Recovering from mental health issues and living with them

Life is fragile.

We can all be struck down by mental health challenges.

Then what do I do?

Should I keep it to myself, fearing of being stigmatized,

diagnosed with a mental disorder and having to take medication?

Or perhaps I should seek help from those around me?

How can I recover and continue living with my challenges?

Now imagine Grethe.

She has a managerial position, she is married

and socially active in various circles, with friends and organizations.

Suddenly, everything falls apart.

Grethe gets divorced and goes on sick leave,

her friends stop calling her and pass her in the street without saying hello.

She isolates herself and is unable to participate in her various social circles.

Grethe seeks help for her mental health issues.

She is given a diagnosis and offered psychoactive drugs

and a list of therapists in private practice whom she can call.

All of them have waiting lists of a year.

Grethe gives up and stops going out and being with other people.

This example shows that the relationship between Grethe as a person

and her life situation is an essential part of living life to the full.

Once you experience mental health challenges

that restrict you, the process of capturing

how to live with these challenges starts.

What is needed in terms of practical and emotional factors

to enable you to live with the things that you find challenging?

Mental health problems are the world’s number one public health issue.

The UN states this categorically in three different reports.

They write that people who experience mental health issues have

– and I quote:

‘… been exposed to exclusion, neglect, coercion and abuse,

and are seen as deviating from prevailing cultural, social and political norms’, unquote.

The reports state that the psychiatric model

is outdated and must be replaced.

According to the UN, a paradigm shift is needed.

So, what are the specific problems with the psychiatric model?

First, the pharmaceutical industry is making huge profits from psychoactive drugs.

Their annual income from sales and use of these drugs

amounts to hundreds of millions of kroner.

Often, they have little effect and cause great harm.

Medication also tends to be the only treatment option

given to people with mental health issues.

Second, the power relations in the field of mental health are skewed.

Psychiatrists and psychologists are at the top of the professional pyramid.

They control the truth about

what is the best and proper treatment for those with mental health issues.

Furthermore, the professionals tend to pay too little attention

to the opinions of the users themselves.

The help offered is often decided without the users

being consulted or allowed to contribute.

Many users have their own experiences of the kind of help

that has been helpful previously, and professionals ought to listen to this.

The failure of professionals to focus on the users’

living conditions, social circumstances and human rights is yet another problem.

Instead, the help is individualized.

This means that it is based on the premise that something

is intrinsically wrong with the person,

and no attention is paid to the ways in which social,

economic, and relational factors affect their mental health.

Third, we are short on local services and easily available help.

We need open, social meeting places with a low threshold, that welcome everybody.

This could be local meeting places with a café

and opportunities to participate in activities such as walking in nature,

music, physical exercise, reading groups and so on.

Those who use these meeting places should decide what activities and services are provided.

The UN reports also point to increasing social disparities

as the main cause of mental problems in our current age.

Living with little food or money,

with no work or lodging, in loneliness and physical isolation

gives rise to mental health problems in our own country and all over the world.

Less social disparity, more equality and fairness

will be the main drivers of change.

Given that the psychiatric model and its approach to addressing

mental health problems are outdated, what can we do?

This is where Recovery comes in!

Recovery means ‘to recover from mental problems

and be able to live with them’.

Recovery is about us as people

and the living conditions in which we find ourselves.

Recovery is a rebellion against being perceived

and treated as ‘ill’ and unreliable.

People who experience mental health problems should not

be treated in psychiatric institutions where they are pathologized and overmedicated.

When people are in psychiatric institutions,

we see only a small part of them.

How can we understand a person’s mental problems when

he or she is far away from their family, friends, work, and everything familiar to them?

As a concept and movement, Recovery started in the 1960s

as part of the civil rights movement in the United States.

The movement demanded that all American citizens

should have the same rights and opportunities,

and this struggle also included persons with mental problems.

‘The Psychiatric Survivor Movement’

fought for survival and against oppression, social stigmatization,

and exclusion, and became part of the civil rights movement.

They documented extensive abuse, coercion, and overmedication

of inhabitants with mental problems.

Similar struggles took place in other Western countries,

with the same demands for equal rights and opportunities,

social, political, legal, and human security, and respect.

Today, Recovery continues to rebel against stigmatization, marginalization

and social exclusion of people who experience mental health problems.

First: Recovery means to challenge psychiatric knowledge

and treatment through diagnoses and categorizations.

Second: Recovery means to highlight and address the violations

and injustice that have been inflicted on people with mental problems as individuals

and as a group – in families, local communities, services, and society.

