Discuss about the Mental Health for Mood and Behavior.
Mental illness is psychological disorder that affects a person’s feeling, mood and behavior. It significantly has an effect on the daily life experience of participants and mentally ill patients are challenged by these issues in their life. Effective recovery process in mentally ill patient is dependent early diagnosis. The recovery-oriented principle of mental health practice emphasizes on delivering the mental health services in such a way that it support mental health consumer in the recovery process. For a mentally ill patient, recovery means retaining the hope, social identify, positive feeling and purpose of life. The recovery principle provides this to patient by identifying the uniqueness of the individual, empowering people to make real choices, respecting rights of patient and preserving the dignity of patients (Kidd, Kenny, & McKinstry, 2015). Through the examination of the lived experience of mental illness in Mary O’ Hagan, the essay analyses the difference between clinical and personal recovery. It also explores the challenges faced by mental health nurses in working according to the recovery-oriented principle.
The analysis of the extract reading from the O’ Hagan, (2014) presents the case of Janet, a nineteen year old girl who started experiencing severe distress and had a difficult life for years. Between the age of 10 to 15, she was sexually abused by her uncle and she later resorted to heavy drinking to deal with her shame. With this background experience of Jane, the article presents two versions of the story. The two versions differentiate between the impact of traditional mental health service and recovery oriented mental health service on health of Jane (O’Hagan, 2014). While the traditional mental health service focuses on clinical recovery, personal recovery is also an aspect of recovery. According to the perspective of mental health professionals, clinical recovery is achieved when patients get rid of symptoms and treatment process restores their social functioning in life. In short, it means getting back to living a normal life (Drake & Whitley, 2014). On the other hand, personal recovery is an idea given by people with lived experience of mental illness and for them personal recovery means the process of changing attitude, values, skills and goal in mentally ill patients. It encourages the idea of living a hopeful life within the limitations of illness. A person can go beyond the devastating effect of mental illness by developing a new interest or meaning in one’s life (Hickey, Pryjmachuk, & Waterman, 2016). Hence, clinical recovery promotes recovery by mitigating the symptoms of mental illness, whereas the personal recovery motivates a patient to live a hopeful life within the boundaries of mental illness.
Recovery-oriented principle also promotes personal recovery of patients. The benefits of recovery-oriented principle and the limitations of the traditional mental health service is understood from the two versions of the story regarding the lived experience of Jane. In the first version, Janet was taken to a mental health service by her friend Emma, when she decided to jump off a motorway bridge. As the GP was not available, Janet finally consulted the mental health crisis team. Due to the irrational response of the crisis team, Janet took an overdose of drugs as she felt humiliated. Janet did not received the proper clinical care that she needed from the psychiatrist and most of the staff were not interested in knowing how Janet felt or coped with her condition on a daily basis. Furthermore, she was overwhelmed with gloomy feelings about future and felt crazy with boredom as she remained locked in the ward. The psychiatrist was very evasive and did not have any feasible practical advice to give to Janet’s mother apart from taking her medications on time. The ultimate impact of such treatment methods on Janet was that she was estranged from her family member. She has left work for almost five years and continuous injections and drug has left little vitality in her (O’Hagan, 2014).
The above experience of Janet reflects that traditional mental health service completely ignored the patient’s belief and dignity while providing care. They did not worked on enhancing the motivation level of patient to promote recovery. This model of clinical recovery focused just on eliminating the symptoms; however it ignored spiritual well-being of patients. In case of mentally ill patients, it is necessary that patient freedom, choices and hope is modified so that they develop a new meaning in life and learns to cope with the disease even if the patients continues to have the disease (Tickle, Brown, & Hayward, 2014). The limitations found in traditional clinical recover process can be addressed by the recovery-oriented principles of mental health. The advantage of this model of care above other mental health service is that focuses on the lived experience of patients to promote attitudinal change in patients. The combination of lived experience along with clinical skill of mental health practitioners offers the opportunity to challenges the traditional method of mental health service delivery. In this case, the treatment in informed by lived experience of patients (Park et al., 2014). Although recovery-oriented practice has emerged as a innovative method of practice in mental health service, however the uptake of recovery orientation has many challenges. Unless a staff understands the concrete benefit of this approach, they cannot implement it in their practice setting. Mental health nurses may not understand the meaning of recovery according to this approach (Slade et al., 2014).
