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?