An Anthem Recovery Month Blog Interview with Andrea Cook
September is National Recovery Month – an opportunity to increase awareness and understanding of mental health conditions and substance use disorders and celebrate the people in recovery. This year the “Join the Voices for Recovery: Together We Are Stronger.” We sat down with Andrea Cook, Program Manager/Advocacy Director at Northern California Mental Health America to learn how we can support our families, friends and communities who are dealing with mental health conditions and living in recovery; as well as become more aware of our own mental health and wellness.
NAB|: What are the basic things that we should know when we think about mental health or recovery? How does someone even start working to achieve good mental health and wellbeing?
AC: I believe that we need to begin looking at the individual as a whole person. Right now there is so much stigma around mental health. We know that individuals living with a with mental health condition have a life expectancy of approximately 20 years less than those without, but it is NOT because of their mental health, it is because their physical health needs are not being met and that could be exacerbating their mental health needs. We need to ensure that we are treating [mental health conditions] like any other illness – such as diabetes — and ensure that we are working with the whole person and that their primary care is being taken care of, their dental care is being taken care of and [all the while] trying to eliminate the stigma of accessing [services and supports]. I think that even the integration that is happening right now with behavioral health and primary care really does combat that stigma.
NAB|: How is stigma ultimately changing the way the folks could be receiving the best services or best care – or maintaining a general knowledge base about positive mental health practices?
AC: I think that it’s not about how they are receiving but if they are even seeking [it]. Because of the stigma and the [perceived] shame associated with mental health conditions, many times individuals will not even seek help. The way that our system is created right now [many] people are afraid to even have that [mental health] on their records. Even to be flagged – especially with certain careers – [there is a belief] it could really hold individuals back and there is a reality to [that fear] as well. I think the way that we go about even documenting and supporting these individuals – we just need an overhaul.
Being somebody who has received services in all sorts of settings, you see firsthand the interaction [that communicates a stigma on people who are working on their mental health]. Even when you go to some mental health clinics, you see law enforcement in front or armed security guards [even though] Individuals with mental illness are much more likely to be the victims of violence rather than be the perpetrator. Combatting that stigma is about raising that awareness and education.
NAB|: You mentioned being on the receiving end of care. What would you consider sharing that you have learned through your lived experience that has informed your work and that you would want people to know?
AC: I think it is important – we are talking about mental health and erasing the stigma, to be able to share. That is one of the most powerful things: that individuals are actually open and honest about their own experiences with mental health. That has been proven as one of the best ways to combat the stigma. When I was first diagnosed, I had no idea what was going on. I remember I was living in Los Angeles and even driving to Cedar Sinai (that’s this big hospital in LA) and I was like “I need to go there – but I don’t even know what for!” Mental health was the farthest thing from my mind. It was [due to] a lack of education [and stigma]. When you look at the media and how it’s portrayed [mental health] is the last thing you want to be associated with. So, because I didn’t know and was completely uneducated about mental health, [my condition] ended up escalating, and I had to be hospitalized. I then refused treatment and got a patient’s rights advocate to get me out, because I was like, “I know what mental illness is. It’s not me.” I ended up being hospitalized again, and after refusing services for a couple of weeks, my grandfather called me, and he came out of the closet [on his own mental health issues]. He said, “Andrea, I want you to know that I love you and that I’ve been there.” I said, ”What the heck?!” because this was a man that I was really close with and an amazing mentor. Turns out he had also dealt with mental health issues and had been institutionalized. He was catatonic for over a year, but after his institutionalization he went on the get his Ph.D. in Chemistry, moved to Northern California and was a chemistry professor for over 40 years. He had a beautiful family, grandchildren, a career and was just a well-respected man all around. He jogged 6 miles a day until he was in his 80s, and I thought, “Well if that’s what mental illness looks like, I got this!”
NAB|: And so, for you, knowing that you were not alone was a big turning point?
