entirely to someone else. In reality, I feel more like it’s been us, me with the help of a trusted clinician, that have claimed any success. I live it though. Any program that empowers, educates and supports people to tap into their own reserves again needs publicity. For the people who would be helped by it, and to show the people that don’t know, that recovery happens. It just isn’t visible all the time. We are more resilient than anyone thinks, but programs like Recovery show the consumer and in reality thats the person who needs to see it.
I want to add something to what Survivorinaction said. It’s great when people can meet with others who have similar problems, especially when some of them have dealt with those problems successfully. That’s what I would call a “support group.” It’s also great when people are empowered and encouraged to take the initiative.
But the group called “Recovery, Int’l” does all that and also does more. It’s what I would call a “self-help group,” because along with doing what a support group does, it also trains its members in the use of a therapeutic method that they can apply themselves. The method can (and probably should) be applied in cooperation with the person’s own professional therapist or councelor. I only know two such methods (there may of course be others) – the Twelve Steps and the Recovery Method. Groups like Emotions Anonymous use the Twelve Steps, and Grow uses a combination of the Recovery Method with the Twelve Steps.
So I wanted to distinguish “Recovery, Int’l” with a capital “R” from the “recovery” movement with a small “r” (although Recovery can be considered a part of the recovery movement). Recovery first got its original name “Recovery, Inc.” in 1939, long before the recovery movement became popular. It’s been empowering people who suffer from nervous and mental illness since long before the idea of empowerment became popular. It was developed by a psychiatrist, Dr. Abraham Low, in such a way as to provide its members not only with encouragement to take their problems into their own hands, but also the tools to do that with.
I was never hospitalized for mental illness, but I suffered for much of my life with severe and painful self-consciousness and social anxiety. I benefitted a great deal from psychotherapy, but reached what my psychiatrist called a “plateau” where I was better but far from cured. I really think I would have suffered the rest of my life if it hadn’t been for my practice of the Recovery, Int’l method.
I want to clarify something about Recovery’s relationship to professionals, by quoting from its leader’s guide:
“Recovery, Int’l does not replace the psychiatrist, physician or other professional. Recovery always expects members to follow the authority of their professionals regarding treatment and/or medication.
In Recovery we do not diagnose, counsel, treat or advise. When members ask questions concerning the nature of their symptoms they are advised to consult their medical professional. It is not necessary for a member’s professional to recommend that he attend Recovery, but if his professional objects to his attendance the member is reminded that he is making a self-diagnosis if he continues to attend.”
We take those requirements very seriously.
I have decided to add a new comment, after thoughtful deliberation of this particular fact. It is completely unrelated to the above. As a working semi professional of this community in Salem, Oregon, I have found that possibly one of the most evil and probably cruelist thing that some one can do to someone else is to keep a person from people they love, by involving the law. It is not only the most painful crissis that I have encountered and will never forgive, but the most evil. To those who have developped a strong fatherly caring or close connecton to someone in their lives, it could be crucial to your life, or possibly run the pathway towards harming oneself, or at least in someway and though we try hard not to think of it, suicide. For those who have lost their families or someone else in their lives that equal a means of survival, it is trying to begin again, and despite all the other things , yes, I will always love you father in my life, for giving me that strength and determination, even though there are those that are less to forgive, who place me in such sad and insensitive situations. Needless to say there are words and thoughts for those who place bad, evil wishes on people upon termination, and I quote “I know that you have alot of friends here and they are friends with you, however, if you come here, I will call….. So it isnt so much who is watching whom, but what comes next. I have realized that evil befalls those who live in it, and will that on others.
Hospitals, by the very nature and motivation of the staff for ethical and caring supportive treatment can be an incentive to recovery. Individuals who are very ill & live on hospital grounds for long periods are definitley happier in an understanding environment than in a neighborhood whose residents fear strangeness or ecentricity.
Where I worked in the mental health field for 36yrs with adolescents, Veterans, MRDD, Schizophrenics, Bi-Polar, Schizoaffective, personality disorders including Borderline personalites, Forensic, and Geriatric with MI what we had in the late 90’s at our institution was an amazing integrated therapeutic environment with numerous successes. It was also home to many who had no other home or those who desired to stay by any means because it was the best place they’d ever been including their own family home.
