The Yale Program for Recovery and Community Health seeks to promote the recovery, self-determination, and inclusion of people facing psychiatric disability, addiction, and discrimination through focusing on their strengths and the valuable contributions they have to make to the lives of their communities.
Why is PRCH called the Program for Recovery and Community Health?
"Recovery" represents both a very old term and a very recent innovation in behavioral health. Consequently, it has been the source of much confusion in the field. As used by PRCH, recovery is taken to refer primarily to the processes by which people living with mental illnesses and/or addictions figure out or learn how to minimize the disabilities associated with these conditions while pursuing a safe, dignified, meaningful, and constructive life in the community. This sense of recovery was first introduced in the self-help addiction recovery community over a half century ago through the founding of Alcoholics Anonymous and other 12-step, mutual support approaches (this is the very old use of the term), and was then adopted by the self-help community in mental health beginning with the Consumer/Survivor/Ex-Patient/User Movement in the 1970’s. In recent years, however, this view of recovery has undergone significant modifications and elaborations, and has increasingly become the guiding vision not only for self-help and mutual support, but for the formal mental health and addiction service systems as well.
PRCH has defined services and supports oriented to promoting this sense of recovery as care that “identifies and builds upon each person’s assets, strengths, and areas of health and competence to support the person in managing his or her condition while regaining a meaningful, constructive sense of membership in the community.”
Thus, instead of treating and/or rehabilitating people, a transformed system’s primary responsibility becomes that of supporting people in their own efforts to manage and overcome addictions and mental illnesses in the process of rebuilding their lives.
Many of the activities undertaken by PRCH are aimed at investigating and describing the ways in which people with behavioral health conditions do manage to recover from or learn to live a gratifying life despite mental illness and/or addiction, as well as at identifying, evaluating, and disseminating ways in which service providers can offer help that promotes and facilitates the person’s own efforts.
"Community Health" is a relatively new term. We use this term to refer to an especially important, but frequently overlooked, dimension of recovery. An extension of a traditional public health model, a community health perspective first emphasizes that the community in which a person lives is an essential and powerful determinant of his or her health. We understand this community to refer to the physical environment in which a person lives, and also to the social, cultural, interpersonal, emotional, and valuative aspects of a given environment as well.
Analogous to the way in which exposure to lead paint can cause neurological impairment and poor air quality can exacerbate asthma, there are numerous social determinants that directly effect behavioral health. Institutional settings, poverty, discrimination, and trauma on the one hand can contribute to and exacerbate addictions and mental illnesses, while supportive and respectful environments, caring and reciprocal relationships, faith, gainful employment, and participation in other meaningful activities provide cornerstones of the recovery process. People will be supported in their hopes for recovery by the qualities of the communities in which they live.
Sustained recovery cannot be achieved in artificial settings, no matter how benevolent their intent or how caring the people who work there, while communities cannot prosper through divisiveness and discrimination. Rather than waiting to rejoin community life until recovery has been achieved (whether through detox, inpatient care, residential treatment, skills training, etc.), we have found people more likely to engage in the work of recovery in the process of establishing or re-establishing their lives in the community. To borrow from the Reverend Dr. Martin Luther King, Jr.'s classic "Letter from Birmingham Jail," we have found recovery delayed is recovery denied.
The ways in which communities can actively support people early in the recovery process to make contributions to their communities and establish a more solid foundation for their ongoing recovery forms a core focus of PRCH's efforts.