On Recovery-Oriented Practice
Today I wish to write to all those affected by serious mental illness. To all those diagnosed with schizophrenia or bipolar or anorexia are any one of the serious mental illnesses categorised in the latest Diagnostic Statistical Manual. To all those with a friend or loved one who have been diagnosed; who have been told they have a permanent psychiatric scar; that they may not get better; that the horizons of their life, of hope, may be shrinking.
I wish to write to you with a message of hope.
A little background first though…
You may or may not have heard of the patient’s rights movement, of reactions against aspects of psychiatry, of “mad pride”. These movements and ideas have developed from the 1970s, although their roots go all the way back to reformers of asylums – where those suffering were isolated, restrained, controlled and left to live their life in imposed institutional pain until their death.
As a result of these movements and ideas there has developed a thing call Recovery-Oriented Practice (or ROP).
It is this practice that I wish to describe to you today and which, I anticipate, may give hope to the person diagnosed with serious mental illness, their carers, families and friends.
ROP begins with a negation. It negates the conservative practice of psychiatry. According to this practice, the experience of self, identity and fulfillment pivots around the act and outcomes of diagnosis. Diagnosis is a vital part of the process of psychiatric treatment (and I do not wish to be labelled as anti-psychiatric). But after diagnosis typically comes medication. The diagnosed person must accept their diagnosis – and with it, a limited state of being. Their diagnosis is a negative, a boundary, a fence.
ROP says there is more to life than a diagnosis. It is true that people suffer severe psychological or psychiatric distress, and that diagnosis may in some cases be a useful tool to determine treatment. But there is so much more to your personality than the diagnosis. You are an individual with values, hopes and dreams. You are a person who is seeking fulfillment. Who may benefit from employment or training or education. You are not “sick”, in a permanent sense, but on a journey that may have its ups and downs, but in which you are moving forward.
Indeed, ROP practices with optimism; it seeks for you to define and achieve your goals. It focuses on becoming a productive and accepted part of the wider community.
ROP is typically practised by social workers and support workers. But there is no reason for its principles not to migrate to mental health nursing; even psychology and psychiatry.
I myself can testify to Recovery-Oriented Practice. My own recovery journey from the diagnosis of schizophrenia towards employment, fulfillment, joy in life has been a positive one, and I have discovered there can be so much more to life than the diagnosis of a permanent illness whose projected outcome is so often terribly bleak.
So, if you are interested in ROP I encourage you to do some research on the net. Get in contact with mental health service providers who have embraced ROP. Try to re-frame your own thinking around illness into a positive, holistic view rather than accept the permanency of negative diagnosis. And, I urge you, bring up Recovery and its practice with your own GP, your own psychologist, your own psychiatrist.
As with all movements, this one will succeed with one small act at a time.
Dr. Richard Schweizer, Policy Officer at One Door Mental Health richard.schweizer@onedoor.org.au.
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