Until the development of the supported education concept (which helps people with psychiatric disabilities choose and achieve educational goals),1 educational interventions and educational outcomes for people with severe mental illnesses rarely had been considered. It has been implemented in a variety of locations (such as California, Illinois, Massachusetts, and Michigan) during the past two decades.2 In the first nationwide survey of members of the organization now known as the National Alliance on Mental Illness, members reported that while only 5% of their relatives with mental illnesses were working full time, 92% had graduated from high school, 59% had attended college, and 17% had graduated from college.3 Depending on the particular sample taken, 52 to 92% of people with severe mental illnesses are high school graduates, and 15 to 60% of these high school graduates attend college.4 Unfortunately, mental health interventions rarely capitalize on people's interest and success in education.
Because we believe strongly that any successful system transformation must include educational interventions, this column and the next will feature two different Recovery Education Centers (RECs) developed simultaneously 2,000 miles apart that share information with one another. Interested readers can choose from various components of these two different recovery education initiatives to develop their own unique recovery education efforts. In this issue, we examine the Phoenix Recovery Education Center.
The Phoenix center's development was a learn-as-you-go process. We began in 2000 with a vision of a place where people could learn how to recover, work, and build social supports. Instead of a one-size-fits-all approach, we envisioned a place that values originality and offers many choices and individualized approaches to the recovery process. We hoped to create a place that could begin to close the gap between people who receive services, providers, and family members by developing a setting where they could take classes together on an equal playing field and learn from each other.
We tried to think of existing models that might serve as a foundation on which to build our vision. We wanted to offer a recovery-oriented behavioral health program that counted on the energy and enthusiasm we know people with serious mental illness have but that often goes untapped. We had memories of being in uninspiring day treatment settings with a strong focus on illness and largely staff-driven. Drop-in centers were more like drop-out centers, with no focus on recovery. The club house model came to mind, but the ones we knew were geared for slow growth; we wanted to create an environment of high expectations and open-ended opportunities to allow people to reach beyond what they had been led to expect of themselves and us.
Overall, it seemed that existing models had been built on a foundation of illness—not recovery. We needed to develop an environment that could support our vision. We wanted to support the person, not his illness, and we knew that if the person could grow bigger than the illness, he would be well on his way to recovery. The illness still would be there, but the person could begin to live his life as a victor instead of a victim. We realized that we may not be able to cure the illness, but we could minimize it and help the person heal wounds and move ahead with his life plans.
Since we wanted to engage people in ways that promoted personal responsibility and self-direction, we chose a foundation based on behavioral health education. We didn't want to perpetuate the myth that we could fix them; we wanted them to learn how to fix themselves. This would allow people to try out the role of “student” as opposed to “patient” and invite them to learn about recovery instead of mental illnesses.
When we opened the REC's doors in 2000, we found that most people coming in for services had no educational goals and had never thought of themselves as “students.” Many had negative experiences in schools, leaving them with more of a sense of failure than of achievement or validation.
The REC is licensed as a Private Post-Secondary Educational Institution by the state of Arizona and, through an agreement with South Mountain Community College, offers credit for most classes and even an associate's degree in behavioral health recovery. Our students are amazed that they can earn college credit for taking Peer Employment Training (a 70-hour class that trains people receiving behavioral health services how to use their personal experience to help others recover), since it values and builds on what they already have learned through painful experiences. Once they take this class, or any other class, and see that they can succeed, they usually become very enthusiastic about continuing to learn recovery and personal growth skills.