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Chapter 1

Research, Writing and Rhetoric on Recovery

Recovery is a series of interconnected subjects beginning with ad-diction and mental health but encompassing ideas about family and spirituality powerful enough to influence an entire culture. One cannot address any part of recovery without soon encountering a larger connected body of ideas, the end of which appears almost limitless. (Meacham 1999: 17)

Since the late 1980s, there has been a veritable “discursive explosion” (Foucault 1990: 17) with respect to mental health recovery.1 In the ever growing literature on the topic, some have claimed recovery, capitalized on it, refuted it and researched it, and many have wanted it pinned down and clarified, ready for application and evaluation. In disciplines ranging from psychiatry to religious studies, each camp has fuelled the furor around recovery and what it means for achieving mental health. Originally created by American survivors in the 1980s, mental health recovery has been defined not as a cure, “end product or result,” but an “at-titude” of healing (Deegan 1988: 14). Bonded to an experiential “journey” through “denial,” “despair” and “grace” when the “birth of hope is called forth by being loved,” recovery in mental health is founded on three corner-stones: “hope, willingness and responsible action” (Deegan 1988: 14). Yet, recovery is not one thing, for there are multiple models, definitions, approaches and explanations of what it is. According to Davidson and Roe (2007), these definitions may or may not share a “family resemblance” (460). For example, William Anthony (1993: 527) defines recovery as

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 the 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.

Similarly, Pat Deegan (1988: 11) defines recovery as “the lived or real life experience of people as they accept and overcome the challenge of the dis-ability… they experience themselves as recovering a new sense of self and of

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purpose within and beyond the limits of the disability.” Yet, there are many more definitions than these, created by such groups as the Scottish Recovery Network, the aforementioned President’s New Freedom Commission on Mental Health and the Mental Health Commission of Canada. In its report entitled Towards Recovery and Well-Being: A Framework for a Mental Health Strategy in Canada (2009: 122), the commission makes clear that in Canada recovery is

a process in which people living with mental health problems and illnesses are empowered and supported to be actively engaged in their own journey of well-being. The recovery process builds on individual, family, cultural and community strengths and enables people to enjoy a meaningful life in their community while striving to achieve their full potential… Recovery does not necessarily mean “cure,” although it does acknowledge that “cure” is possible for many people. Recovery principles — including hope, empowerment, self- determination and responsibility — are relevant to everyone experiencing mental health problems or illnesses, but must also be adapted to the realities of the different stages of life.

Noted recovery scholars Davidson and Roe (2007) go even further, distinguish-ing between “recovery from” and “recovery in.” They explain that “recovery from” is a clear and measureable concept steeped in rigorous longitudinal research studies. Contrary to previous medical arguments, these studies claim 25 to 50 percent of people with mental health issues will, at some point, resume normal activities. Conversely, “recovery in” is an approach based on the civil rights movement. Informed by self-help, it does not presume a return to “normal functioning” nor any kind of “remission” of symptoms. What “recovery in” does presume is that recovery must be grounded in a focus on survivor rights, peer support and recovering from the oppressive effects of being a mental patient. And then there are the recovery models. The Canadian-based team of Ochaka, Nelson and Janzen (2005) developed one useful model. But there is also the Ohio Model, the Maine Model, the Pace Model, the Tidal Model and a conceptual model developed by Jacobson and Greenley (2001).2 There are also the six basic recovery tasks (Davidson 2007), the six characteristics of a person who has recovered from mental illness and the five recovery skills and strategies (Mead and Copeland 2000). Add to these the six steps of Mary Ellen Copeland’s Wellness Recovery Action Plan (2006) and the four recovery dimensions (Ralph 2000), and it is easy to see why the Mental Health Commission of Canada notes that while there has been a great deal of support for the concept of recovery in many Canadian circles over the last few years, there has also been “much misunderstanding and confusion” (2009: 27).

