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February 23, 2012 Volume 3, Issue 7
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To access RTP's Weekly Highlights, quarterly e-newsletters, Webinar recordings,
and PowerPoint presentations,
please visit http://www.dsgonline.com/rtp/resources.html.
Save the date for the next RTP Webinar, "Understanding and Building on Culture and Spirituality
in Recovery-Oriented Practice," on April 4, 2012. Additional information will follow.

Psychiatry, Recovery, and AACP
by Hunter McQuistion, M.D.
Could psychiatry be tuned to recovery-oriented practice? If so, how could it help lead the development of recovery-oriented services? Put another way, must psychiatry itself undergo a form of recovery?

Along with the people it serves, psychiatry—not unlike its allied behavioral health professions—struggles to emerge from the shadows of society's fear of "the other" ("it must be hard working with such hopelessness," or "you must be a bit crazy yourself"). Yet the profession is paradoxically empowered with agency of social control—necessarily exercising it for the sake of personal and community safety, but sometimes in isomorphism with community fear. While this may also apply to other behavioral health professions, it is arguably more often identified with psychiatry, due in part to Western medicine's shamanistic social status, with attendant privileges and legal legitimacies.

A resultant history of professional paternalism has been in some regards a self-protective cloak among practitioners, even when caring—defending against the sense of "the other" while projecting power. In America, as the tide turns with one of our last contemporary civil rights struggles—for people with mental illnesses—the relevance of this model has come under appropriate examination.

Yet, for at least two decades, a growing cohort of psychiatrists has led the examination process. These are forward-thinkers whose practice and advocacy are helping the profession refocus on person centeredness, deemphasizing a perceived focus on "symptoms" and biological or technological interventions in an apparent vacuum of the person being served. Dr. Mark Ragins, an articulate observer of recovery orientation in psychiatry, has invoked essential humanitarianism by saying, "It's a return to why we went to medical school to begin with: to help people."

As the president of the American Association of Community Psychiatrists (AACP), I hope to direct you to one source of energy that focuses on this basic humanitarianism in psychiatric practice: the AACP Web site. For more than 25 years, AACP has served as a bellwether for psychiatry's evolution. The organization's mission is to "encourage, equip, and empower community and public psychiatrists to develop and implement policies and high-quality practices that promote individual, family, and community resilience and recovery." To this end, its members have worked hard to lead the profession in relevance to social evolution, advocating the needs of underserved populations in clinical work and public policy and educating psychiatrists about how to serve their patients in this regard. Among its many other activities promoting quality, AACP has published guidelines on recovery-oriented services and position papers on diversity and access to recovery-oriented services, and crafted an instrument that service providers can use to measure recovery orientation. The organization is also determining how behavioral health can effectively collaborate with primary care to dramatically improve total personal wellness beyond the "Cartesian split" of mind and body, and how that policy movement might itself change behavioral health care delivery systems.

As part of its role as a change agent, AACP has partnered with the American Psychiatric Association in the Recovery to Practice project. Together, we are piloting educational modules for psychiatric residents and practicing psychiatrists. These modules describe recovery orientation and present practical implementation tools. It is an effort to accelerate an otherwise generational process in the necessary transformation of psychiatric practice that emphasizes support of hope and person centeredness—a practice marked by assisting human beings with technical expertise in behavioral health. Hastening this sea change in orientation must begin early in training—as far back as medical school—and certainly in residency, while also focusing on medical educators and mid-career psychiatrists to examine common attitudes and approaches and help promote their innate humanitarianism.

This does not ignore barriers beyond psychiatry (primarily economic), which encourage limitation in professional roles, such as that of the "psychopharmacologist" in some systems of care, with pressure to see as many patients as possible in the shortest amount of time. These realities highlight how recovery orientation demands stakeholder coalition building to help secure the primacy of human needs. Finally, I know AACP looks forward to help in this collaboration, as we all listen to what is important to consumers of behavioral health services.

Dr. McQuistion is the President of the American Association of Community Psychiatrists and Director of the Division of Outpatient and Community Psychiatry at St. Luke's–Roosevelt Hospital Center in New York City.

Depression and Bipolar Support Alliance
Real Recovery Podcasts
Allen Doederlein, DBSA President
Ellen Frank, Ph.D., Distinguished Professor of Psychiatry, University of Pittsburgh School of Medicine

In a recent episode of the Innovations podcast series, Allen Doederlein spoke with Dr. Ellen Frank about "Interpersonal and Social Rhythm Therapy," an innovative treatment for bipolar disorder. The therapy has proven effective in preventing and reducing recurring symptoms.

Listen to the podcast.

RTP Presentation at AACP Conference
Recovery to Practice Project Director Larry Davidson will lead two sessions at the March 23, 2012 AACP conference, "Innovation in Public Service Psychiatry: How Recovery, Integration, and Population Health Are Transforming Our Work." The keynote presentation and afternoon workshop will serve as an introduction to the RTP initiative.

Free WRAP Webinar
Creating a Culture of Wellness: A Path to Eliminating Seclusion and Restraints

February 29, 2012

2–3:30 p.m. EST

The Copeland Center is hosting a discussion with panelists who have led initiatives to reduce and eliminate seclusion and restraints. Presenters will provide a national perspective on eradicating these confines and describe trauma-informed care and cultural changes in hospitals that can help establish a wellness-oriented environment.

Register for this Webinar.

Toolkit for Change
Ironically, people with mental illness often report feeling stigmatized by mental health providers. Despite this evidence, there are no known resources that teach providers to recognize and combat social exclusion within the mental health system. The Anti-Stigma Steering Committee Toolkit was designed to fill that gap. The toolkit comprises various materials to help providers end discrimination and exclusion.

The RTP Resource Center Wants to Hear From
Recovery-Oriented Practitioners!
We invite practitioners to submit personal stories that describe how they became involved in
recovery-oriented work and how it has changed the way they practice.
The RTP Resource Center Wants to Hear From You, Too!
We invite you to submit personal stories that describe recovery experiences. To submit stories or
other recovery resources, please contact Cheryl Tutt, MSW, at 877.584.8535,
or email recoverytopractice@dsgonline.com.

We welcome your views, comments, suggestions, and inquiries.
For more information on this topic or any other recovery topic,
please contact the RTP Resource Center at
877.584.8535, or email recoverytopractice@dsgonline.com.

The views, opinions, and content of this Weekly Highlight are those of the authors, and do not necessarily reflect
the views, opinions, or policies of SAMHSA or the U.S. Department of Health and Human Services.