Culture and Recovery: The Importance of Local Context

Cynthia S. Robins, Ph.D.Westat

Rockville, Maryland

Supported by the Center for the Study of Issues in Public Mental Health NIMH Grant# 2P50MH51359

What cultural features of a locality merit assessment?

• Infrastructure: services and supports

• Attitudes: awareness and acceptance of

mental health disorders

• “Community”: connected-ness

Infrastructure

• Reliable, affordable public transportation?

• Adequate supply of affordable housing?

• Mental health services?

• Psychiatry, counseling, case management

• Crisis services

Attitudes

• What are the predominant views about mental

illness?

• About people living with a serious mental illness?

– Family

– “Characters”

– Outsiders

Community• Does a “community” exist into which

consumers can be integrated?

• Locality versus cultural value

– Connection among members

– Integrity of the social group

– Mutual responsibility

Concept of the “Individual”

“...The independent, autonomous and thus

(essentially) non-social moral being, as

found primarily in our modern (common-

sense) ideology of man and society.”

Louis Dumont

“On the Modern Concept of the Individual”

What does “individualism” look like?

• Cortez, CO– Public park– Closed houses– Dinner seating– Self-service grocery– Lunch cars

• Most of the Eastern Seaboard...

Integration into ...?

• Cortez Kiva Empowerment Center

– Dedicated consumer space

– Mutual support

– Networks

– Connected-ness

“Ghetto” or “Community”?

• Policies of Assertive Community Treatment– Consumer “gathering” as negative– Scattered housing– Serve at home, not at office

• Independence or Isolation?