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Implementing Recovery-based Care: Tangible Guidance for SMHAs - page 35 / 44





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NASMHPD/NTAC e-Report on Recovery – Fall 2004

based practice movement. I emphasize narrowly defined if you actually look at the evidence. RAND Corporation did a review and found one best practice—ACT teams. I don’t think most ACT teams are recovery-oriented, they are maintenance-oriented, although I do know of some examples where ACT teams use a recovery approach. I think a much broader definition of evidence-based practice needs to be created, and if you use this [broader] definition, than self-help becomes a best-practice. It doesn’t have a number of random assignment studies behind it, but then neither do other best practices that are being promoted. I think that the consumer/survivor movement needs to keep up the political pressure to keep recovery on the agenda.  

3) What can academia do to instill the philosophy of recovery into the next generation of mental health professionals?

Deegan: I believe that we need to be extremely conscious of language. I did a brief survey of staff and clients from a very typical mental health service setting. I asked for examples of times when you heard someone who was being disrespected, or a time when you were being respected. These weren’t evil staff and they weren’t particularly awful clients. They were just typical. Their answers included words and phrases like: crazy, nut, psycho, retarded, whacko, nutjob, stupid, sick, creepy, screwy, back-to-the-nut-house, child, drama queen, time-for-the-rubber-room, lazy, get-a-life, substance abuser, loser, for-a-schitzo-you’re-doing-very-well, my-taxes-pay-for-your-SSI, [etc.]. These are just some examples of micro-aggression. This is the kind of stuff that is going on daily in programs. Over time, this begins to wear down people and their hope. It creates a culture of hopelessness and despair. In terms of educating people on language and other aspects, we need to begin to operationalize the recovery-based approaches. We need to come down from the principles and talk concretely about personal choice. We need to rethink professional boundaries. We need to rethink approaches to psychiatric medications. We need to create opportunities for mental health workers and students in the profession to have a ‘disability internship,’ to live in an SRO on $562 month, using day treatment, using public transportation in rural settings. And this is not to impose any suffering on these students, but to let them feel how profoundly disabling poverty is when there is no way out.

Jensen: From the consumer input I have heard, we need to start in the junior high schools, before people even get into professional schools with educational efforts. As a recent grad of an MSW program told me, consumers should come and speak and tell recovery stories. They could discuss what is good and not good about the existing system’s services. Other ideas include having persons with lived experience lead discussions, and to have required courses in recovery competencies. Another idea is to have academics who are also in clinical practice to educate themselves. The concept of recovery is so foreign to how today’s professionals are educated, except for a few isolated departments, that it’s very hard to find information on recovery. It’s more than instilling the philosophy; it’s teaching research-based and recovery-based best practice models in the core curriculum. Things such as strength-based approaches to depression, such as case management, or therapy, or professional conduct between physicians and patients. Another example of a model is implementing WRAP as a model of co-

NASMHPD/NTAC e-Report on Recovery – Fall 2004

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