Mental Health Recovery Newsletter

Introduction

Welcome to Mental Health Recovery Newsletter, begun in March 2000 and published quarterly from the office of Mary Ellen Copeland. This newsletter is for anyone who wants to learn more about recovering from uncomfortable, often disabling psychiatric symptoms. If you would like a copy of previous issues of this newsletter or would like to enter your subscription, please contact the office (by e-mail is easiest for us). Subscription is free to individuals, by email or ground mail. Institutional subscriptions available: 50 copies for $25 plus mailing; 100 copies for $45 plus mailing. Please contact us and let us know whether we can send you the email version to save a tree. You may freely copy and distribute this newsletter, giving credit to Mary Ellen Copeland.

If you would like a copy of previous issues of this newsletter or would like to enter your free subscription, please contact the office of Mary Ellen Copeland by phone or e-mail or click here.

"If you haven't changed your mind lately, maybe you don't have one."
-Kathryne Strouse Copeland

Seminar Schedule

Mental Health Recovery Seminar I: Learning Mental Health Recovery including Wellness Recovery Action Planning

July 10-12, 2001 in Brattleboro, VT

Come to beautiful Vermont in the summer and spend three days learning recovery skills and developing your own Wellness Recovery Action PlanT with Mary Ellen Copeland and her staff.

• Explore the basic concepts underlying recovery and wellness: hope, personal responsibility, self-advocacy, education and support.
  
  
• Learn how to get good medical care and manage the medications you may choose to take as part of your wellness and recovery.
  
  
• Work with others to discover the wellness tools that help relieve symptoms and enhance life.
  
  
• Use these tools to develop your own WRAP or to assist someone else as they develop this plan.

The long term benefits of this program are to:

• promote higher levels of wellness and stability
• increase the use of natural supports
• promote personal responsibility and empowerment
• improve the overall quality of life
• decrease the incidence of severe symptoms
• decrease traumatic life events and stigma caused by severe symptoms
• increase understanding of these symptoms
• decrease need for costly therapies and health services

Completion of this training fulfills the requirements for attending Seminar II: Facilitator Training. The cost of this training is $600, including all materials and texts.

Mental Health Recovery Correspondence Course

The four-part Mental Health Recovery Correspondence Course is offered as an alternative to attending Mental Health Recovery Seminar 1: Learning Mental Health Recovery including Wellness Recovery Action Planning. Participants who successfully complete this course are eligible to attend Mental Health Recovery Seminar II: Facilitator Training. However, many people who do not plan to receive further training have taken this course as a way to enhance their own recovery.

The course includes reading assignments, articles, projects, activities and phone discussion with the instructor. The texts for the course are: The Depression Workbook, Living Without Depression and Manic Depression, and Wellness Recovery Action PlanT.. The cost is $200 per participant, plus the cost of any texts you need to purchase.

Mental Health Recovery Seminar II: Facilitator Training
Spring session, May 21-25, 2001
Fall session, September 10-14, 2001
Brattleboro, VT

In this Facilitator Training, Mary Ellen Copeland and her staff will train you to teach and network Mental Health Recovery information, including how to develop a Wellness Recovery Action PlanT. The Seminar is based on: 1) the findings of Mary Ellen Copeland's studies on how people relieve psychiatric symptoms on a daily basis and how they get well, stay well and move on to do the things they want to do with their lives; and 2) data that shows how to most effectively share this information with those people who can most benefit from it.

Anyone who has met the requirements for the training is welcome. You can meet the prerequisite for this training if you have:

1) prior in-depth experience with Mary Ellen's work;

2) completed Mental Health Recovery Seminar I; or

3) completed the Correspondence Course described above.

Using presentations, demonstrations, interactive discussion and related activities, you will review basic Recovery skills and learn :

• how to support and motivate people in learning and using Recovery/Self-Management skills
• the importance of sharing and networking Recovery information
• effective ways of teaching Recovery information to people who experience psychiatric symptoms, to their supporters, and to health care providers;

Through long term use of these recovery/wellness strategies, we will all see:

• a shift of focus in mental health care from symptom control to prevention and recovery.
  
  
• a significant reduction in the need for costly mental health and emergency services as people who experience psychiatric symptoms effectively take responsibility for their own wellness and stability, manage and reduce their symptoms using a variety of self-help techniques, and effectively reach out for the support of a network of family members, friends and health care professionals.
  
