Addressing Stigma Among Peer Specialists in the Workplace: A Personal Perspective
A counselor and specialist in co-occurring disorders reflects on work, a life in recovery, and what it means to embrace the recovery philosophy.
By Melinda Fox Smith
In the addictions field, clients often find a counselor in recovery who at times shares their experience, strength, and hope with them. But in the field of mental health, practitioners with mental illness often hide their disorder from their clients and co-workers because they fear they might be viewed as incapable of doing their job. The stigma of mental illness is alive today! Most people with a co-occurring disorder would prefer to identify with the substance use side of their disorder rather than the mental health piece.
As a person in recovery with a co-occurring disorder, I understand this phenomenon very well! As a professional working in the field of mental health, I like to think that I have confronted and overcome some of these barriers. As well as the lived experience of having bipolar disorder and being a recovering alcoholic, I am a licensed alcohol and drug counselor and have a master's degree in counseling psychology. I have worked at the Dartmouth Psychiatric Research Center for the past 23 years and have helped design and implement group treatment models for people with co-occurring disorders (COD) and have recently published a relapse-prevention group manual. I provide COD consultation and training around the country, and with another colleague, I have also developed a COD family-treatment model.
Recently I had the opportunity to speak with a group of people in recovery who were thinking about working as peer specialists in the mental health field. The opportunity caused me to reflect on what had helped me maintain my job over the years. During my employment, there certainly have been times when I suffered from severe depression, but my job was never in jeopardy because of my illness.
So what could I share about my work experience that might help people in recovery who are interested in becoming employed in the field? First, for me, was the issue of disclosure. I have always been able—and empowered—to talk about my illness. I have spoken with so many people who have been unable to disclose about their illnesses in mental health settings for fear their jobs would be in jeopardy. My boss, Dr. Robert Drake, knew from the very beginning that I was a person in recovery with a co-occurring disorder. In fact, he always viewed this as a strength of mine! My lived experience gave me insight and knowledge that not everyone had. I understood what it felt like to relapse over and over again because of an inadequate, parallel system of care. I had experienced the pain and despair of addiction and the joy of recovery. These were experiences that shaped who I was as a person and as a practitioner, and they gave me a perspective that the average person did not have.
Through my years with the organization, Dr. Drake has provided me with close supervision, and he has chosen colleagues to provide me with mentoring relationships. He saw very early on that setting boundaries around my workload was not one of my better skills! He would often help me manage my schedule when things became overwhelming. He always had an open door for me and listened and gave me feedback and ideas about next steps. When I needed to take time off to stabilize my mood, I could do that. My mental illness was treated like another co-worker's chronic physical illness. I was never treated like someone who was less than (less capable, less valuable, less respected) others!
I also have a close co-worker, Joan, a great friend and colleague. She is someone who respected me as a knowledgeable clinician but also valued me as a friend. I always knew that if I was having a bad day I could go and sit in Joan's office and talk about it with her and be supported. And the great thing about it was that when Joan was having a not-so-great day, she would share that with me. This made our relationship very equal. She is someone who doesn't just see my illness and recovery but who also helps remind me of what she calls my "fierce discipline and work ethic."
Another part of the equation was a support system at home. I have always been fortunate to have a loving and supportive family. When I began my work at Dartmouth, my husband, Tom, was a psychiatrist who also worked with Dartmouth. He was very proud of my work and my recovery, and he was truly my sounding board at the end of every workday. When Tom died in 2002, I went through a tough time, but Dartmouth colleagues supported me and helped me get through the grieving process. In 2008, I met and married a wonderful guy named Paul who now continues to support me in my work.
When I am working as a clinician providing treatment in a co-occurring group or to a family where a member has a co-occurring disorder, I often share a part of my own story. My bipolar recovery is as much a part of my story as my alcohol recovery. I might share a coping strategy I use or a situation I've had that is similar to one they're experiencing. I do this only when it seems like it would enhance the person's knowledge and also to let the person know he or she is not alone in this experience.
I know I have been fortunate that I have not experienced the stigma that others with co-occurring disorders often face in the workplace. I know, too, that people in recovery bring a valuable perspective and understanding to clinical work. My hope is that as mental health practitioners and clinic leaders embrace a recovery philosophy, they will also embrace employing people in recovery as workers in the field.
Melinda Fox Smith is a consultant, trainer, and supervisor with the Dartmouth Psychiatric Research Center. She specializes in integrated treatment of substance abuse and mental illness. She is the author of the IDDT Recovery Life Skills Program, published by Hazelden, 2011.
For related articles by Melinda Fox Smith, see "Second Chance at Motherhood." (2009). Psychiatric Rehabilitation Journal, 33.2,150-152.