Cambridge University Press 978-0-521-74658-8 - Personal Recovery and Mental Illness: A Guide for Mental Health Professionals Mike Slade Frontmatter More information
Personal recovery and mental illness
© in this web service Cambridge University Press
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Cambridge University Press 978-0-521-74658-8 - Personal Recovery and Mental Illness: A Guide for Mental Health Professionals Mike Slade Frontmatter More information
© in this web service Cambridge University Press
www.cambridge.org
Cambridge University Press 978-0-521-74658-8 - Personal Recovery and Mental Illness: A Guide for Mental Health Professionals Mike Slade Frontmatter More information
Personal recovery and mental illness A guide for mental health professionals Mike Slade
© in this web service Cambridge University Press
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Cambridge University Press 978-0-521-74658-8 - Personal Recovery and Mental Illness: A Guide for Mental Health Professionals Mike Slade Frontmatter More information
University Printing House, Cambridge CB2 8BS, United Kingdom Cambridge University Press is part of the University of Cambridge. , It furthers the University’ s mission by disseminating knowledge in the pursuit of education, learning and research at the highest international levels of excellence.
www.cambridge.org Information on this title: www.cambridge.org/9780521746588 # M. Slade 2009 This publication is in copyright. Subject to statutory exception and to the provisions of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. First published 2009 6thiprintingi2014 Printed in the United Kingdom by Clays, St Ives plc. A catalogue record for this publication is available from the British Library Library of Congress Cataloging-in-Publication Data Slade, Mike. Personal recovery and mental illness : a guide for mental health professionals / Mike Slade. p. ; cm. Includes bibliographical references and index. ISBN 978-0-521-74658-8 (pbk.) 1. Mental health services. 2. Mental health. I. Title. [DNLM: 1. Mental Disorders–rehabilitation. 2. Mental Health Services. WM 400 S631p 2009] RA790.5.S484 2009 616.89–dc22 2009008944 ISBN 978-0-521-74658-8 Paperback
Additional resources for this publication at www.cambridge.org/ 9780521746588 Cambridge University Press has no responsibility for the persistence or accuracy of URLs for external or third-party Internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate. Every effort has been made in preparing this publication to provide accurate and up-to-date information which is in accord with accepted standards and practice at the time of publication. Although case histories are drawn from actual cases, every effort has been made to disguise the identities of the individuals involved. Nevertheless, the authors, editors and publishers can make no warranties that the information contained herein is totally free from error, not least because clinical standards are constantly changing through research and regulation. The authors, editors and publishers therefore disclaim all liability for direct or consequential damages resulting from the use of material contained in this publication. Readers are strongly advised to pay careful attention to information provided by the manufacturer of any drugs or equipment that they plan to use.
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Cambridge University Press 978-0-521-74658-8 - Personal Recovery and Mental Illness: A Guide for Mental Health Professionals Mike Slade Frontmatter More information
for Charlotte
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Cambridge University Press 978-0-521-74658-8 - Personal Recovery and Mental Illness: A Guide for Mental Health Professionals Mike Slade Frontmatter More information
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Cambridge University Press 978-0-521-74658-8 - Personal Recovery and Mental Illness: A Guide for Mental Health Professionals Mike Slade Frontmatter More information
Contents List of case studies x Acknowledgements xi
Problems with evidence-based medicine 48 The dominance of nomothetic knowledge 50 The epistemological tension 51 Epistemology and personal recovery 53 Constructivism – a more helpful epistemological basis 54
Section 1–Mental illness and recovery Chapter 1 Overview of the book 1 What’s the problem? 1 Aims of the book 2 New goals, values, knowledge and working practices 3 Structure of the book 4 Collective nouns 5 Author perspective 6 Chapter 2 The nature of mental illness 8 What is mental illness? 8 Clinical models 8 Disability models 28 Diversity models 30 Adjudicating between models
33
