Ships are safe in harbour, but that is not what they are designed for

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Ships are safe in harbour, but that is not
what they are designed for
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Recovery

• Andy Luckhurst, Service User Consultant, Oxleas
  NHS Trust
• Gina Benjamin, Project Manager, Community Options

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Brainstorm

• What do you think Recovery means?

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Defining Recovery

• A deeply personal, unique process of changing
  ones attitudes, values, feelings, goals, skills
  and/or roles. It is a way of living a satisfying,
  hopeful and contributing life even with
  limitations caused by illness. Recovery involves
  the development of new meaning and purpose in
  ones life as one grows beyond the catastrophic
  effects of mental illness

(Anthony, 1993. pp559-560)
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Questionnaire
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Themes of Recovery

• Hope
• Being believed in
• Developing perspective on the past
• Changing other peoples expectations
• Gradually gaining a sense of greater wellbeing
• Developing a new meaning and purpose in life
• Persevering (not a linear process)

(Turner- Crowson Wallcraft, 2002)
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Themes of Recovery cont

• Taking personal responsibility for ones life
• Acting to rebuild ones life
• Developing valued relationships and roles

(Turner-Crowson Wallcraft, 2002)
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Understanding Recovery

• Recovery is a journey and that is a very
  individual experience for each and everyone
• People can go in and out of recovery
• It is important that a persons personal history
  is listened to
• It is vital to get to know the person not the
  diagnosis
• Goal setting is important, where are you now
  where would you like to be
• Recovery does not offer a cure, but a means of
  looking at your life differently, of gaining a
  sense of hope for a better future for yourself

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Bromleys RecoveryNETMission Statement

• The Recovery Group is committed to the support
  and encouragement of people recovering from
  mental illness.
• Whilst it is recognised that Service Users hold
  the key to their own recovery, the valuable
  knowledge and experience of others is an
  important aspect of recovery.
• The group will provide professional and personal
  support needed to help the individual to take
  responsibility to have active involvement, to
  ensure the ongoing long-term recovery process.

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Bromleys Recovery Groups Mission Statement

• Recovery is
• Maintaining a sense of hope about ones own
  future journey in life. It is about developing
  coping skills to both manage and improve ongoing
  self-development and gaining the opportunity to
  lead an independent, meaningful life in the
  community.
• Recovery is not a linear journey, but a journey
  with many twists and turns.

Bromley Mind
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Understanding Recovery

• While in recovery formulating a wellness
  toolbox (what keeps you well), a crisis
  intervention plan (WRAP, Wellness Recovery Action
  Plan)
• It is important to build up a rapport with your
  support team, you can discuss with them what you
  want out of life, and how they can help you
  attain what you want
• Peer support from other people who are on the
  road to recovery, together you can discuss coping
  strategies
• Look at people holistically, it could be
  housing/lack of benefits/lack of a social
  life/lack of friends and family that are stopping
  them recovering
• Recovery cannot be packaged or delivered or
  done for or to people

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Wellness Recovery Action PlanWRAP

• What makes a WRAP?
• DMP or Daily Maintenance Plan
• Crisis Plan
• Post-crisis Plan

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Before you can create a WRAP, we need to
consider what the words WRAP mean

• Wellness the maintenance of good physical and
  mental health, especially when maintained by
  proper diet, exercise and habits
• Recovery regain your ability to manage your
  life
• Action how you are going to do your plan
• Plan lists what you are going to do

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Recovery Principles

• The Service User directs the recovery process
  therefore the Service Users input is essential
  throughout the process
• The Mental Health system must be aware of its
  tendency to enable and encourage Service User
  dependency
• Service Users are able to recover more quickly
  when their hope is encouraged, enhanced/and or
  maintained
• Life roles at work, and meaningful activities are
  defined
• Spirituality is considered and their culture is
  understood
• Educational needs as well as those of their
  family/ significant others are identified
• Social involvements also need to be identified

Taken from NIMHE (National Institute for Mental
Health in England) Emerging Recovery Policy and
Resource Guide
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Recovery Principles Cont

• Individual differences are considered and valued
  across the whole life span
• Recovery from mental illness is most effective
  when a holistic approach is considered
• In order to reflect current best practice there
  is a need to merge all intervention models and
  approaches, including medical, psychological,
  social and recovery
• Workers initial emphasis on hope and the
  ability to establish trusting relationships
  influences the Service Users recovery
• Workers operate from a strengths/assets model

Taken from NIMHE (National Institute for Mental
Health in England) Emerging Recovery Policy and
Resource Guide
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Recovery Principles Cont

