Best Practices for Mental Health Services Requires a Focus on Recovery

For many years there existed a central attitudinal barrier between people with mental illness and their improvement. The barrier was the assumption by the mental health profession that people with psychiatric disabilities cannot be self-determining because they have lost their capacity for reasoning and making sound choices.

Thus, all of their expressions and thoughts could be ignored and the "system" would take control- for the person's own good, of course. Those with mental illness too often adopted this assumption and, having learned helplessness, reinforced the attitudinal barrier.

In 1993 the Ohio Department of Mental Health began an initiative to systematically reshape the paradigm from a cycle of disempowerment and despair into a paradigm of recovery. Dr. Michael Hogan, director of the Department, stated that in a recovery oriented system, every admission to a hospital would be used as an opportunity for change, not as a crisis to be weathered. "We would move beyond 'maintenance' treatment to actively working to help people control their lives. We would listen more to what people want, and a little less to what we think they need."

Recovery is a multi-dimensional concept, which is rooted, in several basic assumptions:

• Recovery can occur without professional intervention; professionals do not hold the key to recovery. The task of professionals is to facilitate recovery and the task of the individual with a mental disorder is to recover. Professionals must be educated about strategies for encouraging increased independence instead of learned dependence.
• A common denominator of recovery is the presence of people who believe in and stand by the person with mental illness, and the mental health system must acknowledge and support this enormous source of help.
• Recovery can be facilitated by the presence of vocational opportunities and meaningful activities, educational opportunities for consumers of mental health services to learn about their mental illnesses, and opportunities to fully participate in the development, implementation, and evaluation of all services they receive.
• ¨ Empowerment is vital to recovery. In the 1999 Consumer Outcomes Study, consumers' perception of their level of involvement in treatment planning and decisions about services was the variable most highly correlated with the degree to which they felt their needs were being met, and the perception that their needs were being met was the best predictor of positive mental health outcomes.

Washington County is privileged to be one of two counties in Ohio to pilot an important recovery initiative, the Advance Directive, a durable power of attorney for psychiatric care. People with a history of psychiatric disorders can make their treatment preferences known prior to a mental health crisis and appoint an agent to speak for them if they are unable to speak for themselves. The Washington County Advance Directives Team will present a series of three informational sessions about the Advance Directive, which will include an opportunity for people with mental disorders to talk one-on-one with a member of the AD Team concerning how to complete the document. The meetings will be as follows:

• Tuesday, October 17th
  10:00 a.m. at Safe Haven in Marietta
• Thursday, October 19th
  7 :00 p.m. at Worthington Center, 127C Lee St., Belpre
• Friday, October 20th
  1:00 p.m. at Washington County Community Mental Health Services,
  118 Putnam St., Marietta

For more information, call 374-6990.

Instilling hope instead of despair, fostering knowledge and empowerment instead of ignorance and dependence…this is the direction the State of Ohio is taking and the Washington County Mental Health and Addiction Recovery Board is honored to be a part of this landmark movement.