A mental health service user's perspective on the 'Recovery Model'

I would certainly not describe myself as 'recovered', although that is a term and a concept developed by service users as a far back as 1995. It was introduced as a concept to challenge those who would set us apart from others, denigrate us in society. It was an attempt we made to be better understood and accepted.

The response to the concept of 'recovery' has been mixed. It is now adopted as the new model in mental health, no reference or credibility has been given to the service users like myself who initiated the whole concept through giving talks on mental illness around the country, taking questions and answers and so on. Framing mental illness as an understandable phenomenon to everyone. Some of my first thoughts and writings on the subject are in documents archived by the National Perception Forum.

That reality and history has been obscured and, under the recovery model, we are treated as if we are stupid and have to be pushed and cajoled into work as part of our 'recovery'. It doesn't seem to occur to those administering 'recovery' that we do actually live in the community now, so many of us know where and how to find jobs. Many of us have already tried with varying degrees of success to work, we do not need to be pushed around.

The ultimate aim in the 'recovery model' is to discharge us from mental health services and the mental health remit altogether, the 'logic' being that we have 'recovered'. That is dubious and lacks understanding of mental illness, emotional distress and the ensuing disability.

After a true breakdown, we do not ever really recover, as I have not. It still remains that I would dearly like to have a close relationshiop with another person, but that ( which many people may take for granted) is a near impossibility for me. I cannot watch TV as it either bores me to distraction, or I have uncontrollable fits of crying. Emotionally, I cannot cope with being around children. I cannot go out easily therefore I stay in on my own. I cannot go out at night, and have a poor understanding of money. I have auditory, visual and tactile hallucinations, panic attacks, night terrors, panic attacks at night and I self harm, the scars are there for all to see. Then there are permanent physical health problems from the long term use of psychotropic drugs including mood stabilisers, problems such as diabetes, oedema, weight gain, muscle stiffness which leads to a sedentary lifestyle and exacerbates problems.

The 'Recovery Model' now adopted is highly patronising, it assumes we know nothing and that there is nothing wrong with us, therefore there is no duty of care, but we do still have to take medication.

What I would like to know, now that I have expressed a little of what it is like from a service users perspective, is how do the staff feel about constantly making us do their work for them? I will give an example ( although there are plenty of examples like this), it will hopefully make it clear; groups are set up in the community to help mental patients, like a 'walk and talk' group, or a 'walking group', we are then told that we will then (after a period of time) have to run it ourselves. It is because it is an 'aid' to our 'recovery', and we should not get dependant on services. Is it such a terrrible sin to depend on others? ( and are we very bad children if we let this happen?). According to the recovery model, it should not be, we should not be dependent on anyone for anything. Are we not human then? Surely as human beings it is acknowledged that we are social beings and not solitary, does this not apply to menatally ill people too? How come we as mental health service users should have nothing, no support, no day centre, no care ... only medication? Told to do voluntary work? This is not 'recovery', it is more like 'exploitation'.

Treatment and care has come full circle to what was there before, but now, there is actually much less support.

This is known as 'Ego Documentation', here is my up to date version.

Throughout my life, I have felt on the one hand a great love for the world, for people and animals, but also a deep concern. An example of this is how I feared nuclear holocaust in the 1980's; to the extent that I was inconsolable for a long time, my sister managed to talk me round, eventually, when I finally opened up to her and said what was wrong.

Around this time too, I made a decision that I would probably not bring any children of my own into the world as I felt that life was already hard for me and would be getting worse, I did not want them to suffer as I did. I was also feeling that I had no choice but to become active in politics in order to stop the attacks on our livelihoods, ( this was around the time of the Miner's strike; Margaret Thatcher's heyday). It was a fear I had ( maybe irrational, maybe not), that if I became a target because of my views, I did not want to have children who might be used by others as a way of getting to me, forcing me to cease political activism.

As I got more deeply involved in politics, I became bent on being part of destroying the existing system ( capitalism) and that was it. I was singular in this aim, I did realise that it might be a little over the top, but I rationalised this by thinking and believing it was my role in life, that I was a bit like Kali ( the dark destroyer from Hinduism) or that I would emanate her. Such single mindedness may have also been compensation too. An escape and outlet for the unhappy and failed close relationships I experienced that seemed to feature in my life.

Another element was that I felt responsible for many people's spiritual or emotional deaths. On tackling other peoples political beliefs, I would strip them of their own belief systems, attempting to bring forth an understanding of the world as a class system. Any defence of the system was met with contempt and derision from me, I made it clear that a position of defending the system was unacceptable to me. I was highly destructive in many respects.

There were so many issues, political and philosophical that I was unfamiliar with and may not have fully appreciated or understood, but I always did my best to understand theoretical concepts and historical events. I was though, developing a vicious tongue and a heavy burden, in the sense that I felt like all the world's problems were on my shoulder.

So this was me; unhappiness and failed/ failing relationships, anger at the injustice in the world ( which was enhanced by being a political activist, by being more and more exposed to examples of cases of injustice), a combination of emotions that ran so deep within me and it could not go on, so I flipped out and had a nervous breakdown, or, a spiritual death.