  
• increased ability to meet life and vocational goals, significant life enhancement, and gains in self-esteem and self-confidence as people become contributing members of the community.

The cost of this seminar is $900, including the new Facilitator Training Manual.

Upcoming Presentations

• May 3 ISOM 30th Annual Conference, (International Society of Orthomolecular Medicine). Toronto, Ontario. Mary Ellen's presentation is Friday, May 4, 7-9:30 p.m. For more information contact Steven Carter, Journal Of Orthomolecular Medicine, 416-733-2117.
  
  
• May 9-11 Therapeutic Activities and Psychiatric Rehabilitation Conference: Crossroads of the Body and Mind in Philadelphia, PA. Keynote and workshop.
  
  
• May 10 IAPSRS 2001 Annual Conference Houston, TX. Mary Ellen's presentation is entitled "WRAP: An Innovative Self-Management System."
• May 14 Governor's Prevention Conference, Killington, VT. "WRAP: An Innovative Self-Management System."
  
  
• June 10 National Mental Health Association Conference, Washington, DC. Mary Ellen's presentation is entitled: Mental Health and Trauma: Healing the Wounds.
• June 11-13 New York State Best Practices Conference, Brooklyn, NY. "WRAP: An Innovative Self-Management System."
  
  
• June 21 Kansas State Recovery Conference. Keynote and workshop.

New Resources

WRAP on CD-ROM
Due to repeated requests, two versions of WRAP--one for adults and one for adolescents--will be available on CD-ROM by summer (both versions will be on one disk so the user can choose the one they want to use). This means that you can copy the WRAP format from the disk onto your computer and use it to develop your own WRAP or to help someone else develop their WRAP. I have my WRAP on my computer. It makes the plan so easy to use and revise. More information on this new resource will be available in the next newsletter.

Recovery Brochure
Coming soon: Later this month a new booklet will be available from the Center for Mental Health Services: Recovering Your Mental Health: A Self Help Guide. I developed this booklet with the assistance of a focus group of ten people from around the country--people who are working on their own recovery. You can get free copies from KEN by calling the following phone number. Refer to SMA# 3504.

National Mental Health Services
Knowledge Exchange Network (KEN)
1-800-789-2647 (voice)
1-800-790-2647 (bulletin board)
www.mentalhealth.org

WRAP Video
In the summer of 1999 Jack Churchill, director of the Mental Illness Education Project and video producer extraordanaire, filmed me leading a group of 30 people in developing a Wellness Recovery Action PlanT. The goal of this project was to produce a video that anyone could use to develop their own Plan. However, film is just the beginning of such a project. It takes many hours of work and lots of money to take a film and make it into a high quality video. Though work is progressing, the lack of funding is seriously hindering the development of this video. If you could make a contribution to this effort, even a small contribution, it would help. You can send your tax deductible contribution, with a note that says the contribution if for the WRAP video, to:

The Mental Illness Education Project,
PO Box 470813, Brookline, MA 02477

If you have information on possible funding sources for this video, please call Jack or Christine at 1-617-562-1111.

WELLNESS TOOLBOX

Personal responsibility is key to using any wellness tool. It is up to you to notice how this tool is making you feel, to decide whether or not you want to use it, and how much use of this tool is best for you.

Exercise: The Best Anti-Depressant
by Mary Ellen Copeland

Almost everyone benefits from exercise. It is one of the most universal wellness tools. Regular exercise, whatever you can do, leads to an increase in energy levels and a sense of well-being. It relieves anxiety while improving sleep and fitness. You may notice that you think more clearly and feel happier after you have exercised. If extra weight is an issue for you, weight loss is often a welcome side-effect of increasing exercise.

Many people who develop Wellness Recovery Action Plans* include exercise in their Daily Maintenance section. I list exercising for at least 1/2 hour in my Daily Maintenance Plan. I take a walk or exercise in some other way for an hour if I have been "triggered" or have "early warning signs" of a possible worsening of symptoms. When my symptoms are serious, my plan instructs me to exercise with a supporter for at least 1/2 hour, more if I can. My Crisis Plan tells my supporters to offer to take me for a walk or to do some other exercise with me if I am in a crisis, and that I can decide if I want to or not. (*For more information on developing a Wellness Recovery Action PlanT see Mary Ellen Copeland's website at www.mentalhealthrecovery.com, or refer to the enclosed book order form for Wellness Recovery Action PlanT, Wellness Recovery Action PlanT for Dual Diagnosis or Winning Against Relapse, or see issue 1.1 of this newsletter.)

Getting Started
Contact your doctor for a physical examination before you begin increasing your exercise if you haven't been exercising for some time, if you lead a sedentary lifestyle, if you are over 60, if you have a health problem or disability that might be affected by exercise, if you haven't seen your doctor in a long time, or if it just feels like the right thing to do.

Assess the exercise you have been getting as part of your job or daily routine. For instance, if you walk up three flights of stairs each day to get to your office, consider that part of your current exercise.

Begin your exercise program or your increase in exercise gradually. Your body adapts more easily to gradual change and you will miss out on all the aches and pains that come with too much exercise.

Choosing The Right Exercise Program For You
When setting up an exercise program that is right for you, focus on what you enjoy. Whether it be swimming, hiking, dancing, working out on exercise machines while watching television, team sports, skating, raking the lawn, splitting wood, walking, etc., etc., etc... any kind of exercise that you enjoy is acceptable! You can do the same kind of exercise every day. Or vary it according to the weather, what you feel like doing or what you need to get done. It may help if you make a list of exercise options and post it in a convenient place. Then you can look at the list and decide each day how you are going to get your exercise. This makes exercise more interesting for some of us.

Walking
Walking deserves special focus because it is often the easiest, most convenient and best exercise for many people.

• No special equipment is necessary except a good pair of walking shoes.
  
  
• It costs nothing.
  
  
• It is non-competitive, so feelings of not being as good as others don't come up.
  
  
• You can walk anytime, anywhere that is safe. Walking in the countryside or in parks that have natural settings has the added benefit of communion with nature.
  
  
• You can walk in whatever you happen to be wearing. You don't have to change your clothes or shower after walking.
  
  
• It is very unlikely that you will incur the type of overuse injuries that occur with some other types of exercise.

Sticking To An Exercise Program
Like most people, you may have had difficulty beginning or sticking to an exercise program. Perhaps one or several of the following suggestions would help.

• Consider your exercise time as fun or "play" time, not as work.
  
  
• Ask friends and/or family members to exercise with you.
  
  
• Reward yourself each time you exercise or after you have followed your exercise plan for a specific length of time. Eventually the benefits of exercising are enough reward.
  
  
• Combine exercise with other strategies you use to keep yourself well, such as
  1) your need for light exposure,
  2) time for focusing on positive thoughts,
  3) connecting with family members and supporters.
  
  
• Schedule exercise at the same time each day to provide structure and routine.
  
  
• If you find it difficult to exercise in the winter and in bad weather you may want to get a piece of exercise equipment such as an exercise bicycle or rowing machine. You can often find these "used" at very low prices.
  
  
• Avoid sabotaging yourself. If you miss a day, several days, or even weeks of exercise, don't give up and stop exercising. Just start in again. If you have a long hiatus or have stopped exercising because of an injury or illness, start again gradually.
  
  
• It may help you stick to your exercise regime if you keep a record of your exercise. Each time you exercise, write a few sentences in a notebook, describing what you did, how you felt before you did it, how you felt after you did it, and any short or longer term benefits you are noticing. This is a strong motivator if you review your writings from time to time.

RECOVERY TOPICS

Finding Our Voice! Ending The Silence
by Mary Ellen Copeland

Speak out! Speak out! Speak out! If I said this a million times it would not be too much.

I have been doing mental health recovery education for 12 years now. Through that time I have maintained my focus on simple, safe, non-invasive self-help strategies and skills that will help people to feel better. While doing this work I have held the vision that the mental health system would come to appreciate that people can recover and would work with people to assist them in their recovery. Care providers would come to realize that each person must be in charge of and responsible for their own recovery, that they would see the value of validating a person's experience and of peer support. They would support empowerment, personal responsibility, self-advocacy and education for every person.

And, in fact, some of this has come to pass, in places where wonderful work is being done and progress is being made. There are hundreds of recovery educators, many of whom have been users of services, who are teaching others how to develop Wellness Recovery Action Plans and showing them that there are choices they can make in their lives. Mental health commissioners and systems are changing their focus to recovery. Hard working health care providers are joining the ranks of people who understand that these symptoms are not the "end of the road" but are part of the process. Care providers, family members and friends rejoice in our progress.

But there are still many people who are being forced or coerced into treatments and lifestyles that are not their choice. Many people continue to be repressed and stigmatized. Many are being physically and emotionally abused. Many are told they have a medical illness or a "broken brain" and then are punished for their symptoms--symptoms which are often extremely painful and terrifying. And many people stop fighting and end their lives.

Meanwhile, many of us remain silent. Perhaps we have been taught to be silent, taught that we have nothing of value to say and that we must let others determine the course of our lives. We may have been taught or feel that those of us who experience psychiatric symptoms are incapable of rational thinking and of speaking out. We may remain silent because we are part of a minority and our views have often been ignored. Some of us may even fear retribution, such as diminishing support and services, separation from our families, homelessness, or worse if we don't do as we are told. Maybe we just don't know what to do or how to begin. Sometimes it's just easier to look the other way and pretend it isn't happening.

So while I continue to teach about common sense recovery systems that have been overlooked far too long, in this newsletter, in my writings and presentations, you will now hear a stronger voice. A voice that says we must stop this injustice now. We must all speak out--and that includes me.

Many of you are already speaking out. But many more voices are needed. Those of you who can speak from experience but have lost your voice, your voice is important. If you feel like you never had a voice, try using it. The more you use it the easier it is. In order for injustice to be overcome it takes many voices. And the voices we most need to hear are from those of us who have been silenced. It is the only way we can create the change that must happen--many voices speaking as one.

How Do You Find Your Voice?

1. Learn your rights! A list of basic human rights was published in issue 1.2 of this newsletter. These rights include the kinds of things most people take for granted, such as the right to change your mind, to follow your own values and standards, to say no to anything when you feel you are not ready or it is unsafe or it violates your values, to determine your own priorities, to meet your own needs for personal space and time, to decide on your own treatment, to be playful and frivolous, to be in a non-abusive environment, to have the friends of your choice, and to be treated with dignity and respect. If you would like a copy of these rights, please contact the office to request back issue 1.2.

2. Begin practicing using your voice in small ways that feel safe to you. It might be telling someone that you won't give them a cigarette or buy them a beer, that you will do the dishes or take your shower when you want to, that you will decorate your room the way you want it, that "your" treatment plan must reflect your goals and dreams, that if you didn't develop it it is not your treatment plan, that you will decide what you will put in your mouth or do to your body, that you will choose your own friends.

3. When you feel that you have had enough practice, think about something "bigger" in your life that you want and need to address. It might be insisting on a change in medication from one that causes side effects that are making you miserable. It might be finding good housing or getting work that uses your special skills and talents. Lack of self-esteem and fear of authority may have kept you from addressing some issues in the past. Remember, you are as important and special, and probably as smart, as anyone else--even the people who represent authority figures in your life. Regain a strong sense of yourself and the great person you are by

1) writing a paper that lists all your positive attributes, strengths and accomplishments, and reading it over and over,
2) asking people who like you, people that you trust, to make a list of your strengths that you can read whenever you have a chance,
3) taking very good care of yourself, and,
4) working toward meeting your goals and dreams. You deserve the very best that life has to offer!

4. Talk with your supporters about what you would like to do--what change you would like to create in your life or in the world. Plan a strategy, and revise it as you learn more. If your strategy includes talking with an "authority figure" that you feel may be rude or threatening, take a supporter along with you. Then ask for what you want and need. If you are told that you can't have it, tell them again. Keep telling them. If necessary, see someone else. But don't stop until your voice is heard and you get what you need and want for yourself.

5. When you have had some practice with the previous steps, you may feel ready to speak out about more universal mental health issues, like the use of isolation and restraints, abuse, forced treatment, poor treatment, incarceration and keeping people tied into the system who don't need to be there. Get together with others who are working for this cause. You may need to set up meetings and gather people together. If so, please do it. You can work together to strategize as a group about how you will meet this need. Taking action together is very empowering. Visit the National Protection and Advocacy web site at www.protectionandadvocacy.com if you feel your rights are being violated or for more information.

Whenever you feel comfortable, start sending e-mails, letters, phoning and meeting with public officials and others who have the ability to facilitate much needed system change. David Oaks, Director of Support Coalition International, can put you on an e-mail list so that you will be advised of issues related to psychiatric injustice that demand response. Then you can join thousands of others who have responded to this need and ended injustice for many. His contact information is:

David Oaks
454 Willamette, Suite 216,
(PO Box 11284),
Eugene, OR 97440, USA.
Toll free: 1-877-MAD-PRIDE
Web address: www.MindFreedom.org
E-mail: oaks@mindfreedom.org.
General info: office@mindfreedom.org.
Phone: 541-345-9106. Fax: 541-345-3737.

Keep In Mind

As you take up this challenge to speak out, you are certain to meet obstacles. Don't let them cause you to back away. With our collective courage, strength and persistence, we can surmount these obstacles and create a system that works for everyone.

Guidelines For Speaking Out

• Educate yourself about the issues. Read. Explore the internet. Go to meetings. Know the issue. Decide how you feel. Then speak out where you will be heard--contact key officials, go to board meetings, write letters to the editor, call in on talk shows, send e-mails.
  
  
• It takes many people to create change, not just one very strong individual. Beware of people who want to be the only one in charge or the only one speaking out. Circumvent them as kindly as possible.
  
  
• Treat others with dignity, compassion and respect, listening to their views and challenging them when necessary.
  Insist that others treat you well, even when you are saying things that they don't want to hear.
  
  
• Stay as calm as possible when speaking out. If you "lose your cool" you will be accused of being "just another mental patient." You can let out your frustration when you are alone or with good friends.
  
  
• As you find your voice, you may be tempted to talk too much--to go on and on and on. This is never a good idea. If you do this, you silence the voices of others who also need to be heard. Strongly and briefly make your point. Then give others their chance to speak. Again, it is the voices of many, not just one, that will make the difference!
  

Heart Disease: A Woman's Most Serious Health Threat
By Judy Leaver, MA
Vice President, Member Services for WomenHeart,
the National Coalition for Women with Heart Disease

American women are being stalked by a silent killer and are, for the most part, unaware of it. It may come as a surprise to learn that coronary heart disease, not breast cancer, is the number one killer of women in this country.

Historically heart disease has been understood as a man's disease. Doctors are slower to recognize the presence of heart attacks in women because of the assumption that her symptom profile will be the same as a man's. Nearly two-thirds of heart attack deaths in women occur among those who have no chest pain. Being unfamiliar with women's symptoms, they may wait longer than men to go to an emergency room when having a heart attack.

Fortunately, a growing number of health care providers are becoming aware that women are not small men. To get the best care, a woman can seek out a cardiologist who specializes in gender specific medicine. She can also ask her doctors if they are aware of the differences in men's and women's hearts, heart attack symptoms, and treatment. She must become familiar with those differences in case she needs to educate her physician.

WOMEN: Know your heart attack warning signs!

• Discomfort, fullness, tightness, squeezing or pressure in center of chest that stays for more than a few minutes or comes and goes.
• Pressure or pain that spreads to upper back, shoulders, neck or arms.
• Dizziness or nausea.
• Clammy sweats, heart flutters or paleness.
• Unexplained feelings of anxiety, fatigue, or weakness--especially with exertion.
• Stomach or abdominal pain.
• Shortness of breath and difficulty breathing.

Mental health issues are subtly entwined with heart disease. A recent Canadian study found that women are twice as likely as men to experience depression after a heart attack. Some researchers now believe that depression may actually cause heart disease because it creates hormonal changes that put added stress on the heart. Early and proper treatment of depression is critical to a woman's recovery from heart attack, invasive surgery or heart transplant.

Stress and anxiety management are sometimes components of follow-up care after a heart attack or surgery. Managing one's stress has tremendous influence on a woman's ability to survive her cardiac ordeal and recover a sense of balance, control and well being after such a frightening event.

If you smoke, quitting is the best way to improve the health of your heart. Exercise is another activity that improves heart health. It can be as inexpensive as a good pair of tennis shoes to walk in. Take it one block at a time! You might also invest in a DigiWalker (www.digiwalker.com) which will record the number of steps you take each day. Set a goal of 10,000 steps a day. You'll be surprised how quickly those steps mount up.

Responsible self-care is an essential part of recovery from a cardiac event, just as it is from a mental health problem. To learn more about women and heart disease, check out the WomenHeart website at www.womenheart.org or call them at 202-736-1770. WomenHeart is focused on public education, support for women with heart disease, and advocacy for more research and treatment for women and heart disease. Another excellent resource is The Female Heart by Dr. Marianne J. Legato. Also, the Harvard Medical School publishes a wonderful consumer health email newsletter and has an issue on Heart Health. Subscribe at www.intelihealth.com.

Back to Newsletters