Narratives of Recovery from Mental Illness

The role of peer support

Mike Watts, Agnes Higgins

• Publisher: Routledge
• Year: 2016
• eBook ISBN: 9781317536338
• Edition: 1
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Narratives of Recovery from Mental Illness presents research that challenges the prevailing view that recovery from 'mental illness' must take place within the boundaries of traditional mental health services. While Watts and Higgins accept that medical treatment may be a vital start to some people's recovery, they argue that mental health problems can also be resolved through everyday social interactions, and through peer and community support.

Using a narrative approach, this book presents detailed recovery stories of 26 people who received various diagnoses of 'mental illness' and were involved in a mutual help group known as 'GROW'. Drawing on an in-depth analysis of each story, chapters offer new understandings of the journey into mental distress and a progressive entrapment through a combination of events, feelings, thoughts and relationships. The book also discusses the process of ongoing personal liberation and healing which assists recovery, and suggests that friendship, social involvement, compassion, and nurturing processes of change all play key factors in improved mental well-being.

This book provides an alternative way of looking at 'mental illness' and demonstrates many unexplored avenues and paths to recovery that need to be considered. As such, it will be of interest to researchers, academics and postgraduate students in the fields of psychiatry, psychology, nursing, social work and occupational therapy, as well as to service providers, policymakers and peer support organisations. The narratives of recovery within the book should also be a source of hope to people struggling with 'mental illness' and emotional distress

1 Genesis of the book and setting the context

DOI: 10.4324/9781315726243-1

The word ‘recovery’ from mental health problems is ‘in the air’. Everyone is talking about it. Go to any mental health website, sit in on any mental health services development meeting, scan through the curriculum of any education programme for mental health professionals and the word ‘recovery’ is going to be found. Everyone is asking ‘Is this service recovery oriented?’, ‘Is this education programme underpinned by recovery values?’; and the likelihood is that everyone will nod in the affirmative, looking somewhat affronted that the question should be asked in the first place. Is that not what the whole mental health system is about?

Since the 1990s many Western governments have announced policies that champion the idea of recovery. For example, America ‘envisions a future when everyone with a mental illness will recover’ (President’s New Freedom Commission on Mental Health 2003:1). Similarly New Zealand’s publication ‘Recovery Competencies for New Zealand Mental Health Workers’ (Mental Health Commission New Zealand 2001) and the UK’s policy document ‘The Journey to Recovery – The Government’s Vision for Mental Health Care’ (Department of Health 2001) all seek to make recovery the main aim of their mental health systems. In Ireland with the publication of ‘A Vision for Change: Report of the Expert Group on Mental Health Policy’ (Department of Health and Children 2006) the government articulated a commitment to transforming mental health services to recovery-oriented principles. Despite growth in the usage of the word ‘recovery’ within policy and practice discourse, very legitimate questions remain. What does recovery from ‘mental illness’ mean? How is it achieved and how can it be nurtured? Is it a chemical process or a learning and developmental journey? Is serious ‘mental illness’ a permanent condition that requires life-long treatment, or is it indicative of an emotional crisis that is fully resolvable?

The word ‘recovery’ is packed with multiple meanings. Any English dictionary might define recovery as an action or process of regaining possession or control of something stolen or lost or, in a health context, describe it as a return to a normal state of health, mind or strength. Deegan (1995), a mental health activist with self-experience of mental health problems, views recovery as a process through which people acknowledge being socially disabled by their mental health problems and recover a new sense of self. Anthony (1993:527) developed these ideas further by contending that ‘recovery involved the development of new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness’. This means moving away from the currently dominant idea that recovery is primarily to do with a medically supervised process involving medications, the removal of ‘symptoms’ of illness or the return to some ‘pre-illness’ state.

Shari McDaid (2013:8), the CEO of Ireland’s Mental Health Reform, describes recovery as an

individual process of discovering one’s own strengths, values, meaning and aspirations; a self-determined journey that can take place inside and outside the mental health system, through personal development, through partnership relationships with professionals, through peer support or through community support.

It is a process of reconnecting with life that can happen for some with the continuation of ‘symptoms’, while for others, a reduction in ‘symptoms’ is important. This view challenges the idea that recovery from mental distress or ‘mental illness’ must take place within the boundaries of traditional mental health services and is solely dependent on the support of mental health professionals. McDaid’s (2013) view opens up the potential for mental health problems to be resolved within the context of the social system, within the day-to-day interactions people have within their communities and through peer and community support.

This book is largely about recovery from ‘mental illness’ outside the boundaries of traditional mental health services. It is a story of possibility and hope involving the recovery stories of people, all of whom received a diagnosis of ‘mental illness’ and all of whom were involved in mutual support through an organisation known as GROW. What emerges from their stories is a powerful and fantastic story of human effort and healing. This book also tells a story of the capacity for mutual or peer support to reach into the most hidden recesses of human experience and enable a person to find strength, personal meaning and identity. While individual accounts highlight many of the deficiencies of a mental health system rooted in the idea that ‘mental illness’ is symptomatic of a problem within the person, be it genetic or chemical, there is an acknowledgement that medical treatment can, when implemented in dialogue with the person, be an invaluable start to the recovery journey. However, there is also a strong suggestion that recovery can include an appropriate weaning away from the need for medication as other personal, inter-personal and social resources are developed and put into place.

