by Alison Carroll, LCSW-R, VP of Strategic Initiatives
For many, the diagnosis of a mental health condition has been the end of dreams, the end of a future, the end of hope.
Historically, those with more-serious mental health conditions were relegated to a lifetime in asylums or other psychiatric facilities. Even when they lived in the community, they were siloed in communal living situations and daily treatment programs. They were told they could never live independently, work, have a family. The mental health field had no hopes of recovery for this population. Perpetual illness was the bleak expectation, and this lack of hope transferred to those we served.
Today, new philosophies focus on strengths and abilities, rather than on weaknesses and disabilities. And new medications enable people to carry out their dreams, with minimal interference from symptoms. We recognize the importance of work and social factors in recovery. And we embrace the contributions of peers—people whose similar mental health conditions help them relate to and engage others through shared experience. People who are diagnosed with mental health conditions can live fulfilling and productive lives and become valued and contributing members of society.
What has yet to change is the enduring stigma attached to mental health conditions. But progressive practitioners are changing the conversation and looking at mental health as a presence of wellness rather than an absence of illness. It’s very much the “glass half empty or half full” paradigm. As part of its core values, PEOPLe, Inc., a local peer-run organization, says that recovery from mental health issues and trauma is not merely possible, but is “the expectation.” And yet the stigma persists and is often a deterrent to seeking help.
Research shows that the sooner treatment and intervention begin, the better the prognosis for recovery, community participation and positive socioeconomic outcomes. If you were showing signs of a serious physical health condition, you probably wouldn’t wait until you were severely ill before you sought medical intervention. And yet, with mental health, people often don’t seek help until they’ve threatened or attempted suicide; alienated their families, employers and friends; or are threatened with expulsion from school. We’re witnessing epic rates of suicide, homelessness, substance use and involvement in the criminal justice system.
In a field where a diagnosis has often resulted in blame, and a loss of rights, dignity and hope, it’s no wonder that many people avoid seeking treatment until the situation reaches a crisis level. Denial is prevalent, and understandably so. Why would anyone seek help for a condition for which there is ostensibly no hope, no chance of recovery? But there is hope, and there is recovery.
Recovery involves more than just a reduction of symptoms, and although symptoms may remain or recur, people can learn to live with them. Treatment programs must view recovery as a highly individualized process, occurring with the guidance of a practitioner who believes in and stands by the person and imparts hope from the very first encounter.
Unfortunately, people are often unaware of mental health resources in their community until they need them. In such a time of crisis, how do you differentiate between a program that believes in recovery and one that’s mired in the old ways of thinking?
Mental health programs that embrace hope and recovery are evident upon the first encounter. Is the space clean, appealing and welcoming? Does everyone there treat you kindly and respectfully? Are you a true partner in the treatment and recovery process? Are the goals you set important to you, and do they reflect your hopes and dreams for your future? Are you offered an informed choice of treatment options? Is your relationship with your practitioner based on trust? Are people ever discharged, or do they languish endlessly in treatment? Is your success measured in terms of outcomes important to you rather than to the program?
There are many new service models and programs in the mental health field today that embrace these values. There are peer-run programs that offer crisis and hospital diversion, and programs for young adults experiencing a first episode of psychosis. The Personalized Recovery Oriented Services (PROS) program was based on the principles of recovery and rehabilitation and offers vocational services along with an array of other services.
Regardless of which treatment program or practitioner you choose, you have as much right to interview as to be interviewed. You are the consumer of services, and the treatment should be centered around you and your distinct needs and wishes.
It all starts with hope. Hope drives recovery, just as it drives life.