Anne-Marie O’Brien describes using Recovery Oriented Groupwork in Women’s Mental Health in The Bulletin’s most recent issue -Theme Group Work
RECOVERY-ORIENTED GROUP WORK IN WOMEN’S MENTAL HEALTH by Anne-Marie O’Brien
Recovery and Peer support are not new concepts or recent developments in mental health. The Canadian Mental Hygiene Association (now the Canadian Mental Health Association) was founded in 1918 on the knowledge that people can and do recover from mental disorder, and that people with lived experience of disorder make significant contribution to their own recovery and that of others.
After a promising start, mental health reform evolved slowly. Treatment was primarily based in institutions and consisted of such practices as cold wraps, insulin shock, physical restraint, and in the golden age of eugenics – sterilization. Institutions also employed large numbers of hard working, tax paying citizens. The notion that people detained in psychiatric facilities had the same civil rights as people employed by psychiatric facilities was a notion many decades away. The notion of civil rights and citizenship is fundamental to recovery. One has to believe that they have the right to participate in community life, the right to make treatment decisions, the right to say no.
Women’s struggles for civil rights and equality before the law in some ways paralleled mental health reform. The first women in Canada voted in 1918 – provided a woman was white, of British origin and had a male relative who had served in the First World War. In the famous Persons case of 1928, a group of five determined women appealed to the Privy Council for women to be granted person status in law. It wasn’t until 1960 that all Canadian women could vote, and significant social change began to occur in the area of women’s rights. Following the proclamation of the Canadian Charter of Rights and Freedoms, civil rights began to influence how mental health services are provided, e.g. the establishment of the Psychiatric Patient Advocate Office, the Consent and Capacity Board, the notion of capacity, and the notion of informed consent.
The Mental Health Commission of Canada (MHCC) has done significant work in the area of recovery and peer support. They have produced several substantive documents – most recently, Declaring Our Commitment to Recovery and Guidelines for the Training and Practice of Peer Support. The significant flaw in the work of the MHCC is that they are silent on gender issues. The MHCC makes recommendations for practice with diverse populations within Canada, specifically indigenous populations, youth, and the elderly. The need for gender specific services is not acknowledged. How is it we can fully endorse, celebrate, and promote a respect for diversity in terms of culture, and age, yet overlook, dismiss, and marginalize respect for diversity in terms of gender?
Women’s Mental Health at the Royal was made possible by a gift from Shirley Greenberg, a trail blazer in the area of women’s rights in the Ottawa community. Women’s mental health at The Royal provides recovery-oriented services. Recovery, as defined by the MHCC, rests on two pillars: recognizing that each person is a unique individual with the right to determine his or her own path towards mental health and wellbeing; and understanding that we live our lives in complex societies where many intersecting factors (biological, psychological, social, economic, cultural, and spiritual) have an impact on mental health and wellbeing. Our services have been developed in collaboration with the women who use mental health services.
All of the groups we offer have been influenced by women who have themselves experienced mental disorder and recovery. We offer clinical and peer facilitated groups. Skills training is a group facilitated by clinical social workers. It is a component of dialectical behaviour therapy developed by Marsha Linehan who herself experienced mental disorder and recovery. This group format is highly structured, and follows manualized format. (http://www.linehaninstitute.org/)
Additionally, we offer four peer facilitated groups – Wellness Recovery Action Plan (WRAP) developed by Mary Ellen Copeland (http://www.copelandcenter.com), Living a Healthy Life with Chronic Pain (http://www.livinghealthychamplain.ca/ main.aspx), Women Recovering from Addictions, and The Joys and Challenges of Mothering for moms who experience mental disorder.
All of our peer volunteers are women who have experienced both mental disorder and recovery, and have received training in group facilitation. The fundamental belief underlying women’s mental health is that women recovering from mental disorders are the experts on themselves – how they experience distress and what they need to do for wellness. Our motto is “no fixing, no saving, no advising, no setting each other straight”. Our goal is to provide a safe place for women to learn new skills and discover their own path to wellness.
Ann-Marie O’Brien is a social worker and project manager for Women’s Mental Health at The Royal. She is Adjunct Professor at the Carleton University School of Social Work, and she is past chair of the OASW Mental Health Advisory Group.
FYI – The full versions of The Bulletin are posted on the OASW webpage listed below
Précis : Le rétablissement et le soutien des pairs ne sont pas de nouveaux concepts ni de récents développements en santé mentale. Le Comité national d’hygiène mentale du Canada (connu aujourd’hui sous le nom de Association canadienne pour la santé mentale) a été fondé en 1918 reconnaissant que les gens peuvent se rétablir et surmonter des troubles mentaux, et que les personnes qui ont connu des troubles de ce genre apportent d’importantes contributions à leur propre rétablissement et à celui des autres. Le présent article passe brièvement en revue l’histoire de la réforme de la santé mentale au Canada. Il examine l’évolution des programmes de santé mentale des femmes à Le Royal, et montre comment tous les groupes offerts aujourd’hui ont été influencés par des femmes qui ont connu elles-mêmes des troubles mentaux et qui s’en sont sorties.