The core elements of the recovery oriented approach and its holistic benefit is understood from the second version of Janet’s theory, which depicts her health outcome after seeking the recovery-oriented approach to mental health. In this case, Janet’s friend, Emma consulted online mental health service ‘rockup.com’ after Janet tried to commit suicide. In the online website, Janet had to answer some questions and got a phone call from Rock Up. Janet felt very relieved after talking to the peer support worker and the clinical worker as it gave her the feeling that staff are willing to listen and understand. This reflects partnership and communication aspect of recovery oriented principle where carers promote recovery by working in positive partnership with patients to realize the goals and aspiration in mental health. The willingness to listen gives the feeling to patient that mental health professionals and courteous and respectful during the interaction (Rapp & Goscha, 2011). As Lisa also listened patiently to Janet’s health issues and difficulties in life, it promoted sensitivity and respect in patient nurse relationship.
The second version of Janet’s story mentions the adequate support given to Janet by the Rock Up service as she started feeling suicidal after few weeks. Lisa shifter her to a peer-run crisis home where she felt very safe and her peer mentor, Helen counseled her and explained her about the different factors leading to mental problem. In the first version, when Janet was feeling paranoid and felt like she was feeling to die, the nurse did not provided any support to her and just opened the window and asked her to sleep. However, when Janet faced a similar situation at Rock Up, the peer worker rubbed her back and assured her that her feeling will go away after sometime. By this form of practice, mentally ill patients feel valued and develop an optimistic attitude during the treatment process. This is an example of carer-inclusive approach to service delivery (A national framework for recovery-oriented mental health services, 2017).
Helen’s role was influential in helping Janet cope with her life struggles and she became an inspiration for Janet. Many positive outcome was seen in Janet as felt relaxed to share her feelings with someone who had a lived experience of mental illness and who seem to understand her difficulties and struggle very well. Initially she was clueless about her life and felt highly isolated, however after the interaction with Janet she was more hopeful towards life. This was a significant change as this motivated her to engage in pleasure activities like art sessions and creative writing group. She also applied for an online recovery education course. She became aware of the pros and cons of medication and decided to take minimal dose of anti-psychotics. The struggle that she faced initially at nursing school was also addressed by student support services as it helped Janet to find strategies to manage stress in nursing placement. The ultimate impact of the recovery-oriented practice for Janet six years later was that she made new friends and her work gave her the opportunity to shared her lived experience with other patients. Her life is much better and positive most of the time (O’Hagan, 2014). Hence, the analysis of the experience of Janet in Rock Up depicts that other form of response is possible so that patient are engaged in their personal recovery process. Recovery oriented principle not only promotes self-determination in patient to deal with life struggles, it also support them in establishing appropriate connection with the community. Mental health professional following this approach can facilitate social justice for this group of patients too (Gilburt et al., 2013).
The essay developed the understanding of the lived experience of mental health by means of experience of Janet, mentioned in the autobiography by O, Hagan. The account of the lived experience of Janet in two context- the traditional mental health service and recovery-oriented service clearly revealed the difference in outcome between these two forms of intervention in promoting recovery of mentally ill patients. Although the clinical recovery focus on elimination of physical symptoms of mental illness, the recovery oriented principle integrated clinical recovery along with personal recovery to ensure that patients lead a positive and contributing life even with the disease. Recovery-oriented practice is gradually emerging in mental health setting, however nurses face challenges in its application as they feel that they cannot follow it in their day to work. Traditional mental health services ignore this method as any new practice is associated with great resistance from staffs. Appropriate policy and training of staffs is needed to efficiently implement and integrate recovery-oriented practice in mainstream mental health service.
Reference
A national framework for recovery-oriented mental health services. (2017). Retrieved 22 April 2017, from https://www.mhima.org.au/pdfs/Recovery%20Framework%202013_Policy_theory.pdf
Drake, R. E., & Whitley, R. (2014). Recovery and severe mental illness: description and analysis. The Canadian Journal of Psychiatry