From the Spring/Summer 1994 issue of the

Health care reform has only just begun. How it will affect individual Americans is still uncertain. There will always be a need for hospital beds, psychiatrists and high tech medical equipment. But, there is also a growing need for more cost effective community based health care.

Self-help groups are one example of this kind of care: good care that has the potential to save consumers big bucks. Enthusiasts of self-help groups believe that the help given them is relevant, immediately available, caring and personal.

For the estimated 7 million to 15 million participants, the mutual aid and support - provided by members - feel like it saved their lives. And they often do, for those stigmatized and isolated by their problems of abuse, victimization or mental illness.

The oldest and probably best known self-help group for former patients and other persons with mental problems is Recovery, Inc. Founded in 1937 by Chicago psychiatrist Dr. Abraham Low. Recovery has over 800 groups in the United States, Canada and other countries. It maintains a national headquarters in Chicago and is increasingly recognized and used by many mental health professionals.

The organization has a well developed program of leadership training and supervision for members. Weekly meetings are held in public buildings available to all. Patients may be referred by professionals or self referred; and meetings are open for observation by anyone interested.

Recovery meetings follow a structured format aimed at providing a comfortable framework for learning and discussion. Members introduce themselves by first names; listen to a tape of one of Low's lectures; present examples of troublesome everyday incidents followed by "spotting" on the examples. The major portion of the two-hour meeting centers on Low's message and a discussion of incidents that show how participants are learning to use Recovery's selfhelp method. After a question period for newcomers and observers, the meeting adjourns to informal discussion and mutual aid over coffee.

Group leader Mary Jane Spudeas says it takes about six months for an individual to become familiar with the program. "Recovery is a philosophy, a way of living daily life and dealing with everyday situations. It also has its own language; words that have specific meaning for therapy." During the meetings, participants are taught a number of Recovery concepts that they must "spot" or learn to recognize or detect in themselves either as thoughts or behavior."

Recovery provides a lot of support at a very concrete level. The meetings emphasize that what patients' experience are symptoms of their illnesses: restlessness, tenseness, preoccupation, obsessing thoughts or depressing feelings. Participants learn that the symptoms cannot hurt them; that they must not let the symptoms control their lives.

As one group member, Alan, emphasized, "A lot of groups tell you what's wrong but they don't tell you how to deal with it. Recovery gives you a lot of skills and a lot of ways to cope that you can apply every single day." These practical coping skills tend to modify behavior, thereby reducing or preventing relapses and re-hospitalizations .

Recovery group participants all agreed that after attending even one of the meetings they came away with new options, new perspectives and the right to hope. They also found new meaning and a sense of control in their lives. Elmer, one of the newest to join the group, underlines as he reads Mental Health Through Will Training, a book written by Low and required reading for members. "A blue underline means calming thoughts; a yellow line means good advice," he said. So committed to the method is he now, that he will pick up the book in the middle of an uninteresting TV program and find it completely absorbs him.

Many health care policy makers believe that self-help groups should be available to all people in crisis or at risk. Self-help groups stand by as a complement to the professional health care patients receive. The social support is also good medicine and, when given by peers, is a unique form of help. Research statistics show that participants of self-help groups have reduced hospitalizations and symptoms and increased compliance with medical treatment.

Whatever the outcome of health care reform, it will most probably include some form of managed care. Self-help groups could offer reformers another option in crafting treatment plans for U.S. citizens.