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Yet, at the heart of most of these models, tasks and frameworks is an expectation of hope and healing. This expectation sits in direct contrast to the long-held view of many trained within the medical model that, follow-ing diagnosis, individuals with (severe) mental illness could never hope to be well again (Carpenter 2002; Jimenez 1988; Kruger 2000). After years of damning prognoses, a longitudinal research study led by Courtney Harding (1986a, 1986b) followed patients after discharge from Vermont institutions in the 1960s. That study argued that a good number were able to recover effectively, living productive and healthy lives in the community. The study also opened the door for similar investigations, many of which have also called into question the notion that mental illness is invariably chronic (Ciompi 1980; Clemens 1978; DeSisto et al. 1995; Ogawa et al. 1987; Tsuang et al. 1979). Indeed, this kind of research has made it very clear that, depending on how you define it, recovery from mental health issues is entirely possible. With this growing store of proof, many U.S. state governments have moved towards recovery as the guiding creed for local mental health policy, planning and practice (Jacobson and Curtis 2000). But the effects of this move have been varied, ranging from lip service in some organizations to more funding for community supports (Fossey and Harvey 2001; Hoffmann and Kupper 2002; Jacobson and Curtis 2000; Pickett-Schenk, Cook and Laris 2000) that empower survivors and ex-patients (Chamberlin 1988; Chamberlin et al. 1989; Nikelly 2001). These recovery-oriented supports and strategies (Mead and Copeland 2000) include self-help groups (Godlaski et al. 1997) and peer support/mutual aid initiatives (Liberty et al. 1998; Sherman et al. 1998), pharmacology/medication, exercise, nutrition, crisis planning and community programs designed to enable and help former patients hold onto housing (Pejlert et al. 1999) and useful employment (Anthony and Blanch 1989; Liberman 2002; Mueser et al. 2002; Secker et al. 2002).

Supporters and Critics

Not surprisingly, mental health recovery has a growing number of support-ers. Recovery has been lauded by survivor scholars (Brown 2002; Deegan 1988), psychosocial rehabilitation proponents (Anthony 1993; Cohen and Anthony 1988; Fisher 1994; Torrey and Wyzik 2000) and some social work-ers (Carpenter 2002). Policy-makers based in states such as Wisconsin have adopted recovery for mental health planning and practice (Jacobson 2004; Jacobson and Curtis 2000). Similarly, recovery has been praised by those who advocate a more spiritual practice to health (Fallot 2001; Grogan 1986; Krissman and Maurer 2002; Sims 1999). Support for recovery (especially cost-effective employment programs and a reduced need for hospitalization) has also come from some health

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economists (Broadhead et al. 1990; Johnson et al. 1992; Kessler and Frank 1997; Manning and Wells 1992; Simon et al. 2000; VonKorff et al. 1992; Watt et al. 1997) and from psychiatric circles (Amering and Schmolke 2009; Liberman 2002; Mueser et al. 2002). Indeed, mental health recovery has become a worldwide phenomenon, judging by the recent spate of books outlining, clarifying and supporting recovery concepts and practices (Adams and Greider 2005; Amering and Schmolke 2009; Cohen 2008; Davidson 2003; Davidson et al. 2009; Jacobson 2004; Repper and Perkins 2003). However, recovery also has its critics: survivors who question its “sugar-coated message” (Donahue 2000: 435); family groups who query its patient focus (Hall and Purdy 2000; Lefley 1997); Canadian researchers who ques-tion the use and relevance of the term “recovery” for consumers (Piat et al. 2008); and psychiatrists who have identified recovery’s potential to create false expectations (Peyser 2001). Similarly, Davidson (2001) identified a long list of “have to’s” attached to mental health recovery despite its good intentions. For those with severe mental health issues, achieving some degree of normalcy has always meant a “requirement to succeed” (Davidson 2001: 376), including securing em-ployment or going back to school. With the steps, tasks, lists and models of recovery, now there are even more requirements, for making successful strides “in restoring one’s life” (Davidson 2001: 377) seems to mean being in recovery. Questions have also arisen across the Atlantic. A report by the U.K. Mental Health Foundation asked, “recovery from what, recovery to what and whose recovery is it anyway?” (Turner-Crowson and Wallcraft 2002: 245). To some of those cited in the report, recovery felt like “fashionable jargon,” “a born again revival” and an imported American language that perhaps they did not want to speak (167). To others, recovery has felt par-ticularly white and Western (Jacobson and Farah 2010; Lavallée and Poole 2010). Reviewing psychiatric survivor oral histories, Cohen (2005) admits that “being white and having an income” may help people on their road to recovery (339). Not being white seems to have the opposite affect (Jacobson and Farah 2010). Additionally, a recent review of the recovery literature revealed an absence of attention to culture, race and ethnicity (Jones et al. 2007). Recovery ideas were steeped in Western concepts of mental health, individualism and personal responsibility. Communities that valued com-munality and collective responsibility “did not yet completely share in the hope” (Jones et al. 2007: 256). Similarly, Aboriginal communities may not share in the language (Lavallée and Poole 2010), for the very concept of mental health may not exist in such spaces, nor do discussions of recovery principles and tasks. Instead, the healing talk in some Aboriginal communi-ties is focused on colonization, community and, always, identity (Lavallée and Poole 2010).

