Parkinson, C., 2015.

Towards a Recoverist Manifesto

SUMMARY
Over 2012 - 2014 Arts for Health (AfH) worked with people in recovery from substance misuse in the UK, Italy and Turkey exploring self-portraiture in the recovery process. With funding from Grundtvig and working with artists from the three partner countries, we set about exploring the place of the contemporary arts in the lives of people affected by addiction.

The process of engaging with art and artists had a profound affect on participants and a discreet and unplanned element of the project emerged that focused on the lived experiences of people affected by substance misuse and specifically responded to the dialogue that ensued.

Working with contemporary visual art as a provocation, participants have developed a Recoverist Manifesto that gives voice to the marginalised and addresses preconceived ideas around addiction and recovery. Challenging the culture of blame and shame and placing the human being at the heart of the debate, the Recoverist Manifesto is pro-active and gives a human face to people disenfranchised by misunderstanding and stigma. This presentation will share elements of the artistic project, it's outputs and impact - and share the Recoverist Manifesto in full.

CONTEXT
In 1924, a UK Ministry of Health committee was convened to consider the circumstances in which morphine and heroin might be supplied to people experiencing addiction. The Rolleston Committee recommended that doctors be allowed to prescribe addictive drugs in a controlled manner, in the same prescribed way as they supplied other drugs. Addiction was seen as a middle class phenomenon, so criminal sanctions were unnecessary, as few criminal or lower class addicts were known.

In 1952 an anonymous civil servant called Bing Spear, joined the UK Home Office Drugs Inspectorate. At the beginning of his career 56 heroin addicts were known to the UK Government Home Office and Spear knew them all individually. He became the head of the organisation in 1977, when there were fewer than 500 known addicts in the 'system', and with a clean, legal supply of their drug, they remained healthy and were able to live normal lives.

The UK, however, soon adopted the United States model, which was already committed to imposing a global policy of prohibition. People addicted to drugs were forced underground to buy their supplies illegally: the black market blossomed, inflicting illness and infection on addicts and embroiling them in theft and prostitution to find funds. Between 2012/13 around 1 in 12 adults had taken an illicit drug in the UK, equating to around 2.7 million people. The United Nations Office on Drugs and Crime estimate globally that in 2012, up to 324 million people aged 15 - 64 had used an illicit drug, and that around 183,000 drug-related deaths were reported in 2012.

In the UK between 2011/12, there were an estimated 1.2 million hospital admissions related to alcohol consumption. Over the same period there were 178,247 prescriptions for the treatment of alcohol dependence. The Net Ingredient Cost (NIC) of these prescriptions was £2.93 million in 2012. This is an increase of 70 per cent on the 2003 figure (£1.72 million).

The World Health Organisation tell us that globally, harmful use of alcohol results in 3.3 million deaths each year and that "Addiction represents one of the areas of medicine that is least understood, yet generates an enormous burden on society, the medical profession, carers and individual sufferers." When Bing Spear retired in 1986 heroin addiction was part of a complex international black market and today the 'treatment' of people affected by substance addiction has been arguably perverted by politics, that echoes the early days of American prohibition.

With the criminalisation of people affected by addiction and the inequalities that may have played a part in their journey to substance misuse neatly ignored, this historical picture of a transition from sensibly managed addiction, to one of mass consumption, is the one from which our project was born. This presentation tells a different story - not one of the pathologising of substance addiction, but of a reframing through a cultural lens - and one that puts the human being at the heart of our conversation.

THE PROJECT - I AM: Memoirs of Addiction Recovery
Portraits of Recovery is a UK based, international visual arts and education charity. Founded in 2011, the organisation's work supports people and communities affected by and in recovery from substance misuse to open up new ways of knowing and looking at the subject by working with contemporary visual art and artists. Portraits of Recovery believes that the arts & culture can be transformational in and of themselves. Its vision and intent is to improve the lives of people and communities in recovery by increasing access to cultural opportunity.

Portraiture is a starting point for dialogue around self-representation and the revelation of new identities, sensibilities and ways of seeing the unseen. Recovery is a process of transformation, a passage that reconfigures a person's identity. Portraits of Recovery's public facing programme supports voice, choice and control over representation as presented through lived experience of addiction & recovery beyond current clichéd representation.

In 2012, Arts for Health and Portraits of Recovery embarked on a collaboration with the Green Crescent charity in Turkey and the drug and alcohol treatment agencies, FeDerSerD and Gruupo Incontro in Italy. We began a project funded by the lifelong learning stream of Grudtvig to explore how contemporary art might offer us multiple, visible perspectives of what recovery means and looks like.

I AM: Memoirs of Addiction Recovery was a 2 year project that employed art & artists as facilitators of social change within the substance misuse community. Through delivery artists, the participating drug & alcohol agencies and other cultural organisations were brought together to create a cohesive grouping and bring disenfranchised people to high quality, cultural and artistic experiences. Central to its success, was the wider exploration of the social and cultural contexts of recovery within people and recovering communities from Greater Manchester & Liverpool - UK, Pistoia & Pescara - Italy and Kutahya - Turkey, facilitated by Pan-European exchange.

The project provided a platform to look at how the arts and culture can support recovering people to develop new life-opportunities by working with international artists: Ali Zaidi, founding Co-Director of Moti Roti - UK, Cristina Nuñez of the Self Portrait Experience - Italy and Selda Asal, founding Director of the Apartment Project - Turkey.

Portraiture in its extensive conceptual sense was used to facilitate participant's self-representation and was delivered over a series of 5 day artist-led residency workshops in each of the partner countries. The artwork production was a collaborative journey undertaken by the artists and participants demonstrating participants' stories through portraiture that stretches beyond current clichéd representation.

Ali Zaidi utilized food as a starting point for self. Zaidi's series of still & moving image works bypass the addiction label to reveal notions of unseen beauty and in PER TE MAMMA the fragile emotional complexity of the human condition. In the Cristina Nuñez video work UNCOOL; silence subverts addiction through an amplification of the emotive voice that places emphasis on 'self' as both the cause and cure. Selda Asal's, video animation I Need to Change the Last Line presents us with a series of self-storying narratives recounting the reconstructed past, perceived present and the imagined future alongside reoccurring themes of family and love.

Gruupo Incontro aggregated measurements of participant wellbeing and attitudes before and after artist interventions, which formed the basis of this project. In terms of participant evaluation of the artist led workshops, 41 people completed pre and post evaluation questionnaires, which included questions with closed answers (to choose on a Likert scale from 1= lower score/negative attitude and 8=higher score/positive attitude); some open questions were asked and the Warwick Edinburgh Mental Wellbeing Scale was used. The comparison between the pre and the post evaluations reveals an increase of the scores for every examined dimension, in every country.

Specifically we can say: - there was an increase in the self confidence between the first and second questionnaires, with higher scores in the post-evaluation, revealing that people felt more confident about themselves after the workshop with the artist. In particular this trend is more relevant for England where the percentage of people that chose the higher score (8), meaning they feel very confident, went from 12.5% in the pre test to 43.8% in the post-test. In Turkey we observed a major change: in the pre evaluation there were people that chose a lower score of self confidence (around 2 or 4) but in the post-evaluation we can see that the 77.8% chose the score 7, which is almost the maximum.

The ability to work in a group improved in between the two evaluations: for Pistoia there is an increase of the score 7 (almost the maximum) from 22.2% to 33.3%; Pescara went from 14.3% of answers with 7 score to the 57.1%; for England in the post evaluation 50% of people chose the higher score (8) and in Turkey the percentage of the higher scores went from 22.2% to 55.6%.

Whilst the organisers of the project hypothesised that exploring feelings about addiction recovery would be important to participants, it seems that the workshops didn't influence these conversations with no statistically relevant increases in the scores between the pre and post evaluation. However a question requiring a yes/no answer around the importance of taking part in this project for the participants own recovery process was repeated pre and post activity, revealing that in every country, a majority of the participants thought and actually found this project to be very important for their recovery.

In reality, completing a piece of artwork became more important after the workshop compared to the prior evaluation. These are the percentages of the 8 score answer (the higher score) for every country: Pistoia = 55,6%; Pescara = 28.6%; UK = 62.5%; Turkey = 66.7% and exhibiting artwork in an art gallery remained an important aspect both in pre and post workshop evaluation.

A Recoverist Manifesto
It was during the artists' workshops and cultural exchanges that participants expressed thoughts and feelings that didn't fit within the confines of evaluation questionnaires and which extended conversations beyond the scope of the project. In reality, it was the frustration of everyday life experiences and the assumptions and myths that surround addiction and recovery that became a powerful basis for conversation. The organisers of the project had planned to produce some kind of strategic arts and health document, but very soon in the process, it became clear that an advocacy tool of some sort, would offer a more potent voice to both the project and those people taking part in it.

Building on the methodology of a Manifesto for Arts and Health that had been developed in the UK in 2011, through arts-focused conversation and using some of the principles behind appreciative inquiry, we began an exploration of what it is to be in recovery with over 100 people involved in this project.

The Recoverist Manifesto came about in part, as a positive reaction to the US Recovery Bill of Rights which states: "By speaking out and putting a human face on recovery, people in or seeking recovery, and their families, play a critical role in breaking down barriers. These personal "faces and voices of recovery" serve powerfully to educate the public about addiction and recovery and about discrimination against those seeking sustained recovery."

However, in the landscape of 'austerity', there is a danger that the recovery agenda, and its focus on reintegration, appears to be less about reducing stigma and improving people's lives, and more an attempt to curb public spending and reduce the 'drain' on fiscal resources. Professor of Psychiatry at Yale School of Medicine, Larry Davidson, argues that recovery is best conceived as a civil rights issue, which helps us re-frame the issues affecting people with substance misuse problems, away from policy and services, and towards a more useful focus on the relationships between peers and wider society.

A focus on civil rights also helps to align the citizenship struggles of those with substance misuse problems alongside those experienced by other groups who have sought to challenge, unpick and reclaim the ways in which they are perceived and represented as a part of their struggle for civil rights.

We've been exploring artists, manifestos and activism, and central to this has been the idea of our fundamental human rights. With something of the spirit of Nelson Mandela, who was publicly and politically rehabilitated from 'terrorist' to 'saint', we began redefining ourselves from being passively in recovery to being recoverists - sentient human beings with individual voices and a shared vision beyond national frontiers.

The Recoverist Manifesto will be presented at the MAPSI conference, as a discrete part of the larger project, representing the authentic and poetic voices of people connected through the invisible threads of addiction. This is a work that has been born with something of the sprit of anthropologist, Margaret Mead, who unknowingly empowered us when she declared: Never doubt that a small group of thoughtful committed citizens can change the world; indeed, it's the only thing that ever has.

Those of us who have contributed to the Recoverist Manifesto are all affected by addiction in some way, and every word you will hear is gathered from manifesto sessions that are synthesised into sometimes divergent, sometimes convergent, fears, aspirations and vision. Whilst some cultural differences emerged across the three countries, it is the similarities that connect us. For the purpose of clarity, this presentation of the Recoverist Manifesto will be framed in some of the material that was used to provoke discussion, exchange and solidarity.