Everything was there that could be found in regular communities, movies, recreation, day trips, camping trips, employment, all types of educational classes and therapeutic programs and counseling. It was a society and a community in some ways like you’d find on a college campus. In the late 90’s with all the advances made in understanding the mentally ill, medication, symptomologies of all the major brain illnesses, …. each decade brought increased understanding and improved ethical & humane treatments… we were finally getting it right and finetuning it when De-Institutionalization became THE thing to do and THAT has been a phenominal failure.
The construction of the smaller nearby hospital that replaced it, while state-of-the-art & meeting JACHAO, HIPPA and OFLAC standards, was to house 150 MI in crisis for stabilization and then back out into the courts & community. In reality over 50% of the population now are long term Forensic and the hospital is overbeded. The courts in WV state that if patient is NGRMI then they will be sent to William R. Sharpe,Jr or Mildred Bateman Hopsitals often for the maximum time allowed (10-30 years in some cases) whereas if they were not NGRMI and were sentenced to prison, there term of incarceration would be much less.
Meanwhile those patients truly in a psychiatric crises are put in a holding pattern in community medical hospitals throughout the state that have small wings for MI while they wait for admission to Sharpe. The cost of holding these patients of course is billed to the Mental Health Hospital and those expenses mount exponentially as long as Sharpe or Bateman remain overbedded. SO they triage, who can we release as quick as possible, are there any group or nursing homes or AFC homes that can take them… without proper care, in house treatment or community follow-up, they always come back.Once they leave the hospital, they are no longer followed up… that becomes the community mental Health centers responsibility and they are notoriously understaffed, overworked and underfunded.
When I retired the primary mindset of our hospital seemed to be cut costs, cut supply orders,eliminate some programs, streamline, finetune ‘dumb down’ job positions or do not fill vacancies, don’t give raises, etc.. If they can hire someone without the needed education for a position at a lower salary than someone trained… let’s change the job position and post it as something else…. This is also a concern & my understanding, the money saved or rather not used is sent back to the state budget office, the CEO & CFO have stars in their crown for saving the state some money & that money is allocated elsewhere but hey, if they didn’t need that much money well, will give them less next year… see how we legislators save taxpayers money?
Yes, emphatically something needs to change, we need to change the laws. we need long-term treatment facilities to provide in-house care, a supportive therapeutic environment with training, education and therapy provided by well-trained, educated and empathetic staff! We should not have a revolving door, hire imperfect and undertrained staff, we need to not ignore the homeless MI living hand to mouth in the street lost to the voices in their head. We need to give them the opportunity to live with respect and dignity and to find a rewarding productive outlet so that they contribute to socieity Asylums were established following Dorothea Dix rally to get our Mentally Ill out of prisons, jails and locked cellars into a setting for treatment. Each decades discoveries and understanding altered environments found in these asylums but always there was progress. Now we have gone full circle, the MI are found in jails, on the streets and in the gutters…. can’t anyone see what is wrong with this picture?
Concerned: As someone first hospitalized with mental illness in 1964, I want to thank you for writting and posting the above. Now the question is how do we get someone important to read such things and to do something about the situation?
I want to point out that there are existing self-help organizations that can help people deal with the stresses of returning to their community after being released from the hospital. The main ones I know of are Recovery, Int’l, Emotions Anonymous, and Grow. They are free, can be used regardless of where a person is living, and can expand indefinitely to accommodate any number of clients. I’m most familiar with Recovery, and it has a proven track record of helping people maintain their mental health, and avoid relapses and rehospitalizations. It also provides strong encouragement to those who attend its meetings to follow their doctor’s recommendations. If hospitals were to begin cooperating with these self-help organizations, getting clients started in them as they are getting ready to be discharged, it might greatly improve the situation that Concerned is talking about. I think involvement with these self-help organizations can reinforce the effect of whatever other reforms are carried out, in housing, aftercare, and so on.
I think all mental hospitals should only be available to forensic, except when in exceptional need. Many people who are well could become ill from others around them who have more severe illnesses, but more importantly it becomes our responsibilty to help as a community those who are in need and or otherwise left up to the state hospitals.
Where is the quiz? I passed mostly all of the questions