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How do mental health services need to change to support recovery?
Dr Mike Slade: The reorientation that's needed stems right through mental health services work. So, for example, when first meeting someone, asking them about their dreams as well as their problems, moving from seeing the job of the mental health system as providing treatment, to supporting people to get on with their life.
And that suggests a much more outward looking emphasis in the mental health system to focus much more, for example, on amplifying the person's individual strengths and pursuing interests and goals that they have, or activating support systems that exist in the community, rather than taking the person out of their community into what can inadvertently become a mental illness ghetto.
Many of the skills that mental health professionals have developed over the years are fundamentally important to people who experience mental illness, and so nobody would make the case that these are skills that we should diminish or in some way devalue, they are centrally important in many people's recovery journey.
What we are now learning though, is that there are new skills that are needed. So for example, the skill of being an authoritative expert giving a pronouncement on the situation, may be very helpful for people at some points in their life – for example when they are in crisis – but at other points, it can inadvertently disempower the person to find their own understanding of the situation and their own solutions.
So one shift that's needed is in the way that mental health professionals relate to people who are using services – and a bit less emphasis on authoritative and expert roles, and a bit more emphasis on partnership roles and the use of coaching and mentoring skills.
It may be that one of the biggest things we can do in the mental health system is just to slightly slow down and spend a bit more time with people that we are working with – and of course that immediately creates challenges for mental health professionals like me who often feel very overworked already. So how can we address that big questions? – and yet it's an important question, because in order to recover, people need time to connect with other people. And mental health professionals are often a really valuable resources in connecting with people who are at a very disconnected point in life.
Now there are certainly challenges. Some mental health professionals will struggle with the developing of new skills or new ways of relating to people, and similarly some will experience role uncertainty when the question can arise for them of: 'am I still a nurse, or psychologist, or psychiatrist if I work in a different way?' So there is an organisational and professional challenge around that, but at the individual level, most mental health professionals I meet very much want to support the people they are working with to have a life worth living – and that's what the recovery system is all about.
Next page update due: January 2011