For psychologist Arthur C. Evans Jr., PhD, the word “maintenance” exemplifies everything that’s wrong with many programs for people with serious mental illness:
People who would once have been institutionalized in state
hospitals now spend their lives being “maintained” in day
programs instead. “We can do better,” says Evans, commissioner
of Philadelphia’s Department of Behavioral Health and
Intellectual disAbility Services.
What’s needed instead, he says, is a recovery orientation —
an approach that tries to help every person with a mental health
or substance use condition achieve his or her highest level of
functioning and integration into the community.
That has been one of Evans’s top priorities since he became
commissioner in 2004. And he isn’t limiting his efforts to
Philadelphia’s $1 billion public sector behavioral health system
and the 120,000 city residents it serves each year. By working
with APA’s Recovery to Practice initiative and speaking around
the country, he is also helping to ensure that other behavioral
health systems and the next generation of psychologists
embrace the recovery orientation.
Transforming city services …
Recovery isn’t a new idea, of course. The 2003 report of
President George W. Bush’s New Freedom Commission on
Mental Health, for example, recommended strategies for
moving the nation’s mental health system toward a recovery
orientation. What is unusual about Philadelphia, says Evans, is
the community’s embrace of a wide range of strategies designed
to promote recovery.
Evans first began putting his ideas about recovery into practice
as deputy commissioner of Connecticut’s Department of Mental
Health and Addiction Services, when Commissioner Thomas
Kirk, PhD — also a psychologist — signed the nation’s first policy
directing a state service system to adopt a recovery framework.
In Connecticut, Evans and his colleagues initiated the
transformation of the state’s behavioral health system by
developing core values and principles based on input from
people in recovery. With that feedback they retrained the
state’s behavioral health workforce and revamped programs
and policies. The state defined recovery as the “process of
restoring a meaningful sense of belonging to one’s community
and positive sense of identity apart from one’s condition while
Arthur C. Evans Jr. is using a recovery orientation to
transform the city’s behavioral health system.
BY REBECCA A. CLAY