What Is the Recovery Movement?
Answer: The future of mental health
If only I’d known about the long history of recovery from mental illness, the recovery movement, and the remarkable work of those offering peer support (assistance from those with lived experience with mental illness), I might have recovered much sooner than I did.
What we call the recovery movement, often referred to as the mental patients’ liberation movement, started during the mid-twentieth century. The 1960s and 1970s saw the advent of deinstitutionalization. It intended to free those suffering from mental illness from the horrid conditions of most mental hospitals. Patients had been hospitalized either voluntarily, which meant a total loss of individual rights, or involuntarily, which also meant a total loss of individual rights. They were coerced or forced into “treatment.” Imagine going to a “hospital” (i.e., mental hospital) to get help and finding yourself in a locked ward forced to take medications and violently abused.
The goal of deinstitutionalization was to return patients to society where they would be cared for in community mental health centers. Those community-treatment centers never transpired, and many were left on the streets or ended up in prison. But deinstitutionalization also gave those with lived experience of mental illness a voice.
One of the most seminal figures was Judi Chamberlin. A Manhattanite, Chamberlin sought treatment for postpartum depression in the 1960s. After her first office visit, a psychiatrist prescribed her the potent antipsychotics Thorazine and Stelazine. She didn’t improve. The psychiatrist said she should be hospitalized. Over six months in 1966, she went in and out of six New York hospitals. She went into care a housewife suffering from depression after having a child and came out a patient diagnosed with “chronic schizophrenia with homicidal and suicidal tendencies.” With the help of a psychologist and finding purpose in the Women’s Liberation Movement, she recovered—fully—and joined the Mental Patients Liberation Project (MPLP), one of the first patient-run advocacy groups in the country. In 1978, her book On Our Own: Patient-Controlled Alternatives to the Mental Health System was published. It called for a system in which people with mental illnesses weren’t “passive recipients of institutional ‘care’” and instead were encouraged “to see the strong and positive aspects of themselves as they, in turn, help others.”
Chamberlin eventually became part of the anti-psychiatry and psychiatric survivor movements. This aligned her with those seeking to publicize the injustices and abuse suffered at the hands of psychiatry and separated her from groups like MPLP, which sought funding from governmental organizations and sought change from within. Throughout the 1980s and 1990s, the patients’ rights movement gained strength and momentum. It was divided between those who were anti-psychiatry and saw themselves as survivors and those who weren’t anti-psychiatry and saw themselves as ex-patients or “consumers.” The term consumers suggests having influence over the mental health system and inverts the typical power imbalance.
The “news” that a full recovery from mental illness is possible began to gain some traction with politicians at the turn of the twenty-first century. The 1999 Surgeon General’s report was the first policy document to state that recovery from mental illness is possible. (It then went on to define recovery as something only the most virtuous and well-adjusted human could ever possibly achieve.) In 2003, the New Freedom Commission audited the mental health system. Its Executive Summary leads with these words: “We envision a future when everyone with a mental illness will recover, a future when mental illnesses can be prevented or cured…”
That same year—2003—I sat in a therapist’s office off 86th Street in New York. After our brief, initial consultation, she informed me—definitively—that I had major depressive disorder and suggested I see a psychiatrist for medication. As Chamberlin experienced with that first psychiatrist she saw, this therapist knew nothing about me except what I’d chosen to share during the thirty-five minutes we were together. Even if she hadn’t been so presumptuous, the words recovered, healed, or cured weren’t mentioned. A year earlier, a GP I’d never seen before prescribed me valium for my anxiety after a fifteen-minute office visit. He mentioned refills but nothing else. “Call when you need them.” Twenty-one years earlier, my mother sat in the eating disorders outpatient unit and was told that I’d always be anorexic and would likely die. Twenty-seven years later, I listened as my GP explained that my (my) ADHD and then my OCD and then my ADHD and OCD with anxious and depressive elements would be with me always. Nine years later, Dr. M, the bipolar expert, described my future: a life of mixed manic and depressive episodes that could improve—with this drug or that one—but could also worsen over time.
Major reforms of the paternalistic mental health care system have yet to be welcomed by the system, let alone encouraged. Psychiatry invested heavily in the biomedical model that insisted DSM diagnoses are chronic, which means persistent but is often understood to mean lifelong. Psychiatry has a tight relationship with Big Pharma and recovery doesn’t exactly help create a permanent customer base, which would cut into the research funding universities capitalize on and academic psychiatrists build their careers on.
Which may be part of the reason that the recovery community is overlooked, ignored, and underfunded. Peer support also doesn’t deliver clickbait headlines: Another Person Suffering from Mental Illness Finds Solace and Belonging—Fully Recovers. Or maybe it does—if the media would try it.
If there were more publicity around the recovery movement and all it’s done to help people, maybe one of the more mainstream approaches to recovery would have reached me. According to the American Psychological Association and SAMHSA, recovery has ten core principles: self-direction (we get to determine how we’ll recover), individualized and person-centered (we get to do it our way), empowerment (we get to participate in any decision making), holistic (we can recover in every aspect of life—“mind, body, spirit and community”), nonlinear (it won’t be easy and there’s no map), strengths-based (we won’t draw on our weaknesses), peer support (we’ll draw on the life experience of those who’ve been there), respect (deserve respect from “society, communities, systems of care, and ourselves”), responsibility (our self-care is up to us), hope (there’s a better future out there).
I saw three therapists and one psychologist, many psychiatrists, and several GPs, and not one mentioned these principles to me. None mentioned the word recovery. Did they not know? Are we hiding recovery from people?
As Tom Insel, former head of the NIMH put it, peer support is the future of mental health. We need to stop giving people diagnoses and telling them they’re life sentences. We can recover.
Many organizations have been working to train peer support specialists and get people the resources they need to recover from mental illness. Two organizations doing extraordinary work are the nonprofits On Our Own of Maryland and the Wildflower Alliance. On Our Own of Maryland has been at the forefront of peer support for thirty (30!) years. The Wildflower Alliance offers a twenty-four-hour peer support line for those in distress. Please publicize peer support and these organizations. Even better, donate to On Our Own Maryland here and/or the Wildflower Alliance here. Or just share this post.
What is recovery from mental illness?
The Substance Abuse and Mental Health Services Administration (SAMHSA) defines recovery as “a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.”
To learn more about recovery, go here.
Read more about my recovery from mental illness in the exclusive publication of my new memoir Cured. You can read it for free through 2023: