Wednesday, July 22, 2009

Criticisms of the Mental Health Recovery Model

Hello all:

As per Will’s direction on his blog, WillSpirit, I was pointed to a number of criticisms for the recovery movement that I would like to address. Some of them are very valid, others are somewhat misconceptions, but as with every model the mental health recovery model is not without its faults, so in an attempt to give you an unbiased view, I will review such shortcomings and my opinions on them here:

1) The recovery model adds to the burden of the providers

Recovery in fact decreases the burden of the mental healthcare provider. As is demonstrated by both the American Clubhouse model and the U.K. model, recovery oriented clinics tend to lean towards the use of peer mentorships and peer counselors. These advisors (usually individuals on the road to recovery or recovered who suffered from the same or a similar diagnosis) take some of the burden away from case managers and physicians by re-acquainting mental healthcare consumers with basic social interactions, going to the movies, etc.

2) Recovery must involve cure

This is probably the battle that is fought the most in the recovery movement, as the term recovery implicitly refers to absence of ailments, a return to normalcy, and no symptom interference at all. While perhaps a different name would have lead to less confusion, that is the name and there is not much to be done about it now, but recovery in a mental health setting certainly does not imply complete absence of symptom interference. Some mental illnesses are severe and persistent and may never go away; the mental health recovery model merely focuses on empowering individuals to allow them to lead long, fulfilling lives in spite of symptoms and to teach them how to maintain a successful career and meaningful relationships.

3) Recovery-oriented care can only be pursued through new resources

Well…this one is a yes and no. Yes new trainings will need to take place and should a clinic wish to purchase psychographic measurement tools those will need to be brought on, along with their supporting technologies and data-management system. But in terms of actual resources nothing overly extravagant is required of a recovery-clinic that a normal clinic wouldn’t already have.

4) Recovery-oriented care is not reimbursable or evidence based

This argument is flat-out incorrect. The development of psychographics is a growing industry and millions of dollars of funding is going towards research institutes and clinics for the exploration into such quantifiable measurements of recovery. Reimbursement has never been an issue for recovery-clinics. What is a bit of a concern is the expertise needed to analyze the aggregated psychographic indicators; this often times will require an advanced multidisciplinary team, but smaller clinics without such researchers can of course outsource the data analysis to more equipped research facilities or to independent contractors.

5) Recovery devalues the role of professional intervention

Not so, recovery values the role of professionals but creates a relationship between professional and consumer as a team effort towards recovery, rather than in a traditional sense wherein the professional instructed the consumer as to what they were doing wrong and how to fix it. This leads to more constructive internal motivations for the consumer thus is more effective. Recovery does change the role of the professional, as is implied via the team- rather than boss-relationship, and the use of peer mentors and councilors does take away some day-to-day duties of professionals, but this freeing of time should be seen as a relief and an opportunity to devote one’s time to more complicated and intricate matters rather than spending that time showing a consumer where to get a bus pass, etc (which is now a duty taken on by peer support groups and case managers).

These were just some of the biggest criticisms I found on the web. If you have more pressing concerns that haven’t been addressed I would love to address them so just shoot me a comment!

Until next time,
Lex
MHCD Research and Evaluations

3 comments:

  1. Here is my thought on the Recover model. Woring as a professional in Mental Health I have seen this used as a double edge sword. I see the value in it's emphasis on the fact that many people who have a mental illness can recover and lead a productive happy life. Part of the model I have seen emphasized in personal reponsiblity. It' the idea that people need to take responsiblity for their recovery and accept the consequences of their decisions. Here is where the problem comes in.Often if someone is not able to get better they seen as responsible for their failure and not deemed to be "worthy" of furthrer help. It amounts to blaming the victim. Now I know that this isn't what is intended by the supporters of this model but I have seen the ideas get perverted when applied to actual practice.

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  2. I am fiercely critical of the “recovery model” as I incurred a great deal of damage in relation to it. I constantly hear people say well “it works for some” but I have found that in order for it to work for some I have been exploited and when I complain about this the fact that my health has been damaged doesn’t concern those who have exploited me in order to get funding to “help others” and pay their own wages. The recovery model has also been used as a euphemism for neglect. I have very complex emotional and psychological problems and I also have innate undeveloped talents. This has left me wide open to manipulative conceited manipulation and the worst offenders are those who are employed in the recovery industry who have a history of psychiatric problems. Frankly I think the recovery model is vile middle class and right wing. I am clear that it is not my perception that something is very wrong with it, I know from my experience that something is very wrong with it!

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  3. And furthermore, mental health is epidemic because our society is sick. How can people recover into such a society?

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