Entire community has role in helping those with mental illness.

Byline: Susan Ban For The Register-Guard

Consider for a moment how dramatically mental health care has changed over the last century:

Early 1900s: People with mental illness were considered `lunatics' and sent to asylums.

Early 1930s: The notorious lobotomy was introduced, and electro-convulsive shock treatment continued as a dominant practice.

1950s: Psychotropic medication was introduced. Outpatient clinics began popping up all over the country.

1960s: Deinstitutionalization began. Thousands of the mentally ill were released from state hospitals without adequate planning. Sadly, inadequate facilities and systems for their care were the norm.

1980s: Supported housing facilities began opening, such as ShelterCare's Hawthorn Program in Eugene, that soon became a national model of independent living with supportive services. These programs offered stable, safe, community-based housing where proper medications and skill-building greatly improved independence and daily living for people with a mental illness.

2006: The `recovery model' recognizes that given the proper supports and environment, people can live independently and successfully. This is in contrast to the previously prevailing `chronicity model,' which viewed people with mental illness as unable to make any improvements.

What an enlightened and hopeful time this is for people with mental illness, compared to the grim treatments and failed strategies of the past. The knowledge that the mentally ill can and do recover gives hope not only to them but to their families and friends. This knowledge inspires all of us who care about dignity and the human spirit.

In our community, ShelterCare continually seeks new and better ways to help our residents reach new levels of recovery and independence. Over the past year, we've begun incorporating an exciting new approach called the `engagement model' into all our mental health programs. This model has been highly successful in helping individuals recover because they feel supported, respected and in control.

A majority of mental health clients have been exposed to some form of trauma in their lives. If the power and control lie solely in the hands of the care provider - as has been the case when, for many years, people with mental illness have been seen as dangerous and incapable of making good decisions - then coercion can re-traumatize the individual and impede recovery.

The engagement model focuses on developing an environment where clients are respected as capable, responsible individuals who are full partners in their treatment plans.

Because people behave in response to their environment and live up to others' expectations, clients must feel safe and respected before they can engage therapeutically. And as with any illness, unless a person with mental illness determines his or her own path of recovery and decides to make necessary changes, good health can't be maintained.

At ShelterCare we're learning how to more effectively engage our residents in setting personal goals toward recovery. Residents are encouraged to express their needs, desires and aspirations, and to actively partner with staff to determine the best treatment. Residents are assuming more control over their living environment by helping to establish rules. We've seen our residents become more engaged in their treatment, and some have made amazing strides.

While hard work on the part of our residents is key to their recovery, this alone isn't enough. For recovery to be successful, our entire community must `engage' in the concept of people with mental illness living more independent lives. Too many people still have the old image of a person with a mental illness as someone who needs to be locked up for their own safety and for the good of the community. Today, thankfully, we recognize the obvious fallacy in that thinking.

Imagine if everywhere you went you were met with fear and aversion, treated differently than how you saw everyone else treated. Eventually, you'd start to view yourself as someone who was odd or offensive, someone who didn't deserve to be with others, someone who could never be `normal.' How long could you or I stand up to that kind of daily social pressure?

The remedy for reducing the stigma of mental illness is simple. We must all learn to accept and appreciate individuals in our community who are working to overcome their mental illness. Our `engagement' is required in the smallest and simplest ways, such as treating meaningless social differences as common or inconsequential. Or taking a moment to say a kind word and initiate social conversation we might have with any stranger we encounter in a community setting.

The road to greater community acceptance of people with mental illness will be long and will take years to travel, but if you're willing to help us on this journey, we can ultimately bring about this needed change.

Susan Ban is the executive director of ShelterCare, which offers a variety of programs, including services for adults who have a mental illness or brain injury.