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Fall 2012, Volume 20, Number 3

A photograph of a man and a woman smiling at another man

With Peer Support, Recovery is Possible

When Lauren Spiro was 16 years old, doctors told her she had chronic schizophrenia and would never recover. For years, Ms. Spiro kept her diagnosis a secret from the wider world, even as she learned to ignore the voices in her head and became a mental health professional herself. But it was eventually sharing her story with others—and hearing how they overcame similar experiences—that played the most powerful role in her recovery.

“If someone is feeling like ending their life or hearing voices or having thoughts racing, we can say, ‘I’ve been there; I hear you,’” she said. “We can say, ‘I will hold your hope for you if you don’t feel it right now.’”

Today, Ms. Spiro directs the National Coalition for Mental Health Recovery, an organization devoted to ensuring consumers of mental health services have a voice in policy decisions that affect them. She’s also a prime example of both the power of peers and the possibility of recovery.

When National Recovery Month began in 1989, many behavioral health professionals didn’t believe recovery was possible. Thanks in part to advocacy by consumers themselves, the field has made great progress in the 23 years since then.

Mental Health

In the mental health arena, the consumer movement has promoted not only the idea that recovery is possible, but also that consumers should play a key role in their recovery.

“The consumer movement is sort of a civil rights movement,” said Neal Brown, M.P.A., Chief of the Community Support Programs Branch of SAMHSA’s Center for Mental Health Services (CMHS).

The movement began in the 1960s, when former psychiatric hospital patients came together to fight a system they viewed as unresponsive at best and abusive at worst.

It aims to educate people about what consumers with mental disorders have experienced, how people can and do recover, and what approaches facilitate the recovery process. The movement also seeks to empower consumers to make decisions for themselves. “Having a place in their own recovery,” said Mr. Brown, is the essence of the consumer movement.

SAMHSA, through its Community Support Program (CSP), has helped the movement by giving consumers opportunities to come together, by supporting consumer organizations at the state and national levels, and by promoting peer-run programs, shared decision-making, and person-centered care.

The CSP-funded Consumer-Operated Services Program (COSP) Multisite Research Initiative helped establish the evidence base for such alternative programs. It found that participation in mutual support programs, drop-in centers, and other consumer-run services significantly boosts consumers’ well-being and empowerment, and that the more consumers use such services, the greater their gains. SAMHSA used the results of that and other research to create a toolkit called the Consumer-Operated Services Evidence-Based Practices Kit.

In recent years, people in recovery from mental illness have become important members of SAMHSA’s staff and have helped guide innovative activities (see "New CMHS Director"). “SAMHSA has constantly been a support for the consumer movement,” said Mr. Brown, “but it’s the consumers themselves who make it all happen.”

Substance Use

In the substance use field, individuals and families seeking recovery have had challenges in accessing formal treatment services. The 19th and early 20th century saw the emergence of mutual aid societies. Alcoholics Anonymous, for example, began in 1935.

New grassroots organizations developed in the late 1990s that supported the new recovery advocacy movement. The movement organizes local and national communities to give voice to people in recovery and their family members. In addition, the movement is educating the public, policymakers, and providers about the many pathways to addiction recovery.

The Recovery Community Services Program (RCSP) was funded by SAMHSA’s Center for Substance Abuse Treatment (CSAT) in 1998. The purpose of the program is to help mobilize communities of recovery and foster the development of recovery community organizations. In 2002, the RCSP funded local recovery community organizations to provide peer recovery support services and promote the development of peer leaders.

Peer support in Alcoholics Anonymous and Narcotics Anonymous helped keep Charles Thornton away from alcohol, heroin, cocaine, and other drugs. Growing up in Washington, DC, Mr. Thornton started using marijuana, got arrested for possession at age 17, and found himself incarcerated by age 18. At age 29, he received treatment for the first time. A friend in recovery gave him a job and advice as someone who knew what he was going through and for 2 years he lived in a consumer-run, drug-free home. “In certain areas of the District at that time, drugs were everywhere,” he remembered. “To have a safe place and know that other people in the house were recovering also just led to a lot of support.” He also became active in the DC Recovery Community Alliance, recovery clubs, and other groups.

Now Mr. Thornton returns the favor, encouraging others to get involved and providing mentorship and support. “I can be a model, an example,” says Mr. Thornton, who now directs the Mayor’s Office on Returning Citizen Affairs.

Coming Together

The recovery movement is increasingly focusing on both mental and substance use disorders. For example, in 2011, Recovery Month broadened its focus to include mental as well as substance use disorders.

SAMHSA sponsored other efforts in 2011 to promote dialogue and collaboration between the CSAT-funded RCSP and the CMHS-funded Statewide Consumer Grant Program, among other efforts. That same year, SAMHSA and behavioral health consumers developed a new working definition of recovery from both mental and substance use disorders as: “a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.” SAMHSA’s National Survey on Drug Use and Health has also broadened its focus to include mental disorders in recent years.

That integration makes sense for consumers who know firsthand that mental and substance use disorders often go hand in hand.

Eric McDaniel is one such consumer who has struggled with co-occurring disorders. At age 29, alcoholism and depression had destroyed his promising career as a trial lawyer and left him thinking of suicide.

“Everybody hears a lot about active addiction, and we all know what that looks like,” said Mr. McDaniel. “What’s important to get out is that there are millions of Americans in long-term recovery.”

Peers helped Mr. McDaniel with his recovery. In addition to more than a year in a consumer-run recovery house, he had access to group therapy. “It was really important to have people I could share my feelings and experiences with,” he said. “It also helped me, because I was able to learn from the experiences of others.”

Now more than 4 years into his recovery, Mr. McDaniel is Program Coordinator at Faces and Voices of Recovery in Washington, DC, which provides education, advocacy, and capacity-building for the recovery community. Says Mr. McDaniel: “Recovery has given my life new meaning.”

For more information about recovery, visit the Recovery Month Web site. For additional resources, visit “SAMHSA Store”.

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