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A recent community research project in Toronto echoed these concerns (Jacobson and Farah 2010). Gathering a “community of practice” to guide the project, over fifty participants from Caribbean, Tamil and Somali com-munities came together to critique and improve one particular Western model of recovery created by Jacobson and Greenley (2001). This early model conceptualized recovery as a phenomenon with conditions both internal (hope, healing, connection) and external (human rights, positive culture of healing) to the recovering individual. But this model was found wanting, as well as decidedly Western. What emerged was the beginnings of a new “culturally-responsive model of recovery,” one that places “culture, systems of oppression and privilege, the social determinants of health and history in the foreground” (Jacobson and Farah 2010: 21). In addition, a number of disability theorists (Beresford 2000; Donaldson 2002; Eisland 1994; Linton 1998; Secker et al. 2002; Shildrick 2004; Swain and French 2000; Thomson 1999, 2002) have added useful critiques. They do not speak to mental health recovery directly, but they add to the analysis by publicly questioning the Western “ideology of cure,” its “aggressive intent to fix, regulate or eradicate ostensibly deviant bodies” (Thomson 2002: 10) and the money-making op-portunities that come with that intent. Among these writers are theorists who support the social model of dis-ability (Bricher 2000), a model Davidson (2001) argued may be more relevant than recovery for those coping with mental health issues. To social disability theorists, the issue is not about a cure, but about how society has reacted to and oppressed people with physical and mental impairments (Huff 2002: 203). Similarly, for some feminist disability theorists, disability is not a “natural” state of “inferiority” (Hall 2002) awaiting repair. Rather, disability is a state that must be “resymbolized” (Eisland 1994) if the privileging of “normal” bodies is to cease. Feminist disability theorist Rosemarie Garland Thomson writes evoca-tively of the treatment of disabled or “extraordinary bodies.” She describes how individuals with physical and mental difference are taught to “view it as a private matter,” cover up and reassure “normal” people that they are “going to be fine” (Thomson 1999: ix). Citing Mary Douglas’s work on hygiene, Thomson suggests difference is a type of “social dirt” that societies cope with by either tucking it safely into categories (such as disabled/abled), eliminating it (through eugenics or reproductive technologies), segregating it (through regulations such as the “ugly laws” in the U.S. that prevented facially disfigured individuals from being seen in public) or labelling it as dangerous (Thomson 1999: 37). Regarding the last coping mechanism, Thomson writes that the danger stems from seeing the disabled as the ultimate subverters of the “western ideal,” an ideal based on self-government, self-determination, autonomy and progress (Thomson 1999: 42). To the “normal” or abled

