Recovery's Edge

Neely Laurenzo Myers

Description

In 2003 the Bush Administration's New Freedom Commission asked mental health service providers to begin promoting "recovery" rather than churning out long-term, "chronic" mental health service users. Recovery's Edge sends us to urban America to view the inner workings of a mental health clinic run, in part, by people who are themselves "in recovery" from mental illness.

In this provocative narrative, Neely Myers sweeps us up in her own journey through three years of ethnographic research at this unusual site, providing a nuanced account of different approaches to mental health care. Recovery's Edge critically examines the high bar we set for people in recovery through intimate stories of people struggling to find meaningful work, satisfying relationships, and independent living.

This book is a recipient of the Norman L. and Roselea J. Goldberg Prize from Vanderbilt University Press for the best book in the area of medicine.

Sujets

• Médecine
• Spécialités médicales
• Caregiving
• Mental Health
• Medical
• Caregiver
• Anthropology
• History

Informations

• Publié par: Vanderbilt University Press
• Date de parution: 18 décembre 2015
• Nombre de lectures: 0
• EAN13: 9780826520814
• Langue: English

Extrait

“Choice, moral agency, empowerment, ‘patient-centered’ care, user-run services, peer staff, recoveries! All so easily envisioned on paper, in mental health policies, and at conferences. As Myers shows us, doing the work to make these ideas happen in daily life is inestimably trying, unpredictable, unruly, and tumultuous for all concerned.”
—Sue E. Estroff, University of North Carolina at Chapel Hill, author of Making It Crazy: An Ethnography of Psychiatric Clients in an American Community
“Well written and morally compelling, this rich ethnography details both the new promise of recovery from schizophrenia and its pitfalls in an American context. In the process, it explains how the experience of schizophrenia is shaped for so many by American values of individualism, independence, and work.”
—Tanya M. Luhrmann, Stanford University, author of Of Two Minds: An Anthropologist Looks at American Psychiatry
“In public mental health, no term is more troubled and unsettled than recovery—and with the onset of ‘managed behavioral care’ matters are likely to get worse. But one of its versions, in one of its trial stagings, has been graced with an attentive chronicler. Neely Myers has captured the thrilling promise, rampant misunderstandings, mundane messiness, and institutional inertia occasioned (or exposed) by recovery. . . . This is public-interest ethnography with head and heart fiercely engaged.”
—Kim Hopper, Nathan Kline Institute for Psychiatric Research, author of Reckoning with Homelessness
RECOVERY’S EDGE
RECOVERY’S EDGE
AN ETHNOGRAPHY OF MENTAL HEALTH CARE AND MORAL AGENCY
Neely Laurenzo Myers
VANDERBILT UNIVERSITY PRESS
NASHVILLE
© 2015 by Vanderbilt University Press
Nashville, Tennessee 37235
All rights reserved
First printing 2015
This book is printed on acid-free paper.
Manufactured in the United States of America
Recipient of the Norman L. and Roselea J. Goldberg Prize from Vanderbilt University Press for the best book in the area of medicine.
Library of Congress Cataloging-in-Publication Data on file
LC control number 2015010083
LC classification number RA790.55
Dewey class number 362.2'2—dc23
ISBN 978-0-8265-2079-1 (hardcover)
ISBN 978-0-8265-2080-7 (paperback)
ISBN 978-0-8265-2081-4 (ebook)
For Allen, and love that knows no bounds
CONTENTS
Acknowledgments
A Note on Contested Terms
1. Orientation
2. No Direction Home
3. Step One: Take Your Medications
4. Step Two: Self-Advocate
5. Step Three: Work for Intimacy
6. Recovery’s Edge
7. Over the Edge
Appendix. Comparison of Traditional and Recovery-as-Advocated Care
Notes
References
Index
ACKNOWLEDGMENTS
I must first thank my youngest brother, Joseph Laurenzo, for inspiring this book. He is a great artist, listener, comedian, and friend. When he was eight years old, he was placed by the state in a year-round residential treatment institution for children diagnosed with serious psychiatric disabilities. Bearing witness to his and my family’s experiences with the chaotic mental health system of “care” inspires my work.
My mother, Patricia Laurenzo, has offered writing advice, editing, and encouragement at every stage. My father, Steven Laurenzo, has long modeled patient courage, stick-to-it-iveness, and faith. My older brother, Eric Laurenzo, and his wife, Shelly, have always opened their ears, hearts, and home. My in-laws, especially Nancy, Henry, Lisa, Mike, Terry, Tim, Joseph, Dan, and Vaidan, have supported this project from its earliest conception with good conversation and hard questions.
My life’s work is made possible because others have learned how to experience recovery from serious emotional distress—and many have also struggled. There are people who are public about their experiences and people who are not. To those who are—Darby Penney, Oryx Cohen, David Oaks, Daniel Fisher, Pat Deegan, Fred Frese III, Elyn Saks, Leah Harris, Will Hall, and more—some of you are friends and some of you don’t know I exist, but I thank you for all you have taught me while fighting the good fight.
