The psychiatric rehabilitation movement lost its founder this week when Bill Anthony passed away at the age of 77.
Despite his humble, unassuming demeanor, Bill was an essential transformative force in getting the field of psychiatry and the broader mental health system to look beyond people’s diagnoses and what were considered to be inevitably low prognoses and to embrace the principles and practices associated with psychiatric rehabilitation and, ultimately, recovery.
While the ‘mental patients’ of that time were routinely told (and too many still are) that they would never be able to work, get married, own a home or more broadly make good decisions, Bill’s work ensured that ‘patients’ were seen as people who could identify personal goals and acquire the skills and put in place the supports to achieve them.
See an example of one of his seminal writings, ‘Psychiatric Rehabilitation: Key Issues And Future Policy’ at https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.11.3.164 that is chock full of the following modestly stated radical beliefs for the time:
People with or without disabilities generally wish to live, learn, socialize, and work in the real world of the community, not in the artificial world of an institution.
Although some programs may be called "rehabilitation," they may not be psychiatric rehabilitation programs at all. Policymakers need to know what constitutes a psychiatric rehabilitation program and develop quality assurance mechanisms to ensure that programs identified as such accurately reflect the principles of the field.
(Psychiatric rehabilitation) principles include opportunities for client self-determination, equipping clients with skills, modifying the environment, emphasis on the here-and now, and emphasis on clients' strengths. Using these principles as a basis, policymakers could define the principles specific to each type of rehabilitation program and then use those principles to design and monitor the progress of all psychiatric rehabilitation programs. System issues.
One of the most significant policy concerns is that the various system functions (planning, funding, management, program development, human resource development, coordination, evaluation, and advocacy) work in concert to implement a psychiatric rehabilitation initiative.
Because the thrust of the mental health field has long been to treat the impairment, not the consequences of the impairment, psychiatric rehabilitation is not embedded in the traditions and practices of mental health care. Without strong leadership committed to a rehabilitation vision and system functions designed to reinforce this vision, psychiatric rehabilitation will not be made a central part of the system.
Policymakers should ensure that any major system initiative is driven by the clients' goals, not the system's goals. Often clients are not even asked how they would like to see services change. Part of the problem in attaining clients' perspectives is that many people do not believe that persons with psychiatric disabilities have meaningful, realistic goals. Even if system planners recognize the validity of clients' goals, agency and systemwide goals still prevail.
The simple fact is that professional schools of psychology, social work, nursing, psychiatry, occupational therapy, and rehabilitation counseling are not training their students in psychiatric rehabilitation. Effective implementation of psychiatric rehabilitation as part of mental health systems requires that it be taught within professional training programs.
Personnel training and program restructuring must go hand-in-hand. Too often newly trained personnel work in programs that are "rehabilitation" in name only. Psychiatric rehabilitation is not specific to particular settings, however. (Rehab) programs can be found in community residential alternatives, community mental health centers, psychosocial rehabilitation centers, and inpatient settings.
A comprehensive service system of the 1990s must contain a psychiatric rehabilitation service delivery component.
Bill Anthony and the team at the Center for Psychiatric Rehabilitation then spent the next 3 decades helping to inspire people, academics, providers, families and policy makers across the world to believe that recovery is the expectation and rehabilitation offers many a pathway there.
Rest in peace Bill knowing that your legacy is forever.
You can see Bill’s lovely obituary at http://thereadingpost.com/2020/07/16/obituary-william-anthony-77/.
Due to Covid-19, a memorial to celebrate Bill’s life will be held at a later date. In lieu of flowers, we are invited to make online donations in Bill’s name to the National MS Society.