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person the disabled (including Thomson herself) are “ungovernable,” “disrup-tive of the ritualized behaviour on which social relations depend” (37) and “flaunting” of their difference. Yet, in the words of Shildrick (2004), these disruptive “monsters” matter, and they cannot be enclosed, categorized or covered up. They might prove particularly profitable, however. Pedlar and Hutchison (2000) explored the state of disability support ser-vices in Canada, tracking funding cuts over a decade and their link to welfare liberalism. According to Armstrong (1997, cited in Pedlar and Hutchison 2000), welfare pluralism presumes that the state ought not provide all the support needed by a society, but rather the voluntary and private sectors have a role to play, as do individuals and families. With the state as the last resort, billions of dollars in cuts to services for the “disabled” created a lack of resources. The cuts also enabled the “commodification of disability” where monetary value is placed on meeting needs that arise from disability, and services are directed not towards meeting those needs but making money (Pedlar and Hutchison 2000: 637). In turn, commodification brought about a blurring between not-for-profit and for-profit work. It also resulted in an alarming amount of “creaming,” or the provision of service to those seen as easiest to serve in relation to successful outcomes (Pedlar and Hutchison 2000). Addressing recovery directly, other writers have begun to explore simi-lar issues, questioning the commodification of mental “disability” and the ramifications of investing in supports, such as pharmacological treatments and cost-effective user-run services (Cassels 2003; Cross 1993; Lehman 2000; Mechanic 1994, 1997; Scheid 2000). Such writing seems to have begun with the work of Helmut Mohelsky (1988). In the recovery venue Psychosocial Rehabilitation, he argued that, in pursuit of the commodity known as health, mental health has traditionally proven to be an undeveloped periphery, limited in resources and choice. This distance from the centre of cure has allowed those in the periphery to innovate other coping strategies (such as psychosocial rehab and recovery). Mohelsky (1988: 59) warned that such strategies, although seemingly “hopeful,” alternative and not commodity-centric, would eventually be “threatened from within” through temptations to become product- and profit-oriented. He foretold that, at some point, in-novative coping strategies would be annexed by the centre of cure, developed and marketed for profit. Citing theorist Max Weber, Gary Cross (1993) sug-gests that this inevitable development for profit is tied up with the principles of consumer culture. He writes that North Americans will always choose a product over leisure or a quick cure over an extended leave. They make this choice because it does not violate the Protestant work ethic, it meets the need for continued competition and it offers a relatively safe form of indulgence. This is precisely what concerns David Mechanic. Beginning in the late

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1980s, Mechanic, a professor in health policy at Rutgers, has written exten-sively on the economics of mental health and the growing trend towards products and quick cures. In 1994, he turned his attention to managed mental health care, warning “there is a plausible suspicion that mental health man-aged care” is a strategy “to withhold services without necessarily expanding treatment alternatives” (Mechanic 1994: 896). Although full of potential to reduce costs and hospitalizations, managed mental health care could also result in the denial of needed treatment, reduction in the quality of service and cost shifting to patients, families, professionals and the community (Mechanic 1997). It could also lead to the use of medication as a substitute for more costly long-term therapy. Researching this trend (Scheid 2000), interviews were conducted with American mental health professionals working in private practice (but paid by managed-care companies). Among other results, there was an increase in the use of cheaper therapists, such as social workers, and a greater reliance on psychiatric medication. One practitioner in the study was

told by a managed care case manager to tell the patient, convince her to go on medication because we think it will solve her problem quicker… They want to do whatever to get the patient, not better, but in shape and shipped out, off their books. They want her medicated and moved, ready and able to work again. (Scheid 2000: 710)

