Nov 9, 2012


What can we do to counter the "medical horror" component of mental illness stigma? We say that people with symptoms need treatment, but we know that is not completely true.

People fear treatment, and for good reason.

Even SAMHSA publications recognize that the treatments currently available are not fully satisfactory. Here's a quote from a May 2012 SAMHSA "Recovery to Practice" article.
First, the treatments that are currently available are extremely limited in their effectiveness in treating serious mental health and substance use conditions. While some treatments may be effective for many people in reducing the more active aspects of these conditions (such as in reducing psychiatric symptoms or substance use), they typically do not address the more disabling elements (such as neurocognitive difficulties, deeply entrenched patterns of behavior, and social and interpersonal contexts that impede, rather than facilitate, improvement). Should medications be developed that were as effective in treating mental illness and substance use as antibiotics have been in treating certain infections, then we might not find it necessary to change the ways in which we plan and deliver care. Such a day, however, seems far off, should it be achievable at all.

Second, the vast majority of the challenges people face in recovery occur outside of, and beyond the scope of, traditional health care settings such as hospitals, clinics, day programs, or intensive outpatient programs. These challenges occur, and must be dealt with, within the context of the person's everyday life in the community.
If people have reason to believe that what the medical system has to offer are medications with long lists of side effects that dope you up, or electroshock jolts to the brain, or hospitals that steal your freedom, is that stigma or is that the truth?

I am a firm believer in mental illness recovery, but the story I see playing out is not fundamentally a victory of medical science. Recovery happens with the kindness of ordinary people and the support of family and friends. Medication and other treatment may help, but the essence of recovery is a steady focus on making the most of one's talents and capacities, and committing to the struggle of regaining one's life.

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