We are at several turning points in behavioral health concerning the role of medication. In the treatment of substance use disorders, we are witnessing development of new and highly effective medications, yet still working hard to overcome a historical reluctance to use medication to assist people in their recovery. At the same time, the last decade has seen an unprecedented re-examination of medications' role in the treatment of mental illness-not only because of the previously unrecognized deleterious side effects of the newer generation of medications, but also because of exposés of the pharmaceutical industry and studies questioning the effectiveness of what we previously assumed were highly effective medications. Despite the fact that these two fields may be coming from opposite ends of the spectrum, they appear to be converging on a set of common and extremely important questions.
The questions suggest that the prescription and use of medications in behavioral health is far from a simple or straightforward issue. Rather, it represents a complex, dynamic process that evolves over time in the lives of people with behavioral health conditions. This Webinar will be a first attempt on RTP's part to begin confronting these thorny but important issues.
One principle we consider important to emphasize throughout the presentations is that the issues of choice and self-determination are central to the notion of recovery-both in terms of recovery from substance use disorders and recovery from mental illnesses. We know there are many pathways to recovery, that recovery is a unique journey for every individual and family, and that the person himself or herself must be the primary driver of this process. The days of unquestioning compliance with expert practitioners are over-if, in fact, that was ever the real situation.
In this era of healthcare reform, we can settle for no less than a collaborative process in which people with behavioral health conditions and their families make informed and thoughtful decisions about what is in their own best interests. As behavioral health care becomes integrated with physical health care, we will expect the same standards of informed consent, permission to treat, and shared decision making to be equally robust across that dissolving boundary.
Ron Diamond, M.D., has been involved in community-based treatment for people with severe and persistent mental illness for more than 35 years. He has taught and written about staff training and roles, ethics, decreasing coercion, medication compliance, psychiatric administration, and systems design.
Walter Ginter, CMA, is the Project Director of the Medication Assisted Recovery Support (MARS) Project, which is funded by SAMHSA’s Center for Substance Abuse Treatment and designed to provide peer recovery support to people in medication-assisted recovery from opiate addiction. The MARS Project is a collaboration between the Division of Substance Abuse at Yeshiva University's Albert Einstein College of Medicine, and the grantee, the National Alliance for Medication Assisted Recovery (NAMA Recovery). Mr. Ginter is Director of Training and Certification at NAMA Recovery.
Keris Jän Myrick, MBA, Ph.D.c, is President and CEO of the Project Return Peer Support Network in Los Angeles County. She is President of the National Alliance on Mental Illness National Board of Directors, a mental health advocate, a national trainer in recovery-oriented and peer-provided services, and a person with lived experience of mental health issues.
Larry Davidson, Ph.D., is the DSG Project Director for SAMHSA's Recovery to Practice initiative. A Professor of Psychiatry and Director of the Yale University Program for Recovery and Community Health at the School of Medicine and Institution for Social and Policy Studies, his work has focused on processes of recovery from serious mental illnesses and addictions; evaluation of innovative recovery-oriented practices, including peer-delivered services; and the design and evaluation of policies to promote systems transformation to the provision of recovery-oriented care. In addition to being a recipient of psychiatric care himself, Dr. Davidson has authored more than 200 publications, including the 2009 book, A Practical Guide to Recovery-Oriented Practice: Tools for Transforming Mental Health Care, written with several of his colleagues and published by Oxford University Press, and the more recently published book, The Roots of the Recovery Movement in Psychiatry: Lessons Learned, published by Wiley–Blackwell. His work has been nationally and internationally influential in shaping the recovery agenda and translating its implications for transforming mental health practice.
As with all RTP Webinars, participants are welcome to call in or submit their questions and comments for presenters to address at the end of the session.