To the Editor: Davidson and colleagues (1), in an article in the May issue, "The Top Ten Concerns About Recovery Encountered in Mental Health System Transformation," make the following comment: "If mental illness is an illness like any other, it should be treated as such."
Mental illness is not like other illnesses. For example, liver disease, kidney disease, and neuromuscular disease do not affect a person's ability to interact with others, to form relationships, and to understand discussions. By the nature of mental illness, these various functions are impaired. I would consider this a fatal flaw in Davidson and colleagues' argument.
My experience with individuals who have severe neuropsychiatric damage is that much of what is described in the article as recovery-oriented care is simply not possible. In an accompanying commentary on the article, Dickerson (2) highlighted the situation: "Or will the recovery mantra come to represent another cycle of reform … that seems to offer the solution but is later evaluated to have been naïve and unscientific?"
To fail to take into account the cognitive and emotional effects of the disease under treatment is to avoid the issue of the inability to interact as a caregiver with a care receiver.
Dr. Masland is in private practice in Yuma, Arizona.
Davidson L, O'Connell M, Tondora J, et al: The top ten concerns about recovery encountered in mental health system transformation. Psychiatric Services 57:640-645, 2006
Dickerson F: Disquieting aspects of the recovery paradigm. Psychiatric Services 57:647, 2006