Humanizing mental illness. Courtenay Harding, a SAR professor of rehabilitation counseling, a senior director of the Center for Psychiatric Rehabilitation, and director of the Institute for the Study of Human Resilience, works to see and understand the human being behind the mask of mental illness. Her most recent study, funded by Eli Lilly and Company, collected and analyzed the life stories of 884 people living with schizophrenia or schizoaffective disorders, the largest such collection documented to date.

The people Harding interviewed were part of a larger study known as the Schizophrenia Care and Assessment Program (SCAP), which included 2,400 people at six study sites. SCAP collected quantitative information about the patients’ quality of life, level of functioning, symptoms, and utilization and costs of services.

Harding and her colleagues used an interview instrument she developed known as LIFELINE©, which is based on the Life Chart developed by Adolf Meyer, one of the earliest and most influential American psychiatrists. It focuses on ways participants are able or unable to cope with schizophrenia-related symptoms and other problems and identifies external and internal resources that may help or hinder them in the recovery process.

Participants identified seven problems, in decreasing order of importance: symptoms, emotional abuse, physical abuse, substance abuse, medical problems, social isolation, and general stress or anxiety. The most helpful external coping mechanisms included treatment, support of friends and family, hobbies, faith or spiritual practice, work, sports, nature, and having a home. Effective internal coping mechanisms cited were emotional (repeating affirmations of self-worth and other methods of raising self-esteem and self-acceptance), cognitive (meditation, setting goals, scheduling their day), and focusing on the needs of others.

According to Harding, such qualitative research, originally developed by pioneers such as Margaret Mead to study people and cultures of distant lands, helps us look at the individual as a whole, not only in terms of his or her illness. It asks people how they got to where they are today, how they define their problems, what they do to help themselves cope, and what they do to make things worse. Using this type of instrument is in line with a new World Health Organization update of the International Classification of Functioning, a classification based on individual and social factors that can be used to understand and measure health outcomes, which has shifted from an old model of “impairment, disability, and handicap” to one that looks at human functioning as a continuum influenced by both environmental and personal factors.

For more information about Harding and the Institute for the Study of Human Resilience, visit http://www.bu.edu/resilience/.