Craig Winston LeCroy and Jane Holschuh,First Person Accounts of Mental Illness and Recovery

Reviewed by: Melissa Edmondson, University of Maryland, School of Social Work, USA

As a social work researcher and educator whose interests focus on mental health services and outcomes for diverse individuals with severe mental illness, First Person Accounts of Mental Illness and Recovery reaffirmed for me the importance of hearing and understanding the lives of individuals with severe mental illness as they describe and experience them. I spent years as a practitioner and administrator striving to be compassionate, empathetic and work with individuals from a place of hope and recovery. This was, at times, challenging for me, as I made a conscious effort to check biases, listen to my consumers and understand that in the end it was my responsibility to guide and assist as opposed to choose the path their lives would take. As I read through, First Person Accounts of Mental Illness and Recovery, I am reminded that as a researcher my responsibility now is to ensure that the voices of the individuals with severe mental illness are heard through their informed participation in research as well as being informed by their ideas about and participation in research with the ultimate goal of improving mental health services and recovery.

In First Person Accounts of Mental Illness and Recovery, LeCroy and Holschuh (2012) provide the reader with intimate and personal views of mental illness through a collection of first person stories that reflect the lived experiences of individuals with mental illness. This collection of stories clearly and intentionally reflect both a strengths perspective and recovery orientation, both of which are key to working with and for persons with mental illness as a friend, family member, practitioner and/or researcher.

In the introduction, the editors orient the reader to a brief history of first person accounts of mental illness and the relationship of first person accounts to the process of recovery. While the subsequent chapters of this book are organized by the Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition-Text Revised (DSM IV-TR) category of disorders, the authors are clear that this structure is not an endorsement of the DSM IV-TR and stress the importance of the subjective nature of stories throughout the book. Even with the reorganizing and revising of disorders in DSM-5, this book remains relevant as it speaks to the lived experiences of all those coping with and recovering from mental health disorders.

The introduction also provides a summary of emerging themes throughout the collection of stories that range from confusion and pain to strength and courage. Of particular interest to me were the numerous stories that included the theme of stigma and treatment. As my own work and experiences have been predominantly with individuals with schizophrenia, I was particularly drawn to Chapter 1, ‘Schizophrenia and Other Psychotic Disorders’, and the personal accounts of misguided and inappropriate treatment that sounded all too familiar. These stories offer perspectives to mental health professionals that not only serve as cautionary tales, but also provide important guidance for improving the quality and instilling humanity in the provision of mental health services as is poignantly discussed in Benjamin Gray’s personal account:

What I have learnt as an academic and researcher, as well as a mental health patient labeled with schizophrenia, is that what people with mental health problems want is to be treated as equal citizens with equal human and medical rights. People with mental health problems who hear voices or hallucinate want to be valued, as we all do, not feared and ostracized. They want their views and opinions taken into account, especially as regards what sorts of treatment they have and in their care plans. They want a right to accept or refuse medication and not have it forced upon them supposedly for their own good. At the very least, people with mental health problems want their stories, narratives and voices to be valued and taken into consideration. Such an approach would take people’s diversity and their diverse experiences and beliefs, into consideration and not label people as mad or bad but value them as human beings, with all the faults and strengths that being a human being entails. Such an approach would give rise to a more democratic and person-centered psychiatry, which would also view mental health patients’ experiences as a form of expertise to be shared with professionals rather than discounted as delusions. (p. 24)

The personal accounts also describe journeys of recovery, learning and rediscovering personal identities, the importance of social supports as well as providing words of wisdom to others coping with and recovering from mental illness. Leslie Greenblat writes:

What’s the magic cure? How did I go from being an angry, distrusting, ‘treatment-resistant schizophrenic’ to a woman entering graduate school, who lives with schizophrenia? There’s no magic cure. All I offer to my fellow travelers is this: Be patient with yourself. Take time to have fun. Work hard. Be passionate. Be willing to trust yourself and others. Take your meds. If you have issues with your meds, negotiate with your doctor. Have courage. If you are in a difficult or stressful situation, plan your response. Have someone to call. Know your limits, and most important, be willing to grow beyond them, but know where to go for support. (p. 18)

In addition to the multiple first person stories provided, each chapter provides a brief introduction to the category of disorders and questions for the reader to consider. This format renders the book particularly useful for educators and students. For example, Chapter 5 focuses on Substance-Related Disorder and includes the following questions for reflection on three personal accounts of substance use and recovery:

What do the authors of the narratives in this chapter have in common in terms of their experiences with alcohol and/or drugs? Does acceptance of one’s addiction inevitably lead to recovery for every user? What else might be a critical component of recovery? Why is substance abuse such a common problem? (p. 217)

Reflective questions such as these are useful in sparking classroom discussion about individual struggles with substance abuse such as those described in Neil Davidson’s story Goodbye, Johnnie Walker:

I love drinking, and am having a hard time accepting that being sober is somehow a superior state of being. It’s hard to accept that I have to expend even more energy to stay clean than I did when the first thing I thought about in the morning was whether I had enough scotch for the following night. Never having had hangovers, I don’t feel any better when I wake up now than I did when I drank and literally have to remind myself that I didn’t drink yesterday. (p. 218)

At the conclusion of the introduction chapter, LeCroy and Holschuh (2012) present the goal of such a collection of personal accounts of mental illness and recovery:

We hope that reading this collection of first person accounts promotes a greater compassion and empathy; an increased commitment to quality services and treatment; reduced stigma, pain, and suffering; and an expansion of hope and recovery. (p. xxvii)

This book has achieved such a goal and will continue to through future readers whether they are practitioners, students, researchers, educators, family members and most importantly the individuals who continue to cope with and overcome the many challenges to recovery from mental illness.