Nowadays we're seeing more of a top-down thing as governments are realising the cost of maintaining the biomedical model. And the voices of survivors and people with lived experience are apparently held in higher regard although not always thought to be worth their weight in gold by the powers that be.
I'm a relatively new kid on the block in mental health activism terms although have cut my wisdom teeth on a lifetime of community development backed up by postgraduate training based on Freire's pedagogy - “Washing one’s hands of the conflict between the powerful and the powerless means to side with the powerful, not to be neutral.”. For most of that time I didn't have an understanding of the political nature of my work in the community and would have said that I wasn't at all political. It was all about getting together with others and improving community services. Being a natural leader I tended to be the one chairing meetings, pushing forward the ideas with an eye on the horizon. Running ahead and taking folk with me or sometimes going on alone. As long as I wasn't being held back for this has always been my challenge.
I see the psychiatric system as being about maintenance as it's working on the premise of a biological cause, a genetic vulnerability and the likelihood of recurrence or relapse. Sort of like a machine that has a tendency to break down when X, Y and Z are present so requires regular maintenance. If you have one episode it's not too bad for then you might escape without a diagnosis. In my experience the problem is when you have another episode and even another for then you are given the mentally ill label. Which you might welcome and that is OK. But not for me. I want to be free to take the risk of running ahead and out of the system.
Because the mad experience is shared by most of us in my family doesn't mean we all see it the same way. Some have been glad of the system's support and the help available along the way. The diagnoses and drugs seen as part and parcel of staying relatively well. Others of us have managed to walk or run out of the system with no recurring episodes or in spite of these.
I've always thought that a full recovery was preferable to maintenance so have chosen that path when able to, helped along the way by mental health services. But I have to admit to feeling uncomfortable these days with the recovery movement from the top-down perspective rather than the grassroots one of emancipation and empowerment. In Scotland and the UK people on benefits (government financial support) are being pressured to justify their disability or mental illness through ATOS and ESA (back to work) interviews. Failure to attend or answer the questions can result in cuts to benefits.
The Hardest Hit campaign, organised jointly by the Disability Benefits Consortium (DBC) and the UK Disabled People’s Council, has been bringing together individuals and organisations to send a clear message to the Government to stop these cuts. Inclusion Scotland aims to draw attention to the physical, social, economic, cultural and attitudinal barriers that affect the everyday lives of disabled people in Scotland.
Sometimes recovery from mental health problems will involve a level of maintenance by the psychiatric system and financial support from the government. I want the right to choose my path through and out of the system and for others also to have the same rights and choices. Therefore I contend that recovery and maintenance are not always on different sides of the fence.