Is our current emphasis on RECOVERY actually hurting the sickest among us?
A Canadian advocate argues that it is.
“Recovery proponents support a consumer-driven, psychosocial holistic model that promotes hope, self-determination, empowerment, respect, responsibility and spiritual healing to enable people living with mental health problems and illnesses to lead meaningful and productive lives whether or not they are symptom-free. They dismiss the essential role of medications for individuals who are severely disabled by their illness and incapable of managing their own recovery.”
Buchanan warns that many proponents of the recovery model reject the “biomedical model of mental illness,” which identifies serious mental illness as being biological and genetic in origin. Instead, they promote a feel-good philosophy that anyone and everyone can recover without medication if they learn to see their mental illness merely as a sign that they are different, not necessarily physically ill.
“Consumer survivors believe that they are likely to achieve more successful outcomes if they participate in their own treatment decisions. The majority reject the emphasis of the biomedical model of the mental illness, involuntary commitment and coercive treatments. For them, recovery represents a movement away from pathology, illness and symptoms to health, strengths and wellness. They also believe that freedom of choice for the patient is recognized as a basic right. The patient, not the physician, is considered the expert when it comes to treatment options. Many believe that there is no need for a clinical evaluation and evidence-based medical treatment.”
Continuing, she notes:
“Causes and classification of mental illnesses are considered irrelevant since social factors are believed to be the main contributors to the course of the disease and the labeling of mental illnesses is offensive and discriminatory….a key objective of the recovery movement is to help people overcome the negative impact of a diagnosis of mental illness by normalizing mental illness to reduce stigma… Schizophrenia has been described merely as a “mental health difficulty” rather than a complex brain disease that requires pharmacological intervention as well as specialized supports and services…
Today, there is more reason than ever before to believe in the possibility of wellness for people diagnosed with psychotic disorders such as schizophrenia and bipolar disorder. The introduction of more effective and safer antipsychotic agents has greatly improved the promise of recovery for these individuals. Drug therapy continues to be the most effective means of treating psychotic symptoms of mental illness and preventing relapses in the future.
However, the mental health community continues to be divided. Not everyone considers the appropriate use of pharmacological interventions as a crucial aspect of treatment for people diagnosed with severe mental illnesses. Rather than embracing the advances in neuroscience research along with new and innovative medications with fewer adverse side effects, the recovery model reflects many of the anti-psychiatry sentiments of the 1960s that questioned the fundamental assumptions and practices of psychiatry as well as the therapeutic benefit of psychiatric medications…
“The recovery model may be appropriate for individuals with mild to moderate mental health problems – 17 percent of the (MI) population – who can take responsibility for their actions. However, the recovery model does not accommodate the needs of individuals with severe mental illness – three percent of the population – who may lack insight into their illness and are unable to make appropriate treatment choices.”
Is the recovery movement, which is becoming the cornerstone of our mental health system and is now spreading into Canada and other countries, being promoted by anti-psychiatry and holistic healers who are bamboozling the public? Is it, by its nature, anti the medical model?
I’d like to hear your opinion.
There is much about the recovery movement that I support. I believe it is important for us to provide community based services such as housing, jobs, and clubhouses that are not necessarily linked to the medical model. I believe that building self-esteem, fighting stigma, and empowerment can help speed recovery. I’m proud that my son is a peer to peer counselor. His work matters.
But I also believe that mental illnesses are real and are biologically and genetically based, even though we lack the scientific knowledge to adequately explain the cause of them. I know from my experiences with my son that medications are essential for his recovery. I know there are people who are severely ill who are convinced that there is nothing wrong with them. Many of them are dying on our streets. Others are in our jails and prisons for crimes that were committed because of their illnesses. I’ve documented that in my book. Because of this, I believe that involuntary commitment is necessary, although I also see it as a sign of our failure to help someone who is sick before we must intervene. I believe we need better laws to protect persons who are sick but also get them help before they become dangerous.
I believe that persons who are anti-medication are as narrow-minded as persons who believe that all we have to do is stick a pill into a person’s mouth to heal them. One size doesn’t fit all. Healing the mind, I believe, also requires offering HOPE and necessities such as housing.
Today’s Washington Post contains a story about Michael English, a promising young man who hanged himself in a District of Columbia jail cell where he was awaiting a psychiatric review after stabbing a friend.
“Michael English’s parents repeatedly asked authorities for help with their son, at times seeking to protect family members from him. Even English’s probation officer told a court last year: “This officer is extremely concerned about Mr. English’s well-being, as well as the safety of the community.”
His mother, Margaret English, said her son’s death is an example of how difficult it can be to help someone with a pronounced mental illness, even when family members and criminal-justice workers know the person is a danger to society and himself.”
Compromise is not a popular word right now in Washington. It is a tragedy that neither extreme in the ongoing battles between the anti-psychiatry forces and those at the other end of the spectrum cannot find enough common ground for us to create a system that meets the individual needs of a person such as Michael English.