By William Brand
Tri-Valley Herald (Oakland) STAFF WRITER February 22, 2004

Despite the stigma and public neglect, a diagnosis of mental illness is not a life sentence of doom and decay, a prominent mental health researcher said Saturday.

The facts are that a large percentage of people with mental illness can recover, ignore the unjust, prejudiced stigma of mental illness and lead normal lives, said Dr. Courtenay Harding, a psychiatrist who is director of the Institute for the Study of Resilience at Boston University.

Harding is a pioneer in what is becoming known as the "recovery movement," which creates support groups for the mentally ill and works on building self-esteem among former mental patients.

The method has been employed with great success, Harding said.

She delivered the keynote address at a daylong conference on mental health and mental illness at California State University, Hayward. The conference drew several hundred mental health professionals from around the Bay Area.

Harding worked on two 30-year studies of the severely mentally ill, in Vermont and Maine. Researchers traced more than 500 people who had been diagnosed in the 1950s as severely mentally ill.

The follow-up results were startling. They found that 62 percent to 65 percent of the former Vermont patients and 46 percent of the Maine participants had recovered.

Former schizophrenics, once thought to be incurable, had shed their symptoms, many were working and had normal social relations and cared for themselves, she said.

The two groundbreaking studies in the 1980s have been duplicated around the world, Harding said.

"We found (in the Maine and Vermont studies) that some started improving as early as two to five years after diagnosis, some began recovery as late as 40 years," she said.

The lesson is -- never give up on anyone, she said.

The difference between Vermont and Maine was that Vermont had a very comprehensive rehabilitation program that including introducing former patients back into the community. Maine focused on stabilizing mental patients with medications, she said.

But even there nearly half recovered.

Dire predictions about the future of mental patients leaves out an important point -- the ability of humans to overcome terrible situations and bounce back, she said.

It's time for change, Harding said. America has a serious problem with the mentally ill, she said. "There are 5.5 million Americans who are disabled because of mental illness."

That includes one-third of all the homeless, who are seriously mentally ill. Another 25 percent of that 5.5 million are hospitalized and more than 600,000 are in jail or in prison, Harding said.

Of those not on the streets or in jails or hospitals, only 10 to 20 percent are employed, 60 percent live at home and almost all of them are still on SSI disability support, she said.

Add to that a climate of cutting medical care and costs to save money. That's hardly a model for success, Harding said.

Assumptions about mental illness, many commonly held by doctors and psychologists treating mentally ill patients don't help, she said.

For example:

People with serious mental illness never get well and typically don't respond to treatment. They must remain on medications for the rest of their lives.

The mentally ill can't work or compete in the regular world. The best course is to forget about rehabilitation and put them on Social Security disability, or SSI.

And, of course, families are the cause of mental illness.

Add to that, the destructive forces of the prejudice and stigma of being mentally ill, poverty, lack of health care coverage, cost containment policies by health care providers and just plain ignorance, Harding said.

The recovery movement focuses on support among those with mental diagnoses, on building self-esteem and self-determination. It is a philosophy that is slowly spreading in the United States. Schools of social work and psychiatry now teach about recovery, she said.

Those diagnosed with a mental disease need first of all, a home, then a job, friends, social justice and acceptance, she said. And never count out human hope and resilience.