• Workers and Service Users together develop a
  recovery management plan. This plan focuses on
  the treatments and supports that will facilitate
  recovery and the resources that will support the
  recovery process
• Family/significant others involvement may enhance
  the recovery process. The Service User defines
  his/her family/significant other/s
• Mental Health services are most effective when
  delivery is within the context of the Service
  Users community
• Community involvement as defined by the Service
  User is important to the recovery process

Taken from NIMHE (National Institute for Mental
Health in England) Emerging Recovery Policy and
Resource Guide
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P
artnership
o
L
ifestyles
Community Options Flexible Support for People
with Mental Health Needs
e
V
alued
e
working together for social inclusion
D
eveloping
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Bromleys Recovery Groups

• There are currently three groups. One in each of
  the three localities
• Each group session meets weekly for 26
  consecutive weeks and lasts for 1 ½ hours
• The group sessions are held at non-medical/day
  service locations e.g. Church Hall
• Groups have between 6 and 10 members
• The groups decide what issues/topics they want to
  talk about

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Topics that have come out of groups

• Common experiences
• Self-harm
• Overdose
• Hallucinations (visual and auditory)
• Suicide
• The use of illicit drugs
• Obsessive Compulsive Disorder (OCD)
• Treatment
• Debt
• Duvet days
• Stigma (label)
• Coping strategies stress management

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Mental Health Stigma

• These are some of the areas Service Users felt
  there was stigma
• Stigma within services from health professionals
  and admin staff
• Stigma attached to a particular diagnosis
• Negative media coverage
• Family overcoming stigma with family members
• Own embarrassment to have mental illness
• Societies ignorance for example many people have
  the perception that all paedophiles, and those
  that may harm others etc suffer from mental ill
  health
• Stigma within the workplace

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What comes after a group?

• Personal development
• Cognitive Behavioural Therapy (CBT)
• Psychotherapy
• Recovery group facilitation
• Social network building
• Person-centred planning
• Anger management
• Employment supported employment, independent
  employment, volunteering
• Education Adult Ed., College etc
• Healthy living
• Environmental changes e.g moving home

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Experiences of people on their recovery pathway

• Recovery does not mean cure, it is a hopeful
  attitude, a way of approaching the day.
  Practitioners and carers working with people with
  mental illness need to see the person as more
  than the illness
• Pat Deegan (an author, a person diagnosed with
  schizophrenia, living in the USA)
• Recovery requires self-confidence, self-esteem,
  self-awareness, self-acceptance, it is a
  liberating process, a social process and one in
  which practitioners need to believe in
• Ron Coleman (diagnosed with schizophrenia, a
  voice hearer and author)

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Experiences of people on their recovery pathway

• My recovery process involved rest and good food
  but the hardest part was raising peoples
  (including my own) expectations of myself.
• Rufus May (diagnosed with schizophrenia, a
  psychologist)
• Recovering from psychosis is an individual
  journey that needs a wide variety of therapeutic
  options to be available to the person
• Peter Chadwick (diagnosed schizophrenia,
  psychologist and author)

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Experiences of a Bromley Recovery Group member

• The group made me realise that moving on and
  leading a normal life was obtainable and made
  me remember that every morning is a new day. It
  also taught me not to be hard on myself and give
  myself a break once in a while. The group helped
  me gain the confidence and strength to start
  looking at career options and start part-time
  work after many years of unemployment

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Experiences of a Bromley Recovery Group member

• My name is Chris. I am on the pilot recovery
  group. Here are a few thoughts that I have had
  about recovery. I find it very beneficial from
  the point of view that it helped me recognise the
  pattern of my illness, and to ask for help from
  my support team, before my illness gets too bad.
• It has empowered me to have a say with my own
  recovery with my support team and psychiatrist,
  rather than sitting there and letting them tell
  me what to do. Also, it has helped me to take a
  major step, which really is a major step for me,
  to start volunteering in the community, and
  moving away from the safety of my day centre.
• At times, it was not easy because listening to
  other peoples stories was quite distressing for
  me. But we did learn a lot from each other, and
  ways of coping and to accept the bad days as well
  as the good days.
• My own recovery journey has taught me that there
  can be light at the end of the tunnel and my own
  personal experience has not been wasted, because
  now I can use it to help others on their own
  personal journeys of recovery.

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I find that the greatest thing in the world is
not so much where we stand, as in what direction
we are moving.To reach the port of heaven, we
must sail sometime with the wind and sometime
against it - but sail we must, not drift or lie
at anchor.
Oliver Wendall Holmes
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Thank you

• Andy Luckhurst
• Andy.luckhurst_at_oxleas.nhs.uk
• Gina Benjamin
• Gina.benjamin_at_community-options.org.uk

With thanks to Dee Ashton, Bromley Mind