Radical Recovery

From Moral Treatment to Radical Recovery

As the IOL approached its bicentennial during the period of the COVID-19 pandemic, there was a desire to engage broadly with internal and external partners to co-write the next chapter in the organization’s history. As part of Hartford Healthcare, the organization sought to prioritize access, affordability, equity, and excellence as part of its strategic direction. Yet, also recognized that more robust engagement would help translate the principles of Moral Treatment into the 21^st century. The IOL was once a beacon for other organizations, providing thought leadership and guidance on how to center the dignity of those suffering.

A series of focus groups were held with internal and external stakeholders ranging from staff within the IOL to key areas and departments of Hartford Hospital and Hartford Healthcare. There was also considerable community engagement with social service organizations and partners, and engagement with civic leaders in the city of Hartford.

The engagement process led to several insights into the IOL’s strengths and opportunities for improvement. There was also greater clarity regarding aspirations for the future and potential metrics of success. It was clear from the first phase of engagement that the IOL is the birthplace of modern psychiatry in New England with a longstanding tradition of service, advocacy, and excellence. There was pride in the mission of providing the best and most effective treatments for complex forms of mental illness, education for the mental health workforce of the future, and the dissemination of high-impact research. However, there was also recognition that not all members of our community are able to access the services they need.

Opportunities included expanding the IOL’s model of care beyond a restrictive focus on biomedical interventions towards a more integrative approach that is more holistic while remaining anchored to evidence. There was also a desire to reduce fragmentation, enhance engagement with families, caregivers, and communities, and build a stronger foundation of staff well-being. Above all, we knew we wanted to continue our tradition while being bold and innovative for the future.

The concept of Radical Recovery can mean different things to different people. For us at the IOL, it is a vision that encompasses our past, present, and future.

Radical Recovery is anchored on the principles of integration, liberation, and innovation.

Co-Design: Building the Future of Mental Healthcare Together

We believe the future of mental healthcare must be created in partnership with the people who use our services. Our goal is to empower patients, families, and communities as active partners in recovery.

Key actions include:

• Integrating individuals with lived experience: We are embedding Recovery Support Specialists—individuals with personal experience of mental illness or substance use challenges—into all clinical programs and educational activities. They will help design and deliver curriculum for health professional trainees and participate in their evaluation.
• Participatory policy development: We have successfully implemented a process for public input into our policies, ensuring that the rules and procedures that govern care are designed with patients and staff together.
• Co-developing new treatments: Through the Center for Research on Racial Trauma and Community Healing, we are engaging in participatory research to co-develop new approaches to treatment and support for the communities we serve.

Community: Strengthening Connections for Collective Healing

Healing is a collaborative effort that extends beyond hospital walls. We are dedicated to reducing fragmentation and strengthening our ties with the Hartford community to build a more cohesive and accessible system of care.

Key actions include:

• Through our Family Resource Center, we are building strong community partnerships: We are proactively enhancing collaboration with social service organizations and other health and non-health partners throughout Hartford to better integrate care.
• Creating spaces for healing: We are building spaces on the IOL campus for creative expression, storytelling, and collective healing for our staff, such as our wellness space.

Choice: Upholding Dignity and Fostering Autonomy

Our founding was based on a "law of kindness," and we are recommitting to this principle by actively working to end the normalization of coercive practices in mental healthcare. We aim to honor our legacy by empowering patients and becoming a national exemplar for humanistic and compassionate care.

Key actions include:

• Improving transparency: We are co-developing a publicly reported tool to hold ourselves accountable for advancing rights and dignity.
• Piloting less restrictive models: We are actively piloting, implementing, and evaluating less restrictive models of care within our inpatient settings to ensure patient safety and dignity.
• Enhancing family and caregiver engagement: We are improving our infrastructure for family engagement and will launch a program for family and caregiver Peer Support Specialists, expanding the network of support and choice.
• Integrating technology to support patient autonomy: We are committed to maintaining patient access to their personal devices and integrating technology into treatment plans, empowering them to stay connected and engaged in their care.