Wellness and Recovery in Housing Support – Part 1 of 4

I have a very personal connection to wellness and recovery as it relates to mental illness. If you haven’t read my older blog on living with depression, you can read it here. Or if you want to watch my video blog on mental illness and stereotypes that emerged in the wake of Sandy Hook, you can watch that here.

Because I have a personal connection to wellness and recovery, I suppose it should come as no surprise that it is one of my favorite areas to provide training to housing case managers, and to help homeless serving agencies truly understand and embrace. This is a four-part blog that examines wellness and recovery in the process of supporting people in housing, and working to prevent homelessness from happening again to that person/family.

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There’s a story – I don’t know if it is true – about a guru in Eastern medicine visiting a Western teaching hospital. The guru is asked the difference between “illness” and “wellness”. Calmly, he goes to the chalkboard and writes the words “illness” and “wellness”. He goes on to say, “There is an ‘I’ in ‘illness’, but a ‘We’ in ‘wellness’.”

Recovery is a very personal journey. It is a process. While elements of it have individual activities to promote awareness and confidence, there is a fair amount of inter-connectivity to others as recovery takes hold. I take comfort in connecting Recovery to the notion of Wellness…which allows me to distance conversations about a diagnosed mental illness from labels and pathology, and instead focus on a more holistic understanding of what it means to be well.

Truth is, Recovery is still a pretty new concept only starting to take root in the 1980s. It emerges in the delivery of services to people experiencing mental illness when there is a groundswell to re-examine what the intended and preferred outcomes of assistance with the mental illness should be. Let’s remember that medicine and treatment is evolving. Knowledge increases. New drugs are invented. New types of therapy are put into practice. Most of these activities, driven by a (well-intentioned?) medical model saw stability of symptoms as the preferred outcome for treatment. Recovery suggests that persons with a mental illness can achieve more than just stability. To that end, I embrace the definition put forward by Anthony articulating what Recovery is all about:

“…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.”

Orienting our support practices to embrace Recovery requires us to both re-think who delivers support to previously homeless individuals in their housing, as well as to consider and challenge some of the more dominant myths related to mental illness.

It is an unfortunate reality that in service delivery to homeless and formerly homeless individuals too often it is those people with the least amount of training and experience in mental wellness that are working directly with people with the most compromised mental wellness. While well intentioned, they can do more harm than good; make people sicker instead of better. Medications and a psychiatrist are not the answer to everything. We need to invest in better training on Wellness and Recovery to homeless and housing service providers.

As for myths, like any illness, there are some misinformed and biased opinions related to mental illnesses. Some of the most dominant myths that I have come across:

  • Once sick, always sick when it comes to mental illness

  • All people with schizophrenia are violent

  • Mental illness isn’t an illness like diabetes or heart disease. It is “crazy”.

  • Emotional problems are a normal part of life, and people who claim to have depression just need to suck it up like everyone else.

  • Medications always make things better.

  • All mental illnesses are the same.

When support services feed into these myths, people experiencing mental illness are further disadvantaged in the road to Recovery. Fundamental to Recovery, the support provider needs to appreciate that everyone’s experience of Recovery will be different. There are no magical steps to follow. Growth and awareness cannot be forced. And we cannot confuse Recovery with “cure”.

At the core of Recovery, the support worker and the person being supported have to embrace the notion of hope. It can very well be that the support worker needs to be the champion of hope until such time as the person being supported can embrace it on his/her own. Hope is what makes Recovery possible. It is the belief that tomorrow can be better than today; next week better than this week; next month better than this month; and so on. It isn’t carte blanche unreasonable blue-skying in dreamland. Hope in Recovery is anchored in practices that promote and demonstrate improved wellness. It is the passionate commitment to the notion of hope that holds all the other pieces of Recovery together.

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Wellness and Recovery in Housing Support – Part 2 of 4

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Success is Not an Accident