if a person has lost touch w/reality due to their mental illness -- someone should be able to step in (family, friend, etc.) and make decisions for them - even if it is against their will. A trained medical professional should be able to make this determination based on the patient's history and the any relevent history given to them by the persons family, or someone that knows them well, or lives with them. Concerned family members should not have to go to court to get a person medical treatment. This is the way we treat alzeheimer's patients--people suffering from serious mental illness should be given the same treatment. I speak from painful experience. My family worked to force our family member into treatment and today that person is living an almost normal life (a sharp contrast to living on the street in a psychotic state).

in order to "update" these guiding principles, we must touch on three hallmarks of individual/family dynamics: behaviour, planning, and speech. there has been much stressed about proper behavior as that's the basis for committments. disorganized speech can also indicate poor mental health. but, little recognition is given to individual planning. it can be key for successful navigation through the various systems we encounter. yet, everyone is talking around the issues with emphasis on community involvement, acceptance and person centered. these are important principles, although they hardly touch on the realities of dealing witht the "system". as noted, if we have either poor behavior, planning or speech, we're in extremely hot water. why jump off center? we need put the emphasis right back where it is. these three hallmarks are the elephant in the room. so, with the these let's include respect to counter the vice of violence towards others, trust to counter slander and a sense creativity to counter apathy. most important, we need mentors to guide us. i have spun my wheels for nearly forty years by listening to quick fixes from psychiatrists.

Recovery is undeniably important. But in all the words we are sharing about Recovery, we shouldn't forget that 30-50% of individuals with psychotic illnesses (ie schizophrenia or bipolar) cannot "recover" because they cannot first accept that they have anything to recover from. This is the problem called anosognosia - a common symptom of these psychotic diseases - and perhaps the most difficult symptom because it prevents people from accepting treatment and recovery. After all, why would anyone want to be treated for or recover from a disease they don't believe they have. I am concerned that the emphasis on "recovery" and personal responsibility for that recovery, is going to push folks with anosognosia into the category of "folks who WON'T help themselves" rather than "folks whose disease keeps them from helping themselves" I am afraid research into this very troubling symptom will be shortchanged or put on the back burner by people who don't believe it is "real" - And I see this symptom every day. I realize that many of the folks who worked on these principles are consumers - but they are consumers who recognize their problem and are able to speak for themselves. Please work more with families whose loved ones neither recognize their illness nor are able to speak about it "because it isn''t there!!!!" in their reality.

SAMHSA’s definition includes many key elements of Recovery, but does not give emphasis to a foundational component that SAMHSA has stated is at the heart of a Recovery Oriented System of Care (ROSC) -- family. OASAS believes this is a critically important component. Family plays a crucial role in the recovery of an individual. In addition, it is important to acknowledge that the family actually needs to have its own recovery process and access to specialized recovery support services.

The SAMHSA Guiding Principles might also more fully address other major components of recovery, including:

• The role of faith and spirituality;
• The need to include prevention and intervention services, especially for children of recovering persons; and
• The need for ongoing recovery support as part of a chronic care approach.