Independent living and recovery have become the foundation stones of mental health services. Reflecting on my 21st anniversary of actively using mental health services, I can see a huge shift in policy and practice.
In the mid 1980s it was seen as inevitable that my destiny would be in long-term institutionalised residential and day services. A psychiatric admission to hospital was seen as a one-way ticket to a dead end.
I had my fair share of traditional services but decided they weren’t for me. Fortunately with the support of a few enlightened allies within the profession and a dose of belligerence on my part I managed to buck the system.
Alongside a turbulent mental health history I have been able to live (with support) in my own home and establish a career. This has been by no means easy.
However, I am constantly struck by the sense that my continuing and ongoing need for mental health services reflects some sort of failure and unseemly “dependence”.
The “failure” is twofold; I somehow have “failed” mental health services because I continue to need input, and mental health professionals have “failed” because I am not independent of mental health services.
Yet it is less likely the same judgements about failure and dependency would be made if someone required direct payments to employ personal assistants throughout their life or support workers were needed on a long-term basis to support someone with learning difficulties to live independently.
Speculating on the reasons for the different responses it is inevitable there is an element of concern about resource constraints and the need to manage demand. However, I believe there is an overriding and unacknowledged deeply evoked fear around mental distress and “dependency” which leads professionals to make judgements about the “deserving” and “undeserving”.
The concepts of independence and recovery have been used as a vehicle for masking such fears and projecting them on to service users.
Lessons need to be learnt from the wider disability movement, where independent living has been defined as having the right support to exercise choice and control and not having to go it alone or manage without services.
My independence and recovery is about having the right support from mental health services to take control, live my life the way the way I want to and pursue ambitions and dreams that give my life meaning.
This includes mental health practitioners intervening when I am in a downward spiral or in crisis. Recovery for me does not mean I am over “it”.