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Madness in the mountains: lessons of mental health and resilience in exploring everyday life for people in recovery with 'psychosis'

Kristjana Kristiansen , Norwegian University of Science and Technology


This presentation presents emergent findings from an ongoing two-part study exploring the everyday life of people with long-term mental health problems living in isolated mountain and rural communities in North America and Norway. Participating informants were involved in the study design throughout the research process, and continue to be so. All have diagnoses within the broad category known as 'psychosis', primarily 'schizophrenia'. All informants have long-term histories of serious mental distress, including incarceration in psychiatric hospitals, treatment with psycho-tropic medication, and often including periods of involuntary commitment (known in the UK as 'sectioning'). At the time of involvement in this study, all informants had been out of hospital for at least two years and consider themselves to be in recovery, defined here as 'getting on with their lives', typically without help from paid, formalised services.

This presentation will include a brief summary and critical gaze at what is called 'recovery research'. Much recent research literature describes recovery as a social process, involving social 'others' at family/local community and societal levels. The focus of this study explored the lives of people who are living far away from formalised services, and also often far away from most other people. In places such as rural United States experiencing serious economic decline, it is especially interesting and important to explore and understand how people with serious and often enduring mental health problems can manage their own daily lives, since many are without family or close friends, have no full-time employment, and have few (if any) social and health benefits.

The methodological approach for this study is ethnographic in nature, with myself as primary researcher sharing everyday life-settings with participating informants and using an informal conversation style of interview. Seventeen participants from North America were involved during 2006 and 2007, followed up thus far by six individuals in Norway in 2007 and 2008. Settings to meet were decided by participating informants, and mostly included visits in their own homes, work places, leisure-time activities, and being together at local community events and places. Each participant was met at least twice, and my 'interview'/ observation/ participation notes were reviewed by informants to be approved, altered or augmented.

Emergent findings thus far reveal that personal resilience and creativity are important, as well as often having close contact and social roles connected to nature and seasonal routines. Control over one's own life appears to be key, including where and when to have contact with others, thus linking the social dimension of 'recovery' with the important aspect of augmented autonomy. There are also many moments where society plays a critical role, based on the premises of the individual yet still in mutual interaction with others.

Possible implications for service provision and community involvement roles will also be discussed.

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