Dr. Abraham Rudnick, Psychiatrist and Physician Leader of RMHC’s Psychosis Program (affectionately known as “Rami” among colleagues) left Regional Mental Health Care at the end of August for the milder winters of Victoria, BC where he has accepted the position of Medical Director with the Mental Health and Addiction Services of the Vancouver Island Health Authority.
A strong advocate of person-centered approaches in mental health care, Dr. Rudnick has left his mark on staff and patients alike since he started at RMHC in 2004. His particular expertise in psychiatric rehabilitation lies in the recovery perspective for those suffering from serious mental illness.
With a contribution of many faculty from RMHC, he edited a book on recovery titled “Serious Mental Illness, Person-Centered Approaches” published in 2011, helping to place London in the international spot light regarding the recovery orientation.
When asked what exactly the recovery orientation is, Dr. Rudnick is quick to first point out what it is not. “Recovery is not a cure,” he says. “We do not have a cure, yet, for serious mental illness but that is not a reason for despair. There are a lot of important, good things that happen in the lives of people with serious mental illness. What it does mean is that everyone involved; care teams, family members, supports the patient in setting, getting and keeping their life goals.”
“Recovery is an individual journey,” Dr. Rudnick adds. “No one does recovery for a person, but we can facilitate and support by helping them to identify their own goals, understand the realities of those goals, help them work through any risks or challenges involved and then put the right supports and skills training in place so that they not only achieve those goals, but maintain them.”
Often times, with the negative stigma that is associated with mental illness, there come along many barriers to the recovery oriented philosophy which are held by physicians, clinical staff and family members. “People lose hope for those struggling with mental illness. They think there’s not much a person can achieve in their life, other than possibly less symptoms.” Dr. Rudnick stresses however that both research and experience have shown otherwise. “People with serious mental illness can achieve normalized lives often, and if not fully normal for some of them, at least partially normal lives based on their own wishes.”
“There’s been progress, but there is still a lot of ground to cover,” says Dr. Rudnick of how the recovery philosophy is beginning to take hold at RMHC. “It’s an attitude. Skills and knowledge will follow, but first and foremost the recovery oriented philosophy is a mind-set.” He believes that role modeling, through leadership, from physicians, from clinicians and even from mental health consumers and their families is the key to transformation. “That will make the difference.”
He adds that the recovery perspective means reminding people that all service planning by administrators, policy makers and health care providers should be done with, rather than for or about, people with mental illness. He quotes a phrase he read years ago which he believes rings true to this very day in mental health care: ‘Nothing about us, without us’, is a phrase many patients, staff and colleagues will long remember Dr. Rudnick for. “Once professionals adopt the attitude of person-centered care and the ‘Nothing about us, without us’ mind-set, they find it doesn’t only have benefits for professional life and the patients we serve, it has important benefits for one’s own personal life as well.”
His parting message for the staff and patients at RMHC: “There is no consensus on what is normal, so it is best to aim at what wellness means for each person. The art and challenge becomes to understand what is that person hoping for, and if sometimes that’s not possible at that particular time, there is always a way to find out what would be at least a second best for them. There’s always hope…and hope is very individualized.”