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

1. “Ships are safe in harbour, but that is not what they are designed for”

2. Recovery Andy Luckhurst, Service User Consultant, Oxleas NHS Trust Gina Benjamin, Project Manager, Community Options

3. Brainstorm • What do you think Recovery means?

4. Defining Recovery “ A deeply personal, unique process of changing one’s 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 one’s life as one grows beyond the catastrophic effects of mental illness” (Anthony, 1993. pp559-560)

5. Questionnaire

6. Themes of Recovery • Hope • Being believed in • Developing perspective on the past • Changing other peoples’ expectations • Gradually gaining a sense of greater well–being • Developing a new meaning and purpose in life • Persevering (not a linear process) (Turner- Crowson & Wallcraft, 2002)

7. Themes of Recovery cont… • Taking personal responsibility for one’s life • Acting to rebuild one’s life • Developing valued relationships and roles (Turner-Crowson & Wallcraft, 2002)

8. 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 person’s 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

9. Bromley’s 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.

10. Bromley’s Recovery Group’s Mission Statement Recovery is; Maintaining a sense of hope about one’s 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

11. 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

12. Wellness Recovery Action PlanWRAP What makes a WRAP? • DMP or Daily Maintenance Plan • Crisis Plan • Post-crisis Plan

13. 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

14. Recovery Principles • The Service User directs the recovery process therefore the Service User’s 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

15. 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 User’s recovery • Workers operate from a strengths/assets model Taken from NIMHE (National Institute for Mental Health in England) Emerging Recovery Policy and Resource Guide

16. 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 User’s 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

17. Link Up 2 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

18. Bromley’s 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

19. 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

20. 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

21. 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

22. 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)

23. Experiences of people on their recovery pathway “My recovery process involved rest and good food but the hardest part was raising people’s (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)

24. 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”

25. 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 people’s 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.”

26. 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

27. Thank you Andy Luckhurst Andy.luckhurst@oxleas.nhs.uk Gina Benjamin Gina.benjamin@community-options.org.uk With thanks to Dee Ashton, Bromley Mind