When Linda Sarage and Jake Powers first approached me about writing a section for the fantastic manual developed by the addictions community — From the Ground Up: How to Build Your own Peer-to-Peer Recovery Center — that would help connect this manual to the mental health community, I envisioned writing a section that would serve as some sort of translation tool that could connect two very different communities toward a common purpose. After reading the manual, however, I quickly remembered how much the mental health community has in common with the substance abuse community and how little “translation” is actually needed.
In thinking a bit more about this topic, I thought I would expand on what I wrote for the manual, and offer a bit of my own experience with bridging these two not-so-different worlds.
Not So Different
To be transparent, I do not have lived experience with addictions, my personal experience comes mostly from the mental health “side.” However, starting in about 2007, I began working quite closely with the addictions community in Greenfield, MA. I was part of a team that helped to build the RECOVER Project (peer-to-peer addictions community) from the ground up.
It wasn’t the best of starts, as those of us from the Recovery Learning Community (peer-to-peer mental health community), being from the same host agency – the Western Massachusetts Training Consortium – as the RECOVER Project, decided to stake out a corner of the RECOVER Project space in Greenfield. The communication wasn’t great, and “sides” definitely started to be created. “I can’t work with those people,” said members of the addictions community. “I can’t work with those people,” said members of the mental health community. Could it be that stereotypes and strong feelings could exist between these two very progressive local communities? Indeed.
Well, I’m happy to say that communication got a lot better. We started to meet together regularly, and hear each other’s stories. We started to discover that we weren’t so different after all. And we discovered that we could work together. In just a few years time we transformed a neighboring space – a withering, dirty, awful space – into a beautiful Recovery Annex where art, yoga, and community could blossom. We literally built this space from the ground up, restoring the floor to an elegant hardwood, replacing and painting the walls in an artistic style, and furnishing the space.
All of this hard work led to the Substance Abuse Mental Health Services Administration (SAMHSA) recognizing this work as a best practice and a model for others throughout the country. So, given this success, how can we promote better bridging between these two communities? One way is to understand how central traumatic experience is in both communities.
Trauma-Informed Communities as a Bridge Between our Communities
A strong uniting factor is that leaders in both the peer-to-peer addictions community and the peer-to-peer mental health world agree that we should embrace a trauma-informed approach. In fact, if you look at studies like the Adverse Childhood Experience (ACE) study, you find that there is not only a striking link between trauma and later mental health and substance use issues, but there is also a link between these adverse childhood experiences and later physical health problems and ultimately, early death. The lesson: trauma is universal and we should assume that everyone we encounter is a trauma survivor. Doing so is a way of using universal precautions and creating a better, safer, world for everyone.
Most of us can probably agree that trauma plays a huge role for both the mental health and substance abuse communities. I believe that substance use and mental health are more connected than we realize. I would like to suggest that both are ways that different people (or sometimes the same person) at different times cope with very difficult life circumstances. When I am faced with extremely stressful and difficult life circumstances, I tend to turn inward and go on very interesting spiritual/mental health journeys. When others are faced with similar circumstances, they might turn to alcohol or other drugs. I see these as just different coping strategies we have developed as humanity has evolved.
What connects us is that we are all human beings who at some point have to go through very difficult, and sometimes, traumatic life events. This is why the lessons that the RECOVER project has learned around being trauma-informed apply to our mental health communities as well. When you make your program or community trauma-informed, you not only make the community better and safer for trauma survivors, you make the community better and safer for everyone.
The Word “Peer”
Both addictions and mental health communities are using the word “peer” now. In fact, I believe this is a word that we in the mental health community adopted from the addictions community, as peer support has been recognized and valued in the addictions community for a long time, especially after Alcoholics Anonymous was founded. I think we need to remind ourselves in the mental health community that the word “peer” can never be used to describe an individual. It is not just a replacement word for “client,” “consumer,” etc. It is impossible to be a peer in isolation, you have to be a peer in relationship to others in your community that share similar life experiences. In fact, this is where there is potential power in using this term as well, as mental health recovery rarely happens in isolation and peer support has played such a valuable role for so many of us.
When the addictions community talks about creating recovery-informed communities, they are referring to communities that recognize the prevalence and impact that addictions and substance use has on the community.
I think this can be a powerful concept for the mental health community as well although the meaning may be slightly different. Being recovery-informed in our community may mean realizing that the prevalence of people who experience mental health issues, trauma, and/or extreme states is very high. And if we haven’t gone through these experiences ourselves, we most likely have a family member, friend, and/or neighbor who have. In fact, I believe that ultimately being recovery-informed is realizing that these mental health experiences such as despair, anxiety, mania, hearing voices, etc. are human experiences that we all experience to a varying degree.
No Wrong Door for Peer-to-Peer Mental Health Recovery
Just as there is no wrong door to enter the world of peer-to-peer supports in the addictions community, there should be no wrong door to enter your peer-to-peer mental health organization/community. We really need to do away with the “silo” mentality that says these particular people belong over here and these other people belong over there. It shouldn’t matter whether someone is introduced to your organization because they just got out of a hospital, heard about your program through their 12-step support group, or just thought the community work you were doing sounded great and wanted to get some personal growth out of it. Everybody should be welcome and this is why even having a referral process is not a good idea. People should be able to strip their labels and come as they are, and should be welcomed through whatever door they come through.