Aug 25, 2012

My recovery will not be audited.

The more I read about SAMHSA’s recovery platform, the more I’m convinced it’s not for me. 

A recent SAMHSA “recovery to practice” publication has a great title: Why Adding 'Recovery' to a Treatment Plan Does Not Make It a 'Recovery Plan' -- but a disappointing premise.

The art of recovery planning involves being able to imagine and articulate the steps a person can take in the next 3 to 6 months, along with the interventions other people can provide to enable and support those steps, to improve his or her life and move it in the direction of his or her longer term aspirations. The fact that a person has a condition we call schizophrenia may not change over that 3- to 6-month period, but lots else in the person's life can. This is one of the many reasons funders, auditors, and accrediting bodies prefer to see person-centered care plans in medical records, as these plans clearly articulate what objectives the practitioners are seeking to achieve through their provision of services and supports. To meet auditing criteria, these objectives need not only to be measurable, but they also are expected to change over the period relevant to the care plan (for example, 3 or 6 months).

What’s the deal? I never expected funders to audit me!

My recovery is my business, not theirs. The task of health practitioners – mental health included – is to deliver care that facilitates the process of my life. My goal might be to have a nice house, a girlfriend, a good marriage, successful children, a meaningful job that pays the bills, a chance to express myself, or whatever –but does SAMHSA really expect to audit that? Will an influx of accountable service providers make people’s bosses, teachers and relatives less awful?

If SAMHSA truly sees recovery as an intimate, subjective process of personal transformation, it needs to stop treating people’s lives as objects to manipulate.

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