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Nick Bowles preferredfutures.co.uk

Nick Bowles www.preferredfutures.co.uk. The Mental Health Workforce and Recovery: Are You Ready?. Online Resources available here:. Recovery: Are you ready?. Most of our organizations today derive from a model whose original purpose was to control creativity

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Nick Bowles preferredfutures.co.uk

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  1. Nick Bowles www.preferredfutures.co.uk The Mental Health Workforce and Recovery: Are You Ready? Online Resourcesavailable here:

  2. Recovery: Are you ready? Most of our organizations today derive from a model whose original purpose was to control creativity (Boston Consulting Group on Strategy 2006)

  3. The playwright and poet Nathaniel Lee, a 17th Century libertine, drinker and bawdy character, was incarcerated for five years in Bedlam (London) from 1684 to 1689 (dying in 1692 of alcohol related causes), he said: “They called me mad, I called them mad and damn them, they out-voted me”

  4. The Irish musician, poet and legend Phil Lynott, a 20th Century libertine, drinker and bawdy character, was treated for drug and alcohol problems; died 25 years ago (last month) of drug / alcohol related illness, he said: “I’m the rock star who didn’t succeed, I only bleed, bleed, bleed” See: The Phillip Lynott Therapy and Drugs Counselling Service, Dublin (online)

  5. Are You Ready? • People of privilege will always risk their destruction rather than surrender any part of their advantage • Faced with the choice between changing one's mind and proving that there is no need to do so, almost everyone gets busy on the proof • The conventional view serves to protect us from the painful job of thinkingJK Galbraith, Economist 1908-2006

  6. Evolution It’s not the strongest, swiftest or most ferocious who survive… It’s the most adaptable Charles Darwin

  7. Evolution of Psychiatry (101) • Increasingly humane, ethical, values based • Evolved from moral / criminal to medical ethos (Johann Reil 1808) • Bedlam to humane institutions 19C to deinstitutionalisation now… • Psychiatrists abandoned many outmoded treatments • Psychosurgery, insulin coma, ECT, seclusion and sensory deprivation, LSD, physical restraint, treatment for homosexuality, abuse of detention, polypharmacy, benzo abuse, tranx in older people, dubious psychotherapies • Authoritarian / hierarchical era is over in W Europe • Political psychiatry exposed and ended in E Europe after two decades of pressure from WPA but not before millions of people treated in biologically oriented, hospital based services in which dubious diagnoses and violations of human rights were rampant (Van Noren, 2010) • Increasingly good treatment outcomes (Recovery Begins with Hope 2010) • Kraepelin to Engel in 75 years: biopsychosocial model – a good outcome is more than extinction or stabilisation of symptoms • Recovery – mid 1980’s on: basis of some US State (e.g. Ohio)and national MH services (Aus; NZ; UK; Ireland)

  8. Recovery will prevent psychiatric “extinction” • Evolutionary Challenges • Modern psychiatry operates in a theoretical vacuum (McLaren, 1998) • Challenges to the biological basis of psychiatry (usefulness?) • It’s “time to move beyond the mind-body split” (Bracken&Thomas, 2002) • The psychopharmaceutical complex: did we sell our objectivity? • Outdated infrastructure that represents the previous paradigm • The lack of community and primary care • Diagnosis and medication of children • Inefficacy of drugs (such as anti-depressants) • Value vs Risk of psychotropic drugs (e.g. SSRI; Atypicals) • Loss of trust and faith, non compliance and avoidance

  9. Solutions People cannot resolve what’s wrong by just talking about what’s wrong

  10. Recovery • The next step in ethical, democratic, partnership working with people living with mental distress: Not Big • Paradigm over 20 years old: Not New • Offers resolution of increased public expectations, re-invention of our field and recognises today’s social and economic challenges: Not Optional

  11. Elements of Recovery

  12. Recovery Challenges • It’s a process not one “thing” • Definitions vary; some oddities e.g. Tidal Model; yet consensus on: • Principles • Utility of practices such as: • Solution Focused Approaches • Coaching and role of “experts by experience” • Alternatives to hospital • Occupation, structure and meaning – life purpose • Emerging best practices (see ODMH schedule on my website) • Clear requirement for purposeful and effective secondary care • Ditto primary care and community first aid initiatives (e.g. on suicide) • New relationships: housing; employment; third sector • The goal for committed staff is to begin the change – start today • Taking small, catalytic steps • Individuals as “benign centres of excellence” (PJ Harnett, Kerry) • We are all (individuals, teams and services) a “work in progress” • Change or Die vs Change and Thrive (Alan Deutschman, 2007)

  13. Are You Ready? Place yourself on a scale from 0 to 10 where 10 is: a recovery focus “sits well with you”0 is: a recovery focus is absolutely “not for you” Now, suppose for a minute you are just one point higher what’s different? www.preferredfutures.co.uk

  14. Are You Ready? www.preferredfutures.co.uk

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