The goal of recovery has emerged as a core value in the reformation of public and private mental health services in the last twenty years. However, definitions of recovery remain as varied as methods of implementation. Through an ethnographic lens, we examine meanings of recovery in the context of a major statewide reform of mental health services in New Mexico, focusing specifically on provider-voiced concerns regarding recovery and recovery-oriented care. We argue that the concept of recovery functions as a symbol that seemingly reconciles the long-standing tension between biological and social explanations of mental illness. Drawing upon provider perspectives, we also discuss concerns that popular rhetoric about recovery may mask some needed fundamental changes to transform the mental health system to a recovery orientation. Finally, we consider recovery from a capabilities standpoint and discuss how this view lends itself to addressing both individual and social components of mental illness.
Akron, Ohio, is home to many who came to the United States as refugees from Bhutan. Originally of Nepali background, they fled Bhutan during a period of ethnic cleansing beginning in the 1990s. As the Nepali/Bhutanese population grew, local providers (e.g., resettlement agencies, social services, emergency room personnel) noted significant levels of problem drinking compared to other local refugee populations. We use a Critical Medical Anthropology framework informed by intersectionality to illuminate the ways that both the intersecting identities and the interlocking systems of oppression experienced by refugees shape Nepali/Bhutanese experiences in the United States, particularly relating to drinking as a coping mechanism. This study focused on gaining local understandings surrounding alcohol use in the Nepali/Bhutanese community in order to inform culturally sustaining solutions for those who suffer from alcohol misuse. We found demographic variables of the Nepali/Bhutanese, particularly those related to gender and generation, intersect with additional identities acquired in the sociocultural system of the United States, such as that of “refugee,” resulting in unique reasons for problem drinking. Results indicate that these unique reasons for problem drinking necessitate a range of interventions. We provide recommendations for providers, community members, and future research.
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