Is this only a concern for those living with managed mental health care? The short answer is no, according to Alan Cassels, a drug policy researcher at the University of Victoria. In 2003, Cassels documented a leak from the Pharmaceutical Research and Manufacturers of America to the New York Times “in which we learned of industry plans to massively increase lobbying budgets” in Canada (A13). This plan saw more investment in drugs and their development, further limitation of generic drug production and weakening of the common drug review, a national process aimed at reviewing new drugs and recommending some of them for health coverage. These developments, wrote Cassels, “should send chills down the spines of everyone this side of the 49th parallel” (A13). And, yet, the most scathing attacks on recovery come from a group of more popular writers. Turning their attention to re-covery culture in general, they take to task self-help, sharing personal stories and seeking “truth” through self-analysis and talk therapy (Buzzard 2002; Dorsman 2002; Kaminer 1991; Lemanski 2000; Meacham 1999; Peele 1985, 1989; Rapping 1996; Starker 1989; Tiede 2001). Writing in 1991, lawyer and cultural critic Wendy Kaminer saw the effects of this kind of talk therapy everywhere, especially in supposedly critical or academic spaces. She laments:

In our culture of recovery we take confessions for granted and talk-

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ing about yourself is part of the process… Personal development passes for politics, and what might once have been called whining is now exalted as a process of asserting selfhood… You even find it in the halls of academe… Instead of theory, [my students] sought testimony. (Kaminer 1991: 41)

Given Kaminer’s observations, it is perhaps not surprising that there is, at present, comparatively little theoretical analysis of recovery in mental health. Many articles offer proof of recovery, speak to the lived experi-ence of recovery (Deegan 1988; Donahue 2000; Fallot 2001; Peters and Fallon 1994; Reindl 2001), the meaning of recovery (Lunt 2000; Mead and Copeland 2000; Peyser 2001), narratives of mental health recovery (Cohen 2005; Cohen 2008; Ridgway 2001) and recovery’s application to practice and policy (Borkman 1998; Brown et al. 2008; Carpenter 2002; Clossey and Rowlett 2008; Fisher 1994; Frese et al. 2001; Lehman 2000; Torrey and Wyzik 2000). Yet, comparatively few authors have taken a more critical approach, including those based in Canada.

Recovery and Mental Health in Ontario

Many provincial mental-health-system reform bodies in Ontario have en-dorsed the concept of recovery, as have the Kirby Commission, the Mental Health Commission of Canada and various Local Health Integration Networks (lhins). Increasingly, community mental health organizations in Toronto are also seeking to align their policies and practices with the recovery vision and its principles (Jacobson and Farah 2010). In keeping with similar developments in the United Kingdom, Western Europe and New Zealand (Tilley et al. 2005; Tilley 2003), there is an emerging recovery culture in this province. Supposedly first discussed during the mental health implementa-tion task forces sponsored by Premier Harris’s Conservative provincial gov-ernment, recovery has since spawned position papers (Everett et al. 2003; MacKay 2005), working groups, countless forums, conferences and educa-tional initiatives, new programs and policies. It has also birthed employment positions, recovery newsletters (Dewar 2006) and a small army of freelance recovery educators and consultants. Add to this recovery-focused groups, such as the Ontario Recovers Campaign, and projects, such as Building a Culture of Recovery, and it would appear that recovery has become the new cri de cœur for Ontario’s mental health movement. Barbara Everett, former president of the Canadian Mental Health Association and co-author of a Canadian recovery position paper, writes:

One of the tasks of a viable social movement is to create a creed or an ideology which functions as its cri de cœur. Creeds are expressed in

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a variety of ways. Sometimes they are contained in lengthy mission statements or manifestos. At other times they are reduced to catchy slogans or songs, but no matter what their form, their function is to rally the membership so that they are marching under the same banner. (Everett 2000: 186)

