Recovery's Edge: An Ethnography of Mental Health Care and Moral Agency

Book info: Recovery's Edge: An Ethnography of Mental Health Care and Moral Agency (Hardcover, 208 pages) – Vanderbilt University Press, 2015. Language: English.

In 2003 the Bush Administration's New Freedom Commission asked mental health service providers to begin promoting "recovery" rather than churning out long-term, "chronic" mental health service users. Recovery's Edge sends us to urban America to view the inner workings of a mental health clinic run, in part, by people who are themselves "in recovery" from mental illness.In this provocative narrative, Neely Myers sweeps us up in her own journey through three years of ethnographic research at this unusual site, providing a nuanced account of different approaches to mental health care. Recovery's Edge critically examines the high bar we set for people in recovery through intimate stories of people struggling to find meaningful work, satisfying relationships, and independent living.This book is a recipient of the Norman L. and Roselea J. Goldberg Prize from Vanderbilt University Press for the best book in the area of medicine. Excerpt. © Reprinted by permission. All rights reserved. Recovery's EdgeAn Ethnography of Mental Health Care and Moral AgencyBy Neely Laurenzo MyersVanderbilt University PressCopyright © 2015 Vanderbilt University Press
All rights reserved.
ISBN: 978-0-8265-2079-1
ContentsAcknowledgments ix A Note on Contested Terms, xiii,
1. Orientation, 1,
2. No Direction Home, 15,
3. Step One: Take Your Medications, 57,
4. Step Two: Self-Advocate, 87,
5. Step Three: Work for Intimacy, 121,
6. Recovery's Edge, 141,
7. Over the Edge, 155,
Appendix. Comparison of Traditional and Recovery-as-Advocated Care, 165,
Notes, 167,
References, 169,
Index, 187,


CHAPTER 1

ORIENTATION

Where did we come from? We came from nowhere.
We came from institutions. We came from the streets.
We were no one, but we had a desire to change our lives.

— Ed Knight, Keynote, Alternatives Conference, October 2006

Okay, show of hands, how many people forgot their medications today?"

A few hands went up.

"Oh, you're lyin'," Vera said, shaking her head.

The audience erupted in laughter. Most had been prescribed daily medications to address psychiatric symptoms such as depression, anxiety, and psychosis.

"Now, let's get serious," she continued. "If you met me a couple of years ago, you would have seen me walking around like this ..."

Vera hunched her shoulders and stared at the ground.

"Overmedicated, no self-esteem, no self-worth, and — even more so — afraid."

Many audience members nodded.

"Afraid that if I walked into a social service agency they wouldn't help me with what I needed. I was afraid to make a move one way — to go back to work. I was afraid for another hospitalization after several times of being in the hospital for four, five, six months. My life was really changing for the worse until I became empowered. And then, I realized that for my recovery it was more important to help others.... Many people try to help themselves, and then help others, but my road was different. I needed to help others."

Vera was once, she continued, an "unruly mental patient" staging protests at her nursing home. She had been leading advocacy efforts for the past decade, and ultimately became a peer provider at Horizons, an urban psychosocial rehabilitation organization that served more than six thousand mental health service users that they called "members" in the local metropolitan area. With the support of Horizons, Vera recently had applied for and received a grant to run her own, peer-led treatment program, the Peer Empowerment Program — also known as PEP.

On that particular day, Horizons CEO, Steve, had asked Vera to give a speech encouraging other members to seek organizational leadership roles. For Steve and the hundreds of members in the audience that day, Vera was an innovator, and a strong role model for recovery. PEP's radical, groundbreaking feature was that "peers" directed and offered the services — which Vera jested later, "let the lunatics run the asylum." Vera explained to the audience how peers shared many of the same extraordinary life experiences as the members, which she believed made them excellent mental health care providers for members.

"They, too, have been homeless, hospitalized, and alone."

Having peers direct one's care, advocates like Vera believed, was different from having the usual, college-educated "case managers" because "professionals" could never understand how it felt to receive a psychiatric diagnosis or experience symptoms. Peers, they argu