R

Recovery for all

six word short stories

‘He didn't. She did. Big mistake.’

AL Kennedy

‘For sale: baby shoes, never worn’

Ernest Hemmingway‘A&E IOU’

Toby Litt

‘Womb. Bloom. Groom. Gloom. Rheum. Tomb.’Blake Morrison

‘Purse found. "No notes," she said.’Andrew O'Hagan

‘Mother's-milk. Ribena. Tetley's. Chibuku-Shake-Shake. Complan. Morphine.’Marina Lewycka

‘Defenestrated baby, methamphetamine, prison, rehab, relapse.’Jeffrey Eugenides

Overview What is recovery?

Why is recovery important?

Social movement to policy goal

Recovery focused mental health services

Recovery?

• How confident do you feel working in a recovery focussed way?

Scale of 1-10?

What is recovery?

Personal RecoveryMental Illness &

Medical Model

Social movement

• "revolutions begin when people who are defined as problems achieve the power to redefine the problem” McKnight (1992)

• Recovery involves people living with addictions and mental health problems

Defining Recovery

“a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and/or roles. It is a way of living a satisfying, hopeful, and contributing life even with limitations caused by illness. Recovery involves the development of new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness.”

Anthony, 1993

Recovery Timeline

Recovery Model

Anti-

depr

essa

nts,

195

7

Dem

entia

Pra

ecox

188

3

Anti-

psyc

hotic

s, 1

960De-institutionalisation

Psychosocial Rehabilitation, 1940’s - 70’s

Disability Rights Movement

Self

Hel

p, 1

930’

s

Survivor Narratives

Bill

Anth

ony,

199

3

Reco

very

Ass

essm

ent S

cale

, 19

96

Policy, 2006…

Prac

tice

The

Div

ided

Sel

f, 19

60

1959

Men

tal H

ealth

Act

The

Wat

er T

ower

Spe

ech,

19

61

Inte

rnati

onal

Pilo

t Stu

dyO

f Sch

izoph

reni

a, 1

967

Reco

very

Con

fere

nce,

200

4

SRN

, 200

3

WWII: 1939-45

Chlo

rpro

maz

ine,

195

2

Anti-psychiatry

Italia

n Ps

ychi

atric

Ref

orm

, 197

8

1960’s & 70’s

“People need to recover from the system, not their mental health problem.” Ron Coleman

“We have the right to be heard and listened to. We…need not be passive victims of an illness.” (Deegan, 1993)

Foundations of Recovery

Medical Recovery

Maintenance

Personal Recovery

What is Recovery?

People of all ages living with mental health problems and illnesses are actively engaged and supported in their journey of recovery and well-being.

“Mental health service providers should operate within a framework that supports recovery.”

“Rights”

“Best Practice”

“Social Inclusion”

“Active participation & empowerment strategies.”

“Focus on Outcomes”

“Rights, Relationships & Recovery: review of

mental health nursing (SGHD 2006, 2010)

Recovery Policies

Recovery in Scotland Devolution (1999) Recovery conference, Ron Coleman (2004)

Mental Health Care & Treatment Act (2003) Scottish Recovery Network (2004) Rights, relationships and recovery: review of mental health nursing

(2006) (refreshed, 2010) Delivering for mental health plan, 2006 Mental health strategy (2012) New Mental Health Act (2012)

Future: – Personalisation & SDS– Practice & Measurement

Recovery key themes

Being Supported by Others Renewing Hope & Commitment Engaging in Meaningful Activities Redefining Self Incorporating Illness Overcoming Stigma Assuming Control Managing Symptoms Becoming Empowered & Exercising Citizenship

What is recovery?

• A reality (it happens)• A process rather than an event• Processes have fluctuations• Built on growth and learning• Unique experience with common themes

CHIME (Leamy et al. 2011)

What helps recovery?

• Telling your story and being listened to• Developing awareness and skills• Taking part in life • Supportive relationships• The positive role of work• Recovery leadership / champions• Identity , hope and creativity

Recovery-focused nursing

Why is recovery important to nursing?

How can you work in a recovery focused way?

What is holding back recovery?

What it’s not

• A fad, buzz word or new phenomenon• A service model but they do need to

change• All about mental health services

‘I know everyone talks about hope, as if it’s the jargon and the latest fad. The thing is, it’s not jargon. It’s the light in the darkness which kept me going; the wish and yearning for change.’Personal narrative: www.scottishrecovery.net

What it’s not

• Something you can do to people• Necessarily easy or quick

‘Recovery is a personal journey and is different for everyone, and the way is not always easy... My journey to recovery took several years and much time was spent finding out what helped and what didn’t.’ Personal narrative: www.scottishrecovery.net

Implications of recovery

• People in recovery are the evidence• Different knowledge, skills and values• Shared roles - walking alongside• A shift in power

‘I feel that it’s vital that professionals are open to letting people take control, but I know that it’s hard to get it right. Ultimately, it’s about treating people as individuals.’Personal narrative: www.scottishrecovery.net

How do we know this?

• Narrative research projects• Local recovery networks• Promoting WRAP• Influencing services – SRI 2• Encouraging Peer Working• Listening to ‘experts by experience’• Research

The vision (your preferred future)

Let’s imagine a (recovery) miracle takes place…

What do you see yourself and others do?From staff, service user and carer perspectivesWhat’s different about it?

Achieving our vision

What is the first very small step you will take that will let you know that you are moving towards you vision?DiscussAcknowledging powerSMART objectivesRecovery is action oriented

Recovery = Journey

WALK IT!

References• Anthony W. A., (1993) Guiding vision of the mental health service system

in the 1990s. Psychosocial rahabilitation journal, 16(4), 11-23.• Cowan S, Guise J, (2012) Revisiting the narrative research project: a

follow up study of mental health recovery. Available at: http://www.scottishrecovery.net/Non-SRN/View-category.html . Last accessed: 12/01/14.

• Katalova-O’ Docherty Y, Stevenson, C, Higgins, A (2012) Reconnecting with life: a grounded theory study of mental health recovery in Ireland Journal of mental health 21 (2) 136 – 144.

• Leamy M, Bird V, Le Boutillier C, Williams J, Slade M, (2011) A conceptual framework for personal recovery in mental health: systematic review and narrative synthesis, British Journal of Psychiatry: 199:445-52.

References• Stickley, T., Wright, N. (2011) The British research evidence for recovery,

papers published between 2006 and 2009. Part two: a review of the grey literature including book chapters and policy documents. Journal of psychiatric and mental health nursing, (18), 297-307.

• Stickley, T., Wright N. (2011) The British evidence for recovery, papers published between 2006 and 2009. Part one: a review of the peer reviewed literature using a systematic approach. Journal of psychiatric and mental health nursing, (18) 247-256.

• Smith– Merry J, Freeman R, Sturdy S, (2010). Recovering mental health in Scotland: Recovery from social movement to policy goal Louvian-la-Neuve: Universite Catholique de louvian.

• Scottish Government Health department (2006) Rights, relationships and recovery: The review of mental health nursing in Scotland

• Scottish government (2012) The mental health strategy.