Here’s a statement that intentionally “turns around” our usual way of evaluating mental health outcomes: If we want a successful mentally ill person, we could create a group home and help the ill person thrive within it. But if we want, simply, a successful person with mental illness who thrives in the same community with everyone else, we should help them find persons and resources in the community that will empower their strengths and also help them persist and persevere in working to minimize the disabilities brought on by their mental illness.
You help them persist and persevere by engaging them in their areas of strength, not in focusing on their deficits and defeats.
This suggests we should use a strengths model, rather than the problem-based or deficit model for providing services to those suffering from mental illness or disorder.
I first heard of the Strengths Model back in 2000, when I was in graduate school studying community mental health from Professor Charles Rapp’s perspective. A recent text co-authored by Charles Rapp and Richard Goscha, The Strengths Model: A Recovery-Oriented Approach to Mental Health Services, Third Edition, 2012 simply reaffirms its importance in my thinking. I learned to focus on an individual’s strengths as building blocks to manage a situation or a life. I believe that people with mental illness would be >much< better served if all of mental health services had a strengths-based foundation rather than the traditional deficit- focused orientation.
“The strengths model posits that all people have goals, talents and confidence.” Furthermore, “All environments contain resources, people and opportunities.” (Link) But with the deficit-mindset, our perceptions of these are limited and modest and full of considerations of barriers and pathology. Strengths pale in comparison to the deficits.
“The strengths model then is about providing a new perception. It allows us to see possibilities rather than problems, options rather than constraints, wellness rather than sickness. And after being seen, achievement can occur.”
It is Rapp and Goscha’s belief that if those involved in mental health services and policy insist on the “muck and mire of deficits” perception, we cannot be of effective help to all of those affected with mental illness.
I learned that the Strengths Theory has nine key propositions. Several of the nine are block-busters that can explode our current ways of thinking about mental illness services.
Here is their first key proposition: The quality of the niches people inhabit determines their achievement, quality of life and success in living.
A niche is defined as the environmental habitat of a person or category of persons. There are two types of niches at the extreme: entrapping and enabling.
Here are four characteristics of entrapping niches (there are others):
- Entrapping niches are highly stigmatized; people caught in them are commonly treated as outcasts.
- People caught in an entrapping niche tend to “turn to their own kind” for association, so that their social world becomes restricted and limited.
- People caught in an entrapping niche are totally defined by their social category. The possibility that they may have aspirations and attributes apart from their category is not ordinarily considered. To outsiders, the person is “just” a bag lady, a junkie, a schizophrenic….and nothing else.
- In the entrapping niche, there are no graduations of reward and status. …… Thus, there are few expectations of personal progress within such niches.
Here are four describing enabling niches:
- People in enabling niches are not stigmatized, not treated as outcasts.
- People in enabling niches will tend to “turn to their own kind” for association, support, and self-validation. But often the niche gives then access to others who bring a different perspective, so that their social world becomes less restricted.
- People in enabling niches are not totally defined by their social category; they are accepted as having valid aspirations and attributes apart from their category.
- In the enabling niche, there are many incentives to set realistic longer term goals for oneself and to work toward such goals.
The strengths model proposes that finding, cobbling together or creating enabling niches should be the major focus of work for mental health services and professionals. The authors continue, “There is good reason to believe that the niches available to people with psychiatric disabilities influence the recovery process and their quality of life.” (pp. 37, The Strengths Model)
I am thunder-struck, when I think of my life and the quality of my life and its influence on my recovery process. A few thoughts:
I have been very fortunate, that the niches in my life have been enabling in my recovery journey with mental illness. I’ll look at a variety of life domains: home or living arrangement, work, education, recreation, and spiritual . Yes, I did a lot of work to gain recovery….but I had a stable set of niches or habitats. Read on:
I lived in a home all the years I have had an illness. And since the very time of diagnosis and onset I had my own family …… a loving supportive husband and 5 year old daughter and I was pregnant with our second child. We still live in our own home, although it is a different house now, for after 30 years our children are grown. They are fine and healthy and love and care for us as do our two grandchildren. Jim and I continue to enjoy a rich relationship with each other and with our family.
I have had rewarding work. I was employed at St Mary’s Hospital Medical Center and at two nursing homes and one small alcohol and drug rehabilitation hospital as a Registered Dietitian (RD). For 15 years I also taught as a clinical instructor and later lecturer in Nutritional Sciences Department at the University of Wisconsin-Madison. After this career within dietetics, I turned to the mental health field.
I had been able to earn an undergraduate education without much trouble. But much later, when I returned for graduate school, I had a relapse and asked for accommodations. My request was met professionally and I was able to complete the work after some delay but with full effort. I am happy to say that I received my Masters Degree in 2003 from Southern New Hampshire University. In 1993 I had begun a 20 year career of volunteer work with NAMI. After 2007, I joined the staff of NAMI Wisconsin as their Coordinator of Family Programs.
All this work was challenging with a mental illness, but I certainly had roles I valued and that other people valued which were separate from the “role” of being a person with a mental illness. AND NOW, recovered and moved by my life experience I write about mental illness issues and affirm the lives of those who live with them. Today, this website is my vocation in more ways than one.
I’ve lived a whole, stimulating and enjoyable life in large part because the places and people – the niches – I lived in and among were consistently empowering. We must strive to have these empowering environments available in reality for all people with mental illnesses!