This experience made me extremely flat ( zombie like even) and it did feel like I was in Hell. I still had a sense of humour and a sense of love for others and for humanity. Although it was hard to hang on to those things at times, I did manage it and I survived (to tell the tale).

Society vs mental illness

It is hard for people who have never experienced madness to understand what is going on, what it is all about and indeed how best to help that person.

First of all it is something that requires a lot of intervention, and specialist intervention too. We have been cast out in the past, but you cannot wish us away; not accept any responsibility for being part of the society that caused the problems in the first place. It could even amount to individual responsibility for causing emotional and personal trauma in another. If someone suffers emotionally in tribal societies for example, the whole tribe gets together to discuss the problems, they sit down and the first question they ask is what have we done to have caused distress for this person. Rather than cast us out, vilify us, reject us, why not take a good look at yourselves and also look at what we have endured through living in this unbalanced and degrading world we live in?

The sort of intervention necessary when someone is emotionally distraught and they have no knowledge themselves that they suffer from bouts of madness, is to get them to a safe place, somewhere away from the environment where they are suffering unbearably in. Then yes, there may well be a role for some theraputic medication, but in no way should this be the be all and end all of treatment. As it has been discovered already, talking is of paramount importance and time and effort should be put into this activity. Education is pivitol too, teaching people about what the symptoms of madness are, help that person accept it. Then there is art and craft; providing an outlet for the upset and trauma and a medium for communication ( something that I will be going into more depth with in a future post).

There is much talk about 'recovery' and I want to be absolutely clear about this because it was not a term invented by profesionals although they were quick to jump on the bandwagon with all that it mean't to them. For profesionals, mainly senior management it mean't effectively ceasing all treatment and resources for the mentaly ill, a denial even that they had anything that was different about them, apparently we are no different to anyone else now. Funny that, how come we feel, act and behave differently then? Service users invented the term 'recovery', it was a way they had come to understand their difficulties, and the transition they had made from sanity to madness, a way they could hook onto their past and recover an identity that would not render them as useless, second class citizens, written off of and out of society completely.

We wanted to be part of mainstream life ( who doesn't) but of course we are different, just as deaf people are deaf, blind people are blind, learning disabled have a learning disability, we are mentally ill. Once you have crossed that line into insanity, most of us will experience it again and for those who only have it once ( it is very rare) they never ever forget it although in order to fit into to mainstream society they expertly cover it up, however that memory and the pain will never leave.

Madness, or mental illness is not about loss of or lack of intelligence, it has nothing to do with intelligence, there are many people with learning difficulties who also suffer with insanity due to the frustrations they have. There are also highly intelligent people who suffer it. Insanity is not about intelligence, it is an emotional disorder, emotional deficit or emotional over load. Being broken emotionally is life changing and very serious, in fact none of us ever recovers as such, none of us ever can become 'normal' again, that is a person who has no knowledge of what insanity is like. Once broken, or insane, you are a changed person, permanently changed and more vulnerable. A vulnerability that stays with you for life.

I know it is very hard for the mentally ill to accept that they are vulnerable as sometimes they feel they have extra strength and are opposite to the perception of vulnerable, they feel themselves to be strong. Now of course we are strong, but we are also vulnerable. Every breakdown is unique and every persons experience of madness is unique to them and on each occasion. Therefore I thought the best way to attempt to explain how we are vulnerable is to describe it in myself.

It is not easy, but here goes ... I am highly suspicious of others, we could go into what caused this or even just accept that it might be something I was born with; a personality trait if you like. Anyhow I am also inquisitive, sensitive and intelligent and they might be good traits to have, but couple that with a highly suspicious nature and you get explosions, outbursts and misunderstandings. Medication plays its part in subdugation, but the state never fully leaves me. It renders me vulnerable in many ways, but one is that this combination of emotions in extreme tips over to paranoia and I am and become a danger to others. I have never physically attacked anyone ever, but others can sense my unease and it requires intervention from others in order for the pain I am in to be alleviated. I also get very depressed because of this and because I am very sensitive and at times when the depression is accute I am a danger to myself.

There are many people with similar problems, and the way we are, the emotional problems we endure are undoutely exacerbated by the society we live in. The high levels of competiton for example for jobs, housing, qualifications and so on all raise our emotional deficit or overload and make it harder for us to cope, but as I have said before and written about many times over, although we need others perhaps more than people without emotional problems need others, we do also have much to offer life, and if others and society can see and accept what we have to offer, rather than just see us as a problem, it would be for the good of all. Accepting us as we are into mainstream life with all our needs and vulnerabilites would have a very positive effect for us all, for society and for human kind.

Sophie in a Straitjacket

Have you ever felt guilty for just being born? For having a roof over your head? Guilty for having community resources, guilty for having ideas, emotions, ambition?

Due to a mental health disability, I am made to feel like I have no rights. No right to say what my needs are, let alone have any of them met.

I have no support with living in my flat where I am and feel isolated.

Why? Can anyone tell me? Why am I being made to feel like a criminal for just being me and living my life to the best of my ability given the circumstances in which I am in?