While the two people named on the cover of this book, Mike Watts and Agnes Higgins, are the official authors, in fact the real authors of this book consist of the 26 people interviewed about their experiences and journeys. They are the people who put the words on the pages, and we (Mike and Agnes) could be viewed as merely the pen which gave their stories flesh. Having said this, our own biographies no doubt have shaped our interest in the subject area and our chosen method of collecting and analysing the stories. We both have spent our entire adult lives connected in different ways to the field of mental health and during that time have struggled with the meaning of the concept of recovery, including how best to support and nurture it. Both of us have been close observers of the way people diagnosed with ‘mental illness’ have been treated and the effects this treatment has had on them. In different ways we both have been at the very center of Ireland’s own efforts to develop a recovery ethos, Mike through his own personal experience of ‘mental illness’ and recovery and his peer-support work and Agnes through her experience of working as a nurse within the formal mental health services and hospice services and through her research and teaching in the area of mental health.

Mike and Agnes first met in the early 2000s, when Mike came to co-facilitate some teaching sessions on recovery for student mental health nurses with Agnes in Trinity College Dublin, Ireland. Later, as Mike went on to read for a PhD, Agnes became his mentor and academic supervisor. Since then they have collaborated on a number of projects and initiatives, including this book. In keeping with the spirit of the book and in an attempt not to mirror or add to the disparities of power within what is termed the ‘service user/professional relationship’, they would like to tell you something about their lives and motivations so that they are not just anonymous names with academic titles and qualifications.

Something about Mike

I grew up in a medical family. Both my parents were doctors, and my father’s special interest was mental illness in general practice. As a young man I became increasingly beset by fears about myself, about life and about the future. These were exacerbated by a growing reliance on alcohol and later cannabis. On occasion, I had begun to hear menacing voices and to misinterpret the meaning of everyday sounds. I had also begun to develop theories about eye colour that I knew were very strange, and yet I resisted seeking help. Towards the end of the 1960s I agreed to see a psychiatrist, a friend of my father. I thought I was headed for a quiet personal chat where I would find reassurance and perhaps some guidance on how I could help myself. Instead, I was asked if medical students could sit in on my first interview. I can still picture a whole group of them in a small lecture theatre with eager faces and notebooks. I could feel myself clamming shut and wanting to escape. After the interview I was given a diagnosis of pathological shyness, prescribed Librium and told that I was welcome to come back whenever I liked. I never did go back. In 1973, after the birth of our first child, my wife Fran experienced what was termed a classic post-puerperal psychosis. It was probably the most frightening experience of both of our lives. Admitted to hospital and treated solely with drugs, Fran’s diagnoses oscillated between schizophrenia, schizo-affective disorder and bipolar or manic depression. Nobody could offer any advice on how we could help ourselves other than to ‘keep on taking the tablets’. No one ever asked us about ourselves or about any of the traumas we had both experienced along the way. The blunt manner with which Fran was told she had schizophrenia completely stole any hope she might have for the future. She was told that she would need lifelong medication and frequent respite breaks in hospital and should avoid all kinds of stress. The side effects of the medication were horrendous. Fran’s life was over. Barely able to function and massively overweight, we were both told ‘you are cured’, go and get on with your life.

Those two incidents formed the basis of a lifelong passionate interest in recovery. In 1976 we stumbled across GROW, a mutual-help organisation working in the area of mental health. It was manna from heaven. Through GROW we met people who supported us in our recovery, and we, in return, mutually supported them. After 7 years of voluntary involvement with GROW I became a fieldworker and then national program coordinator, a role I played for 20 years.

As part of my own recovery I returned to third-level study, studying psychology and later family therapy. I also became involved in many artistic groups such as painting, writing, music and poetry. In the mid 2000s, at the end of a 5-year spell as a service user member of Ireland’s newly formed Mental Health Commission and after spending more than 30 years working in the area of recovery, I undertook a PhD degree.

Something about Agnes

I grew up in the west of Ireland, a middle child of seven, two sisters and a brother older and two sisters and a brother younger. Born into a small rural farming community, I was no stranger to farm work and the long idyllic days in the hay field or bog, but neither was I a stranger to the harshness of rural communities when one was perceived as different. The stigma and shame associated with having a ‘mental illness’ or having to spend time in the local psychiatric institution was very real, with very real consequences for the person and family concerned.

I commenced mental health nurse training in 1978, not exactly with the approval of my parents, as they worried about me and would have preferred if I had chosen ‘real nursing’ (general nursing). Indeed, I am still unsure why I chose mental health nursing. My decision to accept a place as a student psychiatric nurse, in St Vincent’s Hospital Fairview, Dublin, Ireland, was strongly influenced by the warm, friendly and caring atmosphere created by the people who interviewed me. Some might say it was a naive way to make a decision about something as serious as my future career. Looking back, I feel fortunate as I have never known a morning that I was not excited or hopeful about going in to work, whether I was working in a mental health service, hospice, general hospital or an academic institution. This is not to suggest that I was not challenged or distressed by the stories I heard, the people I met or the inadequacies of the services and system that I was part of and, some might eve...

Table of contents

• Cover Page
• Half-Title Page
• Title Page
• Copyright Page
• Table of Contents
• List of figures
• Forewords
• Acknowledgements
• Section 1
• Section 2
• Section 3
• Index