In all our sanctuaries we sit at risk

Mental Health Witness – Marketing “Recovery”


In the mental health services, the “Recovery Model” has achieved good sales in recent years. Good pitch, good branding. Upwardly-mobile managers and organisations able to lay claim to being passionate about “recovery” win brownie-points and funding. We function in that sort of climate these days, in the care services.

But this seems more than just a “brand.” I meet people who speak of it as a whole new route to enlightenment. I have heard the word “inspiring” used a lot in relation to it and I’ve seen short tracts and quotes from its literature on the walls of mental health agencies, exactly as if it were some new religious dogma. The tracts imply that all we need do, we souls lost in the wilderness of self and society, is read those words on the notice-board and we will be found, taken up, set free. Day services become “Recovery Colleges.” Trainers become bearers of the Word.

But what Word ? Why its appeal and ubiquity ? What’s new here ? It’s hard to see anything clear through the glaze of enthusiasm, except ever rising levels of Public Relations gloss and avoidance, and a new way of excluding people with longer term needs, adding to their sense of failure and threat (“What will happen to me if I don’t ‘recover’ ? Will they tell me to pull my socks up ? Will they take my Benefits from me ? Will they refuse to accept me if I seem too serious a case to ‘recover’ in their time-scales ? Will they reject me?”). And is anyone seriously suggesting that, before this model came along, social workers, occupational therapists, psychologists, and, yes, medical practitioners, were not supporting healing, were not working in support of healing, all possibilities of renewal and growth and coping, day in, day out ?

I am not particularly concerned here with the model itself, its provenance, history or rationale. As with purely religious sects of one kind and another, I have no reason to doubt that the original intentions were worthy and even good. I am looking instead at its shape and effect on the ground, at this time – when the cuts are biting, and morale sinking ; what it has made of present conditions, and what present conditions are making of it. As far as I can see, it is essentially a position of defiance against stigma and, by inference, against the medical model. This psychiatric diagnosis you have given me need not define me. It need not be a life-sentence. There are things I can do to make a meaningful life for myself, within Society, not excluded from it.

So the “Recovery Model” is at least in part a kind of self-help philosophy which at the same time requires of services that they provide resources in support of self-help, even at the expense, sometimes, of people less capable, more damaged. I think also that, too easily, it allows people, both users of services and people who manage and practice in services, to deny and shy away from the reality of mental disturbance, which is often difficult and complex and resistant of quick resolution. In other words, the model has become another fundamentalist retreat from complex reality into black and white simplicities and certainty. According to this simplification, all you need to overcome your mental health problem is have the right attitude and attend some classes. Having a mental health problem is no more than having a head-cold. We are all in this together in a shadow-less world of phoney bonhomie.

In decrying the recovery model, I am not thereby surrendering to an equally simplistic medical one, which can seem to suggest that the individual is bound by the iron laws of diagnosis which, once activated, allow you no escape ; so that, after being diagnosed with something long-standing, you cease to be you, unique and God created, you become instead your “illness“, just a set of predictable responses, determined by an incurable condition. How can one fail to understand the dread of being classified, imprisoned, in this way ?

To treat anyone as just a diagnosis, just an “It” of two eyes and two feet, is actually a kind of escape mechanism for the perpetrator. Of course we know that the model itself allows the scientist to reach for some diagnostic conclusions drawn from research-based methods of categorisation ; in turn, this opens the way to some medical interventions. But theory is one thing, human inter-action is another. A model based on detachment and general rules can also provide an excuse for the person within the scientist to avoid real and sometimes difficult human engagement, by staying detached, humanly and emotionally absent from the individual being in front of you. As far as the recipient of that behaviour is concerned, its detachment constitutes bad and even abusive practice by any standard and from any professional point of view. No good practitioner, of whatever discipline or helping profession , would follow it.

But that’s the point. You don’t need a whole new model, a whole new service, to change the approach of a few inadequate workers. At most, you should look to correct the fault, and the despair it can elicit, by improving your recruitment practice, the quality of your staff supervision and support, and your systems for keeping work-loads under control.

For if, in your reaction against one form of over-simplification, you merely set up another, you have actually done nothing except caused unnecessary disruption while joining forces with the real enemy. You thought you were righting a wrong. Not so. All you have done is give wrong a new colour. You have found a new way of failing people, a new golden calf to worship, just another false god.

I would argue that something larger applies here, as well, or at least is relevant. How do we measure our worth, our value, our place in the community ? Do you only have worth if you function like the majority of “well“ or “recovered“ individuals, taking your place in the rush hour crush and scramble, flagging up and waving about what socially acceptable emblems you can earn, maintaining your outward face ? If so, then to be labelled disabled or unable or “unrecovered” is indeed a social disgrace and puts you beyond the pale. You may have rights, and allies to help you fight for them, but you have no sense of worth to help you rest at nights, no social capital.

But if we accept that real human worth is not to be measured by material possession, acquisition, conformity, occupation ; not by the amount of “striving“ you do in contrast to “skiving“ (what a wicked, socially mischievous, loutish distinction that was – a real Bullington Rude-boy try-on), not by the amounts of tax you can dodge, but by qualities of soul, levels of generosity and truth-telling, then having a diagnosis, being “un-recovered,” being seen as out of kilter with the norm, is of no essential matter. Of course, nobody would have wished it on themselves or on loved ones. But in essential terms, there is no matter here. Some of the most wonderful and inspiring encounters of my life have been with people diagnosed as “incurable,”“unemployable,” “un-recovered“. Human worth, and a socially valuable human life, are not threatened or lessened by a diagnosis, and you do not need to have “recovered” to be a privilege to know and a force for good.

There is one more thing I want to say on the subject of the Recovery model. It concerns the use of language. Has anyone noticed ? Language is being used here not to describe but to persuade, not to share a fact but to convert to a belief, not to illumine but to sell, not to reveal but to dress up. We are dealing with a propaganda operation here, whereby people who are “enlightened” are trying to persuade people into the “correct” frame of mind. In plain actuality, the “Recovery College” is a mental health community centre which runs a programme of lessons, lectures and presentations. Some people with mental health problems, most of them at the less serious end of the spectrum of disability, enjoy attending. That’s fine but limited (and a questionable use of scarce resources). But to call this recreational centre a “Recovery College” is to claim something much more, both for the agency and about mental disturbance in general. It is not a description but a public relations gloss borrowed from the market place. It is spin, spin being so habitual to us now, that we can serve it up almost as a form of instant therapy. However worthy the intentions, this and similar selling slogans do subtle but profound harm to the integrity of relationship and partnership between a helping service and those who turn to it for help.