Chapter 3 What is recovery? 35 One word, two meanings 35 Are clinical recovery and personal recovery incompatible? 40 Personal recovery and mental health services 43
Section 2–The primacy of personal recovery Chapter 4 Epistemological rationale 45 What is knowledge? 45 The development of a science of mental illness 46
Chapter 5 Ethical rationale 57 Working with the consumer 57 Compulsion justification 1: benefit to society 58 Compulsion justification 2: best interests 58 Balancing ethical imperatives 60 Chapter 6 Effectiveness rationale 63 Creating markets 63 The ‘science’ of commercially funded drug trials 64 The actual effectiveness of pharmacotherapy 65 An empirically supported view of medication 66 Chapter 7 Empowerment rationale 69 The changing treatment of mental illness 69 The empowerment rationale for personal recovery 72 Chapter 8 Policy rationale 74 Policy in the United States of America 74 Policy in Australia 75 Policy in New Zealand 75 Policy in Scotland 75 Policy in England and Wales 76 Summary of the policy rationale 76
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Cambridge University Press 978-0-521-74658-8 - Personal Recovery and Mental Illness: A Guide for Mental Health Professionals Mike Slade Frontmatter More information
Contents
Section 3–Recovery-focussed mental health services Chapter 9 The Personal Recovery Framework 77 Empirical foundations 77 Identity 81 The four tasks of recovery 83 Identity and relationships 87 The Personal Recovery Framework The job of mental health professionals 92
Narrative-based practice as a contributor to recovery 139 Values-based practice as a contributor to recovery 140 Rehabilitation as a contributor to recovery 141 Differences between traditional and recovery-focussed services 143 90
Chapter 10 Fostering relationships with a higher being 94 Healing 94 Spirituality 95 Mental health services can support spiritual development 95 Chapter 11 Fostering close relationships 99 Chapter 12 Peer relationships 103 Mutual self-help groups 103 Peer support specialists 104 Peer-run programmes 110 Chapter 13 Professional relationships 114 Types of clinician–consumer relationships 114 Detached and partnership relationships 115 Real relationships 119 Reconstructing professionalism 121 A professional relationship 122 Chapter 14 Promoting well-being 125 What is positive psychology? 125 Interventions to promote well-being 132 Chapter 15 The foundations of a recovery-focussed mental health service 135 Values 135 Evidence-based practice as a contributor to recovery 139
Chapter 16 Assessment 144 Using assessment to develop and validate personal meaning 144 Using assessment to amplify strengths 149 Using assessment to foster personal responsibility 154 Using assessment to support a positive identity 155 Using assessment to develop hope 157 Messages to communicate through assessment 158 Chapter 17 Action planning
160
Chapter 18 Supporting the development of self-management skills 165 The offering of treatment 165 Supporting self-management 165 Supporting the development of agency 166 Supporting the development of empowerment 167 Supporting the development of motivation 170 Chapter 19 The contribution of medication to recovery 172 Medication and choice 172 Medication and recovery 173 Chapter 20 The contribution of risk-taking to recovery 176 Two types of risk 176 A recovery-supporting approach to risk 178 Chapter 21 Recovery through crisis 182 Compulsion 182
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Cambridge University Press 978-0-521-74658-8 - Personal Recovery and Mental Illness: A Guide for Mental Health Professionals Mike Slade Frontmatter More information
Contents
Preventing unnecessary crises 184 Minimising the loss of personal responsibility during crisis 184 Maintaining hope during crisis 186 Supporting identity in and through crisis 188 Chapter 22 Recognising a recovery focus in mental health services 191 Quality standards 191 Belief markers 192 Discourse markers 193 Evaluating success 194 Chapter 23 Improving social inclusion 197 Mental health professionals can improve social inclusion 198 The role of consumers in improving social inclusion 206 The role of governments in improving social inclusion 207
Chapter 25 Concerns held by consumers 217 Chapter 26 Organisational transformation 221 Action one: lead the process 221 Action two: articulate and use values 223 Action three: maximise pro-recovery orientation among workers 224 Action four: develop specific pro-recovery skills in the workforce 228 Action five: make role models visible 230 Action six: evaluate success in relation to social roles and goal attainment 231 Action seven: amplify the power of consumers 233 The future 234
Section 4–Challenges Chapter 24 Concerns held by clinicians 211