It was THEN that I started taking personal responsibility. It took a long time, but I think that having a role model that really showed me that this is just a speed bump – not a life sentence and that you can have a fulfilling life after diagnoses really changed everything. I moved into this career and I just have so much hope for individuals and I think that we have all of the tools and resources, we just need to start actually utilizing them and having these real conversations.
NAB|: So once we begin to accept the fact that mental health is something that everyone should be aware of, how do we start working toward better mental health outcomes?
AC: I think one of the biggest things that we need to start doing is to restructure the way that we measure outcomes – because now what we are doing is very medical model. When you think about mental health and the recovery model, we don’t have a consistent way to measure life outcomes – like quality of life factors. In Los Angeles there is a project called The Village and the whole premise was around meaningful recovery outcomes. It was to create a Recovery Focused Based Public Mental Health system, and they had such amazing outcomes with this program that it was part of the reason that Prop 63 in CA was created. And so I think it is really about looking at the whole person and not judging on necessarily decreasing symptoms but increasing quality of life factors.
NAB|: What should we be teaching young people, families, friends and communities about what to do when you run into your own mental health crisis from a lens that moves away from stigma and into acceptance and positive action?
AC: Well I am a fan of mental health first aid –it goes a long way in really helping individuals that are not familiar with mental health experiences on how to be community responders and how just even with communicating with individuals when they are in distress on how you can de-escalate a situation and provide support. I think that having those types of resources available goes a long way to giving family members and community tools on how to better support.
I am a big advocate for peer support and I believe that one of the things – especially for community members and family members that are impacted by a loved one with a severe mental health condition – is self-care. They need to take care of themselves first and foremost because if they don’t, there is no way that they will be able to support their loved one. I recommend supports also seek counseling and support for themselves, this will enable them to be more effective support their loved one. There are other tools that are really powerful that can help individuals with lived experience as well as family members. I don’t know if you are familiar with an evidence based practice called WRAP? I think that is a really powerful tool–for organizations, too, because it has been proven to create a healthier, safer, more productive workforce as well.
NAB|: What is WRAP?
WRAP stands for Wellness Recovery Action Plan and what’s pretty phenomenal about it is that it was created though the client movement. Mary Ellen (Copeland) is the author. She’s not the creator because what she did was she surveyed individuals across the nation that were living successful lives with mental health conditions. She found these key concepts that everybody had in common, and the first one was Hope. So everybody had hope that they could and would do better – that this was a speed bump, as I said earlier. The next one was that they were willing to take personal responsibility and I think that is really difficult for individuals, because it is a lot easier to blame your providers, or your family, or society, or the stars, than it is to take responsibility for yourself. It also talks heavily about educating yourself around your diagnosis and the supports within your community. WRAP really gives individuals the tools to be their own self advocates. It supports a more thoughtful planning for medical supports, like what are the highest things in the hierarchy of needs; what do I really want to address? Then it helps individuals create a peer support network so that they can foster more independence and build a more independent community. It is really cool, and it’s not rocket science. It’s really simple and a lot of it (to me) is common sense.
NAB|: That’s awesome. I love the fact that perspective also shows that managing good mental health is something we may do for ourselves as well as something that we all can do for each other. So if there is someone reading this and they have never had a mental health crisis for themselves or for a family member, what would you would want them to know?
AC: You know it sounds like such a cliché but I’d want them to remember that anyone [could experience a mental health condition] and it could happen at any time in their lives, so just practice self-compassion, self-awareness and reflection – for self and others in your community. Life can be hard whether you have a mental health condition or not, so a lot of the things that we talk about in mental health and in the recovery movement is transferrable to all communities and all people. I just want to reiterate that life is short and precious and to practice wellness.
Andrea Cook is the Program Manager and Advocacy Director at Mental health America NorCal. If you or someone you know is in crisis now, seek help immediately. Call 1-800-273-TALK (8255) to reach a 24 hour crisis center.