The History of Recovery in Tennessee

The foundation of the recovery movement in Tennessee began with the development of the family and consumer self-help movement. In 1983, the then-named Tennessee Department of Mental Health and Mental Retardation received three federal grants that provided financial assistance for the development of family and consumer self-help groups: namely, the Tennessee Alliance for the Mentally Ill (TAMI) in 1985 and the Tennessee Mental Health Consumers’ Organization (TMHCA) in 1987. TMHCA began largely through the efforts of Dennis Wenner, then Director of Adult Services for the Department of Mental Health and Mental Retardation, and Bob Long, consumer advocate. TMHCA soon began sponsoring a statewide conference specifically for mental health consumers, which has become an annual tradition that continues today.

The impetus for the Tennessee Alliance for the Mentally Ill began in 1984, when the Tennessee Mental Health Association proposed forming and overseeing a statewide support organization for the families of people with mental illness. But some family members, including Joyce V. Judge of Knoxville, had another idea: that family members should form and oversee their own statewide support organization. A model for such an organization already existed. Called AMI (Alliance for the Mentally Ill), it had been founded by two women from Wisconsin (mothers of consumers) who initiated the national organization in 1979. By 1984, AMI was organizing in states nationwide—and becoming NAMI in the process. In 1985, Judge returned from the NAMI convention in New Orleans determined to bring the zeal and urgency she saw there to Tennessee. In order to form a state-wide NAMI, four family support groups came together in 1986 at Fall Creek Falls State Park. They elected officers and adopted by-laws, and they called their organization TAMI, which later became NAMI Tennessee.

While NAMI Tennessee was forming, Tipper Gore founded Tennessee Voices for Children in 1986, a time when more mental health services were needed in Tennessee for children and youth. Focusing on improving the coordination and delivery of children’s mental health services, this statewide coalition grew into an influential statewide non-profit organization with offices in each region of Tennessee. 

The family and consumer self-help movement changed how mental health services were delivered as families and consumers became an integral part of Tennessee’s mental health system. In the late 1980s, Tennessee’s mental health system was undergoing a period of significant change and transition. Community services that were once focused exclusively on treatment were now including case management, employment, supported housing, psychosocial rehabilitation, social support services, family education and support, and peer support services. More importantly, both the mental health system and consumers were realizing that recovery from mental illness was possible and that mental health consumers could direct their own recovery.

The recovery movement in Tennessee gained momentum in 1989, when plans for Tennessee’s first drop-in center, Friends Helping Friends in Nashville, began with the help of another federal grant. The development of the center evolved naturally out of the consumer self-help movement. Its creation was a partnership between the local consumer self-help group, Park Center, and the Department of Mental Health and Mental Retardation. The drop-in center had four goals: 1) To empower consumers by helping them to gain control over their lives and the services they receive; 2) To provide emotional support to consumers; 3) To combat the stigma of mental illness; 4) To promote independence through consumer-operated services. An evaluation conducted at the end of the three-year federal grant found that the drop-in center was successful in accomplishing these goals. As a result, the Department of Mental Health and Mental Retardation set aside money for additional drop-in centers throughout the state.

By 2005, important changes were taking place both within the consumer movement and the mental health system of Tennessee. The continued growth of the consumer movement in Tennessee has increasingly raised the awareness on the part of mental health consumers of the possibility of recovery. As the recovery movement grew, drop-in centers changed their name and their focus to become Peer Support Centers. The name “drop-in center” no longer reflected what was occurring at the drop-in center nor was the name in keeping with the recovery vision. The Peer Support Centers also shifted to a more recovery focus with an emphasis upon Peer Support Centers becoming places where consumers can obtain the needed education and information they need to manage their own recovery process.

Peer Support Centers in Tennessee have evolved into places where consumers direct their own recovery process and acquire the needed skills for the utilization of resources within the community. Consumers can become educated about their mental illness and its treatment and can learn about the resources they need to achieve their own individualized recovery goal plan. The centers offer a range of skill-building and recovery activities developed and led by consumers. The consumer staff is well trained in the recovery process and how to engage other consumers in their own recovery process. The attitude and approach of the staff and the activities of the center promote the involvement of mental health consumers in their own treatment and recovery from mental illness. The consumers who attend the center also have an opportunity to develop peer leadership skills that enable them to participate in various roles within the center. The centers have become a resource for consumers for integration into the community rather than the only source for emotional and spiritual sustenance.

Tennessee’s first Symposium on Recovery and Resiliency was held on November 3, 2006. The symposium was jointly sponsored by the Department of Mental Health and Developmental Disabilities and Magellan Health Services, the Behavioral Health Organization (BHO) for TennCare at that time. The symposium also included as planning partners representatives from NAMI Tennessee; Tennessee Mental Health Consumers’ Association; Tennessee Association of Mental Health Organizations (the trade association for the mental health providers); and Tennessee Voices for Children. With more than 300 consumers, family members, and providers in attendance, the symposium succeeded in its goal to develop a common understanding that recovery and resiliency are real, possible, and achievable. Additional Recovery and Resiliency symposia sponsored by the state’s managed care organizations have continued each year.

In 2007, Tennessee received a Real Choice Systems Change Person-centered Planning grant from CMS. This three-year grant has enabled Tennessee not only to develop the Recovery within Reach website but also to offer free trainings throughout the state to train teachers of the Wellness Recovery Action Plan (WRAP) and the SAMHSA evidence-based practice of Illness Management and Recovery (IMR). Since the grant began, 340 people have become WRAP facilitators across the state; those WRAP facilitators have in turn taught WRAP to 3,542 consumers. Likewise, since the grant began, 208 people have become IMR facilitators across the state; those IMR facilitators have in turn taught IMR to 288 consumers.

In 2008, Tennessee launched a certification program for consumers to work as Peer Specialists in community mental health agencies. Peer Support is a best-practice model for supporting people with mental health disorders. This model relies on individuals who live with mental health disorders to provide peer-to-peer support to others, while drawing on their own experiences to promote wellness and recovery. This model is fostered in Tennessee through the Peer Support Specialist Certification Program administered by the Department of Mental Health. Peer Certification expands professional employment opportunities for consumers.

A Certified Peer Support Specialist has self-identified as a person with a mental illness or co-occurring disorder and has successfully navigated the service system to access treatment and resources necessary to build personal recovery and success with his or her life goals. This individual undergoes training on how to assist other persons with mental health disorders in fostering their own wellness, based on the principles of self-directed recovery. Certified Peer Specialists deliver unique services in the mental health system, provide Medicaid-billable services through provider agencies, assist service recipients by promoting self-directed recovery goals, and function as life coaches, advocates, teachers and group facilitators. Certified Peer Specialists uphold the principles of peer support, including personal responsibility, identification and empathy, modeling recovery and resiliency, and instilling hope. Certified Peer Specialists have helped to take Tennessee to a whole new level of recovery and will undoubtedly lead the way for Tennessee’s future.