Other teachers have also been invaluable. At Exeter, Douglas Rogers, George Mangan, and Michael Drummey taught me to write. Russell Weatherspoon and Robert Thompson fostered my faith. Corey Zimmerman and her mother, Alice, Shannon Powers (may she rest in peace) and her parents, Robert and Pamela, and Jesson Alexander all helped me cope with my brother’s increasingly challenging experiences and learn how to channel my despair into writing and service. Later, my professors at the University of Virginia, most notably Eve Danziger, Edith Turner, and George Mentore, breathed life into my intellectual orientation for this project and inspired me to become an anthropologist.
Tanya Luhrmann and Kim Hopper—both incredible scholars and people—have been extraordinary mentors throughout my graduate and postdoctoral years. I cannot thank them enough. They have inspired me with their own work and always believed in mine. Countless hours have been spent advising me personally and professionally; helping me to navigate the inner workings of fieldwork, academia, life-work balance, and publishing; and writing letters of support. I could never be who I am without them.
The Department of Comparative Human Development at the University of Chicago was an excellent home for me in my graduate years, and I am especially grateful to Janie Lardner, our department administrator; Beth Angell; Sydney Hans; and Bert Cohler—all excellent scholars and good people. Later intellectual support and funding came from mentors funded by the National Institutes of Health (Grant No. 5-T32-AT000052): Ann Taylor of the Center to Study Complementary and Alternative Therapies at the University of Virginia and Mary Ann Dutton of the Department of Psychiatry at Georgetown University, Mary Jane Alexander of the Nathan Kline Institute’s Center to Study Recovery in Social Contexts (Grant No. P20 MH078188), and Michael T. Compton, now Chair of Psychiatry at Lenox Hill Hospital in New York. Carole Sargent of the Office of Scholarly Publications at Georgetown University and Barbara Miller of the Department of Anthropology and Director of the Institute for Global and International Studies at the Elliott School of International Affairs at the George Washington University also offered critical support as I sought publishers for this book.
My reviewer Jim Baumohl and another anonymous reviewer provided excellent critiques that shaped the final manuscript. But really, it was Michael Ames, my editor at Vanderbilt University Press, who made this book what it has become—going line-by-line through drafts, and seeing the book as a civil rights document from the start. Joell M. Smith-Borne has also been an excellent and supportive copyeditor, and I am so thankful for her careful attention to this text.
In no particular order, I also appreciate the encouragement, comments, and intellectual contributions of Sue Estroff, Barbara Belton, Lisa Dixon, Janis Jenkins, Rebecca Lester, Eileen Anderson-Fye, Mary-Jo Delvecchio Good, Byron Good, Nancy Scheper-Hughes, Daniel Lende, Helena Hansen, Anne Lovell, Tom Csordas, Paul Brodwin, Conerley Casey, John Lucy, Mara Buchbinder, Kenneth MacLeish, Mark Furlong, Christine Nutter, Johanne Eliacin, Elizabeth Nickrenz, Sara Lewis, Jennifer Hammer, T. David Brent, Beth Broussard, and the students in my Culture and Global Mental Health seminars at the George Washington University in Autumn 2012 and 2013. My colleagues at Southern Methodist University, especially Sunday Eiselt, Nia Parson, Carolyn Smith-Morris, Caroline Brettell, Victoria Lockwhood, and Ron Wetherington urged me to finish this book—always a help! And my department chair, Karen Lupo, tirelessly helped me secure the resources I needed to manage it all.
In addition, good friends provided relaxation and support throughout my fieldwork and writing period, including: Amy Horn, Andy Davis, Hallie Kushner, Lainie Goldwert, Pinky Hota, Brian Mulhall, Jennifer Brondyk, Leah Sumner, Jennifer Lynch, John Blaeuer, Maricruz Merino, and Elizabeth Byrd. Their refrain—when is your book coming out, again?—kept me hard at work.
I am also indebted to the multiple community-based service settings at Horizons: the numerous administrators, social workers, and staff who supported this project. They allowed me free range and asked nothing but constructive criticism in return. The people using services at Horizons, the members, were also incredibly welcoming, as you will see, and accepted me, with all of my imperfections, as one of their own.
Last, but not least, I am grateful to God for the love I have found in my lifetime and my own little family. During my fieldwork and the writing of this book, my best friend and husband, Allen, and our precious border collie, Hunter, were constant companions. Allen—thank you for the ways you share your love—your music, your faith, your patience, and our children. Even my sweet girls, Lilliana and Madalyn, joined in the fun. Lilliana was in utero my last few months in the field, and Madalyn came a few years later. Both made the writing of this book possible with their wonder and joy—my little candles in the dark.
A NOTE ON CONTESTED TERMS
There are many contested ways to talk about people who use or have used mental health services (in no particular order):
Patients
Consumers
Users
Refusers
Mad people
Survivors
Ex-patients
C/S/Xers
Members
Clients
Participants
Peers
While trying to raise awareness of the identity politics of each of these terms, this book upholds local usages as thoroughly as possible—an ethnographic tradition.
1
ORIENTATION
Where did we come from? We came from nowhere.
We came from institutions. We came from the streets.
We were no one, but we had a desire to change our lives.
—Ed Knight, Keynote, Alternatives Conference, October 2006
Okay, show of hands, how many people forgot their medications today?”
A few hands went up.
“Oh, you