I like to be creative, so why am made to feel that I ought to get a proper job or do more work than I already do and am capable of?

Its hard to put your finger on what is actually happening to me and people like me in the world today. It can be summed up though as feeling like you're being placed in a straitjacket. Like we should not have any entitlement to do anything at all, just pushed around and gawped at, tormented even.

Our very existence as people with special needs is being denied, we are being denied the right to be ourselves. Expected to be like some fictitious other that exists in the imaginations of high ranking officials and actually bears no resemblance to reality; the reality of who and what we are.

Disability and resulting human compensation for it.

The exhibition is now in its third week and we were wondering whether two weeks would have been enough and is it dead on its feet now. I thought so, but the afternoon at the exhibition proved me so wrong. There was a steady stream of visitors all afternoon and someone had made their way from Maidstone to come to it especially (and its a hidden away venue - not easy to find) so that was particularly heartening, and we spent a good three quatres of an hour talking too which was very nice. The guest from Maidstone was a special treat for myself as curator and for the exhibition itself. If she is reading this blog, I must encourage her to go for it, do an exhibition with the photography for example, it is so worthwhile and can lead on to other things.

There was also a very nice and posh middle class and middle aged lady who I got talking to at the exhibition. She told me that in life there are some things that should be kept to yourself unless you really trusted someone. My answer ( and I presumed she meant our openness regarding our mental health capacity) was that sometimes someone had to make the first move and also as well as that, the particular experiences that we ( the exhibitors ) have had, has been so life changing and significant that it rendered us unable to keep it to our self.

Then it was how sorry she was for us incapables, or words to that effect, to which I bought her attention to the fact that anyone with any disability or finds themselves compromised in some faculty usually not only learns to live with it, but also compensates for it. I gave the example of how blind people might have enhanced hearing facilities or any other such combination to which she found herself agreeing.

So for us, what is our compensation, this nice lady said she thought that we must have 'psychic' abilities as compensation. Now I don't strictly disagree, its just that I think everyone has psychic abilities and it is nothing special, what I said to her was that our compensation lies in our healing abilities, our art, our ability to entertain etc.

This again goes back to our show piece Vincent, his true life story seems to be covered up somewhat by those who do not want to hear the facts about his mental illnesses and his incarceration in mental hospitals.

Perhaps they just want us to not have any talents, because we can't do a regular nine to five, we have to be patronised, written off, medicated to the land of nod, isolated and forgotten about. Of course our brothers and sisters won't allow this to happen and neither will many of us, but it can be extraordinarily difficult at times, sadly many do give up and mortality rates for mental health service users can be higher than the general population. Although it is not always the case, but I have had that many friends die by taking their own lives, and die from general ill health and neglect, it does sadly ring true.

Charity, Creativity and Mental Health

Sunset with boxes by Chris Barchard


Something that I didn't expect from the Exhibition was the amount of interest people would have in the charity, 'the National Perceptions Forum', a mental health charity sponsoring the event.

A few years ago we produced a DVD about ourselves, our history, how we formed, who we are and what we are about. We still had quite a few in the office cupboard so I took some to display at the exhibition, they went like hot cakes on the opening night and everyday since then, so too has our magazine 'Perceptions'. So today the office administrator came down from London to replenish our stocks.

It rings true for so many people that mental health problems and emotional instability go together with creativity, real creativity that is. Not learning a few tricks to go on huge canvases to make a financial killing, no, our work, the work shown on the exhibition by the six is stuff that comes from our hearts. We put everything from ourselves into it and we are not ashamed to do this, we don't hold back mainly because we have a need to express our wrought emotions somehow.

Suffering with emotional problems can mean for many of us that we have consequential social and relationship problems. Statistically I read somewhere that people with a diagnosis of a serious mental health problem are less likely to be able to manage long term relationships and among the people I know it does see to be the case.

Van Gogh really is a case in point and our lovely showpiece 'Vincent in the Yellow Room' illustrates this beautifully. Vincent did his best work in a mental institution and he never sold one piece of his work in his lifetime preferring instead to hang on to them maybe? His life was plagued by inappropriate relationships and emotional instability but the work he produced was exquisite. I have been compared to Van Gogh's story by my close friends and family on a few occasions something that I find both alarming and complimentary.

The unexpected upshot of this exhibition is an understanding of what it means to have mental health problems, the exhibition shows what we *can* do and hopefully people can see the love that is in our hearts. Something that we may not be able to show to people in any other way other than with clay, canvas and other artistic mediums.




Vincent in the Yellow Room by Maureen Oliver

Picture at The Exhibition

Here is one of my favorite pictures currently being shown at the Art Exhibition I am busy organising called 'Art of Recovery' at the Nucleus Arts Center.

It is entitled 'War' and is by Chris Barchard.

The reason why I love this picture so much is because it speaks volumes about the injustice of War. The form at the top right hand corner is rounded and to me looks like it has a heart in its center and is shedding a tear as the aggressive and angular forms making pointed, incessant scheming and vicious attack. It reminds me of Picasso's Guernica.