Appendix: Electronic resources to support recovery 237 Reference list 239 Index 266
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Cambridge University Press 978-0-521-74658-8 - Personal Recovery and Mental Illness: A Guide for Mental Health Professionals Mike Slade Frontmatter More information
List of case studies Case study
Location
1
Peace Ranch
Ontario, Canada
2
Family peer support workers
Melbourne, Australia
3
Sharing Your Recovery Story
Philadelphia, USA
4
Developing a peer support specialist infrastructure
Scotland
5
Youth peer support workers
Melbourne, Australia
6
Warmline
Wellington, New Zealand
7
Rethink garden project
Salisbury, England
8
The Light House
Napier, New Zealand
9
In-patient psychodrama group
Melbourne, Australia
10
Collaborative Recovery Model
New South Wales, Australia
11
Person-centred planning
Connecticut, USA
12
The Golden Ducky award
Los Angeles, USA
13
The Strengths Model
Melbourne, Australia
14
The Living Room
Phoenix, USA
15
Key We Way
Kapiti Coast, New Zealand
16
IPS for young people
Melbourne, Australia
17
Education for well-being
Boston, USA
18
The MHA Village approach to employment
Los Angeles, USA
19
Mental Health at Work
Australia
20
Like Minds, Like Mine campaign
New Zealand
21
Implementing the Collaborative Recovery Model
Victoria, Australia
22
Implementing pro-recovery policy
New Zealand
23
Implementing the Strengths Model
Melbourne, Australia
24
Recovery Innovations
Phoenix, USA
25
Recovery Devon
Devon, England
26
Trialogues
German-speaking Europe
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Cambridge University Press 978-0-521-74658-8 - Personal Recovery and Mental Illness: A Guide for Mental Health Professionals Mike Slade Frontmatter More information
Acknowledgements The streetlights and signposts on my journey down the recovery road have been provided by many people, including Allison Alexander, Retta Andresen, Bill Anthony, Janey Antoniou and Pippa Brown (who contributed Case Study 7), Paul Barry, Chyrell Bellamy, Pat Bracken, Simon Bradstreet, Michael Brazendale, Peter Caputi, Laurie Davidson, Pat Deegan, Bob Drake, Marianne Farkas, Cheryl Gagne, Helen Gilburt, Helen Glover, Sonja Goldsack, Courtenay Harding, Ruth Harrison, Nick Haslam, Mark Hayward, Nigel Henderson, Dori Hutchinson, Gene Johnson, Lucy Johnstone, Levent Küey, Martha Long, Jenny Lynch, Pat McGorry, Chris McNamara, Graham Meadows, Lorraine Michael, Steve Onken, Rachel Perkins, Debbie Peterson, Vanessa Pinfold, Shula Ramon, John Read, Julie Repper, Priscilla Ridgway, Sally Rogers, Marius Romme, Diana Rose, Alan Rosen, Joe Ruiz, Zlatka Russinova, Beate Schrank, Geoff Shepherd, Greg Teague, Phil Thomas, Heidi Torreiter, Eric TrippMcKay, Bill White, David Whitwell, Paul Wolfson, Gina Woodhead and Sam Yeats. This book has been influenced by them all. Many experts generously commented on chapter drafts: Neal Adams, Piers Allott, Michaela Amering, Janey Antoniou, Jonathan Bindman, Jed Boardman, Derek Bolton, Mike Clark, Sunny Collings, Mike Crawford, Trevor Crowe, Larry Davidson, Pete Ellis, Alison Faulkner, Bridget Hamilton, Dave Harper, Corey Keyes, Eóin Killackey, Elizabeth Kuipers, Rob MacPherson, Paul Moran, Kim Mueser, Lindsay Oades, Mary O’Hagan, Ingrid Ozols, Dave Pilon, Stefan Priebe, Glenn Roberts, Jörg Strobel, George Szmukler, Graham Thornicroft, Janis Tondora, Tom Trauer and Rob Whitley. Their insightful suggestions led to the correction of a host of errors and mis-statements – those that remain (and the overall views expressed in the book) are of course my responsibility. This book was written during a leave of absence from my normal duties, for which I sincerely thank the Institute of Psychiatry, the South London and Maudsley NHS Foundation Trust, and colleagues who generously covered my responsibilities: Tom Craig, Neil Hammond, Louise Howard, Morven Leese, Paul McCrone and Sara Tresilian. My visiting appointment with the Melbourne clinical service headed by David Castle was organised by Tom Trauer, who provided consistently wise advice. I was fortunate to have excellent administrative support from Kelly Davies, Natalie Knoesen and Joe Mirza. Katie James and Richard Marley at Cambridge University Press provided consistently constructive guidance. Acknowledgements often recognise the contribution of family, but perhaps I have more to thank mine for than most authors. Writing this book involved living abroad for a year. To make this possible, my family left work, school and home for life on the road. Their unfailing love and support has helped me to learn more about life as well as work during the writing of the book. I am supremely grateful to Charlotte, Emily and Isabel.
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