Social movements, Everett notes in her book, go through a number of phases in their development. Citing theorists such as Goldberg (1991), Janeway (1980), Mayer (1991), Melucci (1989) and Plotke (1995), Everett describes how a movement begins with a refusal by “outsiders” to accept how “insid-ers” have defined them (Everett 2000: 53). As the movement comes together, it develops a structure and ideology. It also must decide on how to resist or promote change. And yet, according to Goldberg (1991), movements can also succumb to a number of unhappy fates. They can have no affect whatsoever, their actions ignored by the powerful. Their language may be appropriated, making “real change” unlikely, or a movement may be co-opted, “its leadership absorbed into the ranks of the powerful while the general membership remains in much the same state as before” (60). In truth, Gamson (1995) argues that while approximately 40 percent of movements achieve their goals, another 40 percent do not and 20 percent are either “pre-empted or co-opted” (cited in Everett 2000: 60). Everett’s interviews with survivors, part of her doctoral research in the mid-1990s, speak to how survivors began to organize into a social movement in the 1980s and 1990s, voicing outrage, joining policy discussions and agitating for change in Ontario. As a result, actions were taken, commissions were struck and survivor partnerships with government flourished. In addition, more funding flowed to community mental health programs, including those run for and by survivors with experiential knowl-edge of the mental health system. Scholar Kathryn Church (2004: 4) has also written of this time in what she calls an “outsider’s account of psychiatric survivor activism.” She argues that the “psychiatric survivor movement” has had three “incarnations” over the past forty years: anti-psychiatry, consumerist and entrepreneurial. Although “earlier phases of the survivor movement continue to exist alongside newer forms” (4), it is possible to argue that the first phase (anti-psychiatry) emerged in most Western nations during the 1960s. With a focus on self-help groups, it challenged not only the powers of the psychiatric establishment but also its “allied” intellectuals. This challenge was made in print (see Bonnie Burstow and Don Weitz’s book Shrink Resistant (1988) for example), as well as through direct action around housing and psychiatric treatment. The 1980s saw a different incarnation, a second phase Church calls “consumerism” for its focus not on overturning the mental health service

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system but infiltrating and controlling it through consumer participation and leadership. It was during this phase that Pat Capponi emerged as a mental health leader in Toronto, the Consumer/Survivor Development Initiative3 was launched and Ontario had a “mental health bureaucracy temporarily sensitized to psychiatric survivor issues” (Church 2004: 6). Faced with spend-ing cuts and the 1995 election of a right-wing government no longer inter-ested in this kind of consumer participation, “entrepreneurialism” emerged. With a push towards survivor-run businesses and a focus on “participatory management,” “its leaders used the discourse of business and the processes of community economic development to organize their members” (Church 2004: 7). Harvey Simmons’ (1990) history of mental health policy in Ontario between 1930 and 1989 paints a picture of mental health as an exercise in elite policymaking, “wheel re-inventing” and “ad-hockery” (ix). Driven by politicians with little or no interest in mental health and pandering to psychia-trists’ preference for hospital clinics (as opposed to asylums full of the “poor who could not pay”), Simmons’ is an interest group analysis that suggests Ontario’s mental health policy-making has always been “unbalanced.” He argues funds were regularly squandered on building institutions designed to win political support and provide employment rather than care. Radical treatments such as insulin injections, lobotomies and shock treatments were often “administered haphazardly” (15). Indeed these treatments were often chosen for their “ease” and for whether they “calmed the patient and made work easier for medical staff ” (15). And yet, “every five years from 1930 to 1985, a report, analysis or critique of Ontario’s mental health system ap-peared, reports which recommended major changes and reforms. Without exception, each report recommended a major extension of community health services” (xiii). These reports and recommendations went ignored until there were changes in mental health law and until the development of patient rights groups across North America, deinstitutionalization and what Simmons calls transinstitutionalization (the practice of moving the elderly out of the asylums and into cheaper residences). Simmons notes that deinstitutionalization in the 1960s and 1970s was heralded as a more humane step towards community health. However, it was also the result of a “fortuitous linkage between the forces of fiscal conservatism anxious to save money by closing large mental hospitals… and pressure groups and other humanitarian forces which saw the large mental hospital as the symbol of everything that was wrong with mental health policy” (158). That convergence created a condition of pos-sibility that not only enabled the government to look good but to boast of financial “recoveries” totalling $5 billion (115). Picking up where Simmons leaves off, a second text by Church (1995)

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explores the other kinds of costs and savings inherent in the mental health policy-making process in Ontario. Using a qualitative research method known as critical autobiography, Church delves deeper into the emotional costs for survivors who were part of the “consumerism” and “partnership” phases in the late 1980s and early 1990s. Exploring the “theatre of power” (1995: 116) of mental health policy in this province, Church takes us backstage and into the depositions, policy meetings and debriefs about what was “hot” for survivors at the time. Essential is her analysis that mental health had always had a “tiny voice” on the political stage (126). Fundamental is her observation that the survivor movement still did not have a “strong or unified agenda for structural change” (127) in the mid-1990s. Even more valuable is her reading that the rules of the game were about to change quite dramatically. I argue that those rules are bound up with two key notions Church ad-dresses in her analysis, issues often overlooked in other readings of mental health. The first might best be termed the hegemony of moderation. Citing Lyman (1981), Church observes how survivors participating in consultations were taught very specific rules for speaking and acting around the table: “Don’t give offense. Don’t be unpleasant or adversarial. Don’t complain or fight. Be nice. Be reasonable. Be considerate. Be co-operative” (90). These rules, she writes, were bound up in the “domination of professional conscious-ness,” a consciousness common to liberal capitalist societies and one that demanded the exclusion of feeling and “proper” participation etiquette, and created a “tendency in professionals” and policy-makers to “bypass radical consumers and critiques” in favour of more “moderate” ones (90). Second, Church attends to the power of speech, describing how cer-tain words come to resonate in mental health. Admitting that “arguments over words” were always part of the “struggle to write documents which might shape policy” (12), Church sensitizes us to the language battles that predated recovery’s arrival in this province. Pondering the popular words “community” and “consultation” in the early 1990s, she writes, “control over symbolic representation is vested with mental health professionals. The mentally ill have very little influence on the words and images which describe them” (11). They have always been “verbally” (and discursively) “disempowered” (11). Given word battles, rules and moderate participation, interest groups and a catchy new slogan, what has taken place in Ontario that has made the emergence of mental health recovery possible? Given the history of “unbalanced” policy, calming treatments, anti-psychiatry, consumerism and entrepreneurship, is recovery a more effective action to recover power by survivors? Is it a means to recover anger and the feelings that break the “rules” of the mental health game (Church 1995)? Is recovery a new expres-sion of professional consciousness or another type of “creaming”? Following

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Simmons, might it even be another convenient convergence that benefits government, recovers money and looks more hopeful and humane? In 1995, Church wrote of her “deep longing to speak and write differently about what I was embedded in… to break down old patterns of thought, to break through into a different perception of issues” (21). Following her lead, in the following chapters I seek to “speak and write differently” about mental health recovery in Ontario. I will track the rhetoric and words used in mental health circles. I will ask how those words may serve the “moderate” or speak to how people with mental health issues come to be categorized in Ontario’s mental health community. I will ask who is using these words and why (now). And, with a nod to the work done by those discussed in these pages, I will ask if this new wave of mental health recovery talk is really new at all. In short, building on what has been cited thus far, this analysis seeks to take us toward a different perception of what so many, including myself, have been embedded in for so long. Exploring mental health recovery in a theoretical way, this analysis seeks to ask questions and uncover possibilities for a system so long “unbalanced.”

Notes

1. As the recovery landscape changes daily, this first chapter is by no means meant to be an exhaustive review on the literature on recovery.

2. See the Ontario-based Building a Culture of Recovery Project at <cultureof-recovery.org> for more.

3. This organization was funded by the Ontario Ministry of Health to support the development and maintenance of over fifty consumer/survivor initiatives in Ontario. It has since seen its funding reduced and been re-named the Ontario Peer Development Initiative.