Bioethics Blogs

Neely Laurenzo Myers’ Recovery’s Edge: An Ethnography of Mental Health Care and Moral Agency by Ellen Rubinstein

Recovery’s Edge: An Ethnography of Mental Health Care and Moral Agency

by Neely Laurenzo Myers

Vanderbilt University Press, 2015, 192 pages


Neely Myers’s beautifully written ethnography is a detailed look at one organization’s attempt to follow the Bush Administration’s 2004 unfunded mandate to make mental health care services more “recovery-oriented.” Broadly speaking, recovery-oriented care means eschewing the traditional focus on symptom reduction and relapse prevention in favor of finding ways to reintegrate individuals with serious mental illnesses as valuable members of their chosen communities. For recovery advocates, such care requires upsetting the traditional clinician-patient power dynamic by enabling and encouraging patients (now “consumers”) to make their own decisions. For policymakers, it means reducing the cost of caring for chronically ill mental patients by preparing individuals to re-enter the workforce as productive, taxpaying citizens “in recovery.”

Myers explores what recovery-oriented care looks like at Horizons, a rehabilitation organization serving over six thousand “members” (mental health care service users) throughout a large city. Horizons’ new CEO upsets the organization’s status quo by hiring “peers,” individuals with lived experience of mental illness, to spearhead Horizons’ recovery-oriented restructuring. Enter Vera, the feisty and passionate “person in recovery” who is tasked with running Horizons’ first peer-led treatment program, the Peer Empowerment Program (PEP). Vera is a constant, guiding presence throughout Myers’s book, alerting Myers to the daily indignities that members suffer and demonstrating what truly empathetic care looks like. She has a knack for connecting with the most downtrodden, frustrated, angry, and seemingly hopeless individuals who come through PEP’s doors.

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