Third: Recovery has a liberating force

and gives people the courage to act.

Fourth: Recovery creates communities that enable people to live

with the challenges that life confronts them with.

As people, we are born into relationships,

we live in relationships and we die in relationships.

The number of our relationships is not what counts –

but the quality of the relationship.

In fact, for those who have experienced mental health problems,

it is sufficient to have one strong, positive relationship to another person.

This could be a friend, a significant other or a mental healthcare professional.

Our mental health unfolds in our relationships

with our family, friends, work, economy, home, and society.

We also engage in relationships with animals, nature, culture,

our neighbourhood, and society.

It is essential for our mental health to have a home;

not merely a place to live, but a place to call home.

A place where I can close the door,

feel safe and know that this is where I belong.

Many studies have shown that having a home

is completely essential in Recovery.

Engaging in life’s different relationships means engaging in communities.

Communities that are inclusive, that value diversity and show care and compassion.

People who experience mental health issues

report that engaging with a community has been crucial for them.

Many feel overjoyed at entering a safe community

that welcomes them as they are, and where they

can develop solidarity and friendship with others.

People who have reached a turning point –

meaning their lives change for the better –

often mention very concrete actions

and experiences that helped bringing about the change.

It could be going out into nature,

finding a new friend, a dog, a significant other or a new health professional.

Mental healthcare professionals also provide concrete examples

when describing how to work in a Recovery-oriented way.

It might be having an ice cream together in a park, going for a walk,

discussing an author they both like and sharing their interest in music.

One day, Grethe in the example above

is contacted by a woman who also has struggled with mental health issues.

This woman tells Grethe that along with some others, she has started a football team

for girls and women with mental health issues.

They meet once a week for a training session,

followed by lunch together.

Grethe has never played football before.

‘It doesn’t matter,’ the woman says.

‘We can meet at your place and go to football ground together.’

Reluctantly, Grethe agrees to join.

This will be the first step in her Recovery process.

In the football team, she gets to feel that together we are less alone.

Recovery happens between people –

within and around a completely ordinary, and yet completely special community.

When Grethe participates, she is more than just Grethe as an individual –

she is the community and Grethe.

Research about Recovery shows that the simple is often the best.

Unfortunately, I find that Recovery-oriented services sometimes are made

too complex, and quite unnecessarily.

The service provision can be so complicated as to be out

of step with what the users themselves want.

It is often forgotten that small things that mental healthcare professionals do,

can in fact be perceived as big and important by the users.

For example, this could be a ride home or a friendly smile,

being shown trust, a professional who stays longer than planned,

or even comes along to a concert or a football match.

Sometimes, Recovery can be seen as really simple.

Often, these simple and highly effective aspects of Recovery

are adapted to the requirements for standardization and equal treatment that are set by the mental healthcare services.

The importance of the small, simple steps therefore often lose out

to services that should be the same for all –

with no adaptation to each individual.

The Recovery process starts on a small scale with a big question:

What is important to you?’

In this way, I am invited to work with the things that are

important to me in my life in order to recover.

Recovery is not about standing alone

on your own two feet without anybody else.

Recovery is more than just coping with life

and realizing our potential.

Such an individualized version of Recovery

implies that we should strive for maximum independence

and separate ourselves from communities.

Life is relational and is lived relationally.

Recovery is about hanging out with people

and being a part of various communities.

In the football team, Grethe experiences a turning point

and finds out how it is possible to work on her recovery.

She experiences inclusion – and trust –

in a community of women which is caring and accepting.

Being in the company of others who have also experienced

mental health issues gives her strength.

And not least: people who have experience of how they can learn

to live with mental health challenges –

alone and in the company of others.

The physical activity also helps Grethe feel

that she lives better with her mental – and physical – health.

Recovery is about the simplicity and greatness in inviting someone into community and helpful relationships.

Your wishes and your own insight into what might be helpful

and supportive are the starting point,

together with ensuring your rights and fulfilling your obligations.

The person who is living in Recovery

must be in the driver’s seat –

professionals and others should support the person in these efforts.

All those who wish to be helpful must walk alongside

this person – not in front.

Such persons could be family, friends,

colleagues, professionals or neighbours.

Development of Recovery-oriented services

happens in collaboration with users,

relatives, professionals, leaders and decision makers.

And: we must constantly consider whether our Recovery practices

and Recovery-based services in fact

represent the best and most liberating aspects of the Recovery tradition.

We need to ensure that the Recovery services are not

adapted in such a way that everything just continues

unchanged – in the same way as it has always been.

Summing up:

As humans, we are stronger together –

humans need humans.