A young lady once shared her outpatient experiences with me. She said that, even though she’s been discharged from inpatient hospitalization, she still feels imprisoned in her mind. She told me that most of her experiences with outpatient services have focused solely on her being a mental health patient and nothing more. She said, “It makes me feel suicidal to know that all I can be in life is a patient.”
Her transparency raised my awareness of a nationwide problem.
Dan Fisher, a consultant at the National Empowerment Center and one of the few psychiatrists in the country who openly discuss his battles with mental illness, says it best: “medications and psychiatric treatment provide the foundation for your house, but then you have to build your house.”
Borrowing Dan’s analogy, I believe there is not enough dialogue on “building one’s house.” In other words, I believe providers need to do a better job of helping people build fulfilling lives. And they can do this by using recovery-based approaches.
Helping People Reclaim Their Lives
When it comes to the current state of mental health services, I envision a jar in which mental health patients have been given certain tools, but service providers have put a lid on it. The idea that people with mental illness can have a life beyond the patient role is kept outside the jar and is inaccessible —which can have detrimental psychological costs on how people view themselves.
As people engage in psychiatric services, both inpatient and outpatient, they are told to be compliant with their medications and to see their social workers regularly. Many have been assigned the “patient role” repeatedly over the years. But at a certain point, we have to take the lid off the jar and ask the people we serve “How do you want to reclaim your life again?” Then, we need to guide them on that journey.
What Does a Recovery-Based Approach Look Like?
Recovery-based approaches challenge people with mental illness to see themselves as more than just a “walking, talking chemical imbalance.” Although recovery requires awareness of one’s mental health conditions, those affected do not wish to define themselves by their diagnoses. They hope to explore other roles and identities, beyond being “the patient.” The recovery-based approach includes employment, meaningful relationships, hobbies, family, purpose and commitment to community.
Recovery-based approaches have a language that stands apart from more traditional services. For example, one might categorically reject the phrase, “I’m John, and I’m a schizophrenic.” Rather, we can explore the multi-faceted approach, “My name is John, and I have schizophrenia, but I’m also a spouse, an artist and I enjoy writing.” Similar to physical illnesses, we hear people say, “I have Lupus,” not “I am a Lupus.” Our language will reflect whether mental illness is merely a part of who we are or the totality of who we are. If we believe the total sum of who we are is our mental illness, how can we fathom getting our lives back?
Providers can be helpful by not defining mental health recovery by solely the reduction of symptoms. Naturally, clinicians focus on symptom management because, in theory, symptom relief leads to a better quality of life. But real recovery is more complex. Indeed, one can find relief and be stabilized on their medications, but not be in recovery. A person may not be depressed or experiencing psychosis, but they may stare at the walls of their apartment and refrain from engaging in life.
Perhaps they have found relief — but they have not found what makes their life fulfilling. Providers can assist by encouraging their clients to take (healthy, measured) risks. These could include exploring different roles in the community, cultivating new relationships, helping mental health peers find meaning and purpose through enriching activity and unearthing new interests that resonate. This requires thoughtful discussion and trust between the person and provider — and it is not an immediate process. But symptom management cannot be the only measuring stick by which we gauge a person’s recovery.
It’s become obvious there’s a primal scream from mental health peers who reject the notion of being trapped by the patient role and being solely defined by their mental illness. As the young lady taught me, such modes of thought are unhealthy for our recovery. Human beings are multi-faceted gems and should be treated as such.
Tony Foster has been Executive Director of Amarillo Mental Health Consumers (AAMHC) for nine years. AAMHC is a peer-driven activity center focused on recovery from mental illness. His responsibilities include advocacy, peer mentoring, wellness programming, facilitating peer-led groups and instructing GED classes.Tony’s local and state advocacy efforts are focused on increasing funding for the mental health system, challenging mental health consumer stereotypes and building a progressive mental health provider system that includes peer support models. He is an accomplished author with peer-reviewed mental health and math articles published in Europe’s Journal of Psychology and Cambridge University’s Mathematical Gazette.