The Four Walls: Mark Ragins

Here’s another great blog from one of my favourite psychiatrists, Mark Ragins of The Village fame. I first posted this article that Mark wrote on Recovery Stories back in October 2013.  Mark wrote the original article in 1998. [NB. I have broken up some of the original paragraphs to make it easier to read online.]

‘In 1989, the California State Legislature authorized the funding for three model mental health programs, including the Village Integrated Service Agency in Long Beach, in part to answer the question, “Does anything work?”

We created a radical departure from traditional mental health services basing our entire system on psychosocial rehabilitation principles, quality of life outcomes and community integration. Arguably, we have created the most comprehensive, integrated and effective recovery based mental health program anywhere.

In recent years, encouraged by our success, both our attention and the legislature’s have turned to the further question of “How can our whole system be more like the Village?” Undoubtedly, there are numerous serious beaurocratic, funding, and system design issues relevant to that question, but I would like to focus on the personal issues staff must face.

I believe that basing mental health services on recovery is the paradigm shift that can finally make the dream of deinstitutionalization a reality.

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Mark Ragins: Village Recovery Writings

Recovery-based psychiatrist Mark Ragins has an extraordinary collection of personal writing known as the Village Recovery Writings. Dr Mark worked for 27 years as the Medical Director at the MHALA Village in Long Beach, California, an award-winning model of recovery-based mental health care.

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‘Dr Mark and The Village’ by Mark Ragins

I was going through some of my old blog posts and came across a 2014 post from one of my favourite people in the mental health field, award-winning psychiatrist Mark Ragins. I thought it was time to post it again. First a few words from Mark about himself which I consider particularly pertinent:

‘I am a recovery-based psychiatrist.  After 27 years working as the Medical Director at the MHALA Village in Long Beach, California, an award-winning model of recovery based mental health care, I moved on in 2017 to be the only psychiatrist at CSU Long Beach providing innovative psychiatric services for the students there.  I also continue to work as an independent trainer, consultant, speaker, writer, and transformation leader in the Mental Health Recovery Movement. I believe that:

> My work should be person-centered, working to help people grow and develop into the person they are meant to be, not just to treat mental illnesses or conditions.

> My relationship with the people I work with should be collaborative and client-driven working on your goals, rather than pressuring for compliance with my treatment.

> People recover because of the strengths and resilience that they use and develop, not because I took care of them and fixed what was wrong with them.

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What facilitates recovery from mental health problems?: Scottish Recovery Network

It is important to note the close similarity in the nature of elements that underlie recovery from serious substance use problems and recovery from mental health problems. 

An excellent 2007 paper published by the Scottish Recovery Network by Wendy Brown and Niki Kandirikirira, entitled Recovering Mental Health in Scotland: Report on Narrative Investigation of Mental Health Recovery, provides important insights into the latter. This research involved the recovery narratives of 64 individuals in Scotland who identified themselves as being in recovery or recovered from a long-term mental health problems. Here is what the authors write in the Executive Summary of the Report (NB. That I have broken up one long paragraph for ease of reading online]:

‘Across the stories consistent internal and external elements could be found. For a recovery journey to begin and continue to prosper, narrators accounts of their experiences suggest that six basic internal (individual and self controlled) elements were required (though not necessarily in this order and not necessarily seen in every case):

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Voices of Recovery: Pat Deegan

In my humble opinion, one of the most impressive people and inspirational people in the mental health field is Pat Deegan. I love the above film clip from the Hogg Foundation of Mental Health, On becoming Doctor Deegan, of Pat talking about her experiences when diagnosed with schizophrenia as a teenager, and during her journey to recovery. It is an extraordinary Story.

‘… at the time I was told that I had schizophrenia. I was told that I needed to retire from life. That I needed to avoid stress and I needed simply to take large doses of antipsychotic medications for the rest of my life, and basically retire from living at the ripe old age of 17 years old. For me, that was a prognosis of doom.’

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Voices of Recovery: Pat Deegan

Dr. Patricia E. Deegan is an independent consultant specializing in research and education about mental health recovery and the empowerment of mental health consumers. She is an activist in the disability rights movement and creator of CommonGround, a web-based application that helps consumers prepare for visits with mental health practitioners in order to better advocate for their treatment and recovery. She is an Adjunct Professor at Dartmouth College School of Medicine and Boston University, Sargent College of Health and Rehabilitation Services. Hogg Foundation for Mental Health. 1 May 2015. [5’27”]

What Does the Recovery Model Look Like Today: Mark Ragins

Dr. Mark Ragins, a leading figure in mental health recovery, emphasises three key features of recovery-based care: 1. Is the service person-centered rather than illness-centered? 2. Recovery programmes move from being professional driven to being client-driven. 3. Is the programme really strengths-based rather than deficits-based? NAMILosAngeles. 9 April 2021. [4’32]