Mary Ellen Copeland is a woman with a diagnosis of a mental illness who has difficulty taking many medications due to allergies. As a result, she has thought about other ways to recover from psychological symptoms that worked for her and developed her ideas into a program she calls WRAP (Wellness Recovery Action Plan). She leads workshops and trains other people to learn her methods so that they can help themselves and teach other people. In addition to having written several workbooks, she publishes a newsletter available for free on line or in the mail. At a workshop I attended, people appreciated her sincerity, directness, and ability to form a plan that people can use as a discipline in their recovery. I will discuss what I learned from the workshop and how to get further information about her and her work.

She feels many psychological symptoms come from trauma, loneliness and lack of support. Like others who have developed behavioral or cognitive theories, she looks at what’s going on in our lives at this moment and has created a practical plan to treat the symptoms. She hopes her work will complement other programs advising that no one stops taking medication, particularly abruptly, without the advice of physicians and supporters.

"No one knows what is going to happen to you in your life and no one told me I couldn’t do anything I wanted," declared Ms. Copeland. Hope, personal responsibility, self-reliance along with help from others and education will help us move toward wellness, happiness and lives of satisfaction. She calls for balance in treatment, careers, living space, relationships, and leisure time activities. Attending workshops and lectures as well as reviewing educational resources and talking with others who have had similar experiences and health care professionals can be helpful. Her method revolves around setting personal goals and working toward them. She urged that we "go for recovery with courage and persistence undeterred while expressing ourselves calmly" as we reach those goals, a form of self advocacy. Emphasizing that each person needs to develop a support system of family, friends and health care providers, she stated "everyone needs at least five good friends or support people." Support people are caring, empathetic, accepting, affirming and validating. They should be able to help you advocate as well as enjoy sharing time and having fun with you. People to talk to and provide companionship can help you figure out things and make decisions, even taking over for you if needed. Her five steps to developing a strong support system are becoming an active member of a support group, joining community activities, volunteering, staying in touch with friends and acquaintances and making mutual support a high priority. You can see why she was asked to speak at a national conference for a mental health self-help group.

Her toolbox includes reaching out for support, peer counseling, ongoing dialogue with health care professionals, counseling, focusing exercises and relaxation techniques for stress reduction. She advocates taking time for diversionary activities (things we enjoy), journaling, improving our diet, finding time for light exposure and good sleep, increasing or decreasing stimulation as needed, securing the environment and planning the day. To get started devising an individual written plan use a 3-ring binder with dividers or tabs, paper and a pencil and a friend for feedback. If you do this when you are feeling well, you can refer back to it when you are not.

Her recommendation for every day includes eating three healthy meals and three healthy snacks, drinking six, 8 ounce glasses of water, exercising for ½ hour, getting light for ½ hour, taking medications and vitamins, spending 20 minutes in relaxation or meditation, writing in a journal for 15 minutes and taking ½ hour for a fun, affirming activity. This could be listening to music, walking in the woods, or taking time with pets. One section in the notebook is for listing your qualities such as bright, talkative, boisterous, athletic, or argumentative. Then you also list external events that make you uncomfortable such as anniversaries, being judged or teased, noises, too much time alone or relationships ending.

The wellness plan includes the musts for each day in one column and the choices in another. These are different for everyone. What you must do could include some of the healthy activities listed above that you want to find time for every day. Next is a list of reminders of things you could do such as spending time with a friend, partner, or family member, setting up appointments, gardening, reading a good book, singing, soaking in a hot bath, or planning a vacation or outing. You also list the early signs of trouble such as anxiety, forgetfulness, inability to experience pleasure, avoiding doing things, or obsessions about not controlling things. When things are breaking down, you learn to identify the signs and symptoms by looking over your notes so that you have a clear response system you can access. At that time, you might get extra medication, change your job, stop driving, help someone else, stay around people, call a therapist or take three days off from household responsibilities. What has worked for her is knowing someone will find someone to take her place. I’m not sure how most people could "change their jobs," but I would think this might include taking time for a walk at lunch, taking a day off, or modifying your work or work hours in some way.

There is a section for creating a crisis plan written while you are well and still in control if others have to assist you with your health care. You can repeat what you are like when you are well and then list symptoms that may show you are not doing well such as uncontrollable pacing, neglecting personal hygiene, abusing substances, threatening suicide, skipping cooking or housework. This is where you name the five people who you feel are responsible, sincere, calm, understanding, honest, knowledgeable and compassionate. I would think people who know you well would hopefully understand these symptoms and help you with feedback. I can see why you might not want to burden one person, but it might be hard to have too many people involved. This may be anticipated since she suggests you write down names of people you don’t want involved with your care which could settle disputes among your supporters.

In New York there is the legal provision for a health care proxy. I believe many doctors prefer that this one person make final decisions about your medical care. Also included here are names and phone numbers, allergies you may have, medications you are taking and would prefer not to take, treatment which is acceptable or not and where you would like to stay, if necessary, with family or friends or which community facilities you would choose for care.

Your plan would include things that need to get done such as taking care of the car or pets, and your preferences for your care, for instance, a daily massage, foods that you like and what you do not like such as chattering, certain music, impatience, or not being heard. She discussed how you let people know what you want. I remember recently reading a story about a woman who was in a coma where caretakers played music by a group they thought was her favorite. When she awoke, she announced she hated it. It sounds to me as if this is a way to feel empowered that you have made arrangements ahead should the need arise. You must let people know when you do not want to use this plan anymore. It is also important to have a Durable Power of Attorney that you could put into place.

In Mary Ellen’s newsletter she lists the following long term benefits: "to promote higher levels of wellness and stability, increase the use of natural supports, promote personal responsibility and empowerment, improve the overall quality of life, decrease the incidence of severe symptoms, decrease traumatic life events and stigma caused by severe symptoms, increase understanding of these symptoms and decrease the need for costly therapies and health services." She encourages people to come to Brattleboro, Vermont for more training to help themselves or others and lists places where she will be speaking. She would like to see mental health commissioners and systems change the focus on recovery. People should not feel punished for symptoms which may be painful and terrifying, be coerced into treatment or lifestyles that are not their choice or stop fighting and end their lives.

The titles of topics in two recent newsletters are "Motivation, Postpartum Depression and Anxiety, Building a Career When Living with a Mood Disorder, Exercise, Finding Our Voice: Ending the Silence and Heart Disease: A Woman’s Most Serious Health Issue, and Light Therapy." She has published workbooks for adolescents, people living with depression and manic depression or loneliness, and women healing from the trauma of abuse. Additional subjects of workbooks are about winning against relapse, WRAP for people with dual diagnosis, controlling worry, and living with fibromyalgia and chronic myofascial pain syndrome. To get in touch with her on line, she is at www.mentalhealthrecovery.com or or write PO Box 301 W. Dummerston, VT 05357. Her phone is 802 254-2092.

I think she offers a program that would appeal to people who want a practical plan to help them manage their recovery and welcome the discipline of following a plan daily. Some people would probably choose to remember activities or to tell friends and family what to look out for rather than write it all down. It also seems very helpful for people who have trouble with side effects from medication, or want to decrease its use. I don’t know if she has discovered any new strategies that I had not heard before because I have not read her books or attended a full training session, but she is certainly inspiring. With two master’s degrees, Mary Ellen can relate to people as a peer and educated consumer. It has helped me to remember her WRAP plan and to try to follow it consistently. Some people might prefer to work on their own using her workbooks. Others could benefit by the energy and input from others that they would find in a group workshop. I would recommend learning more about this program if you are looking for a common sense, daily living plan to help you or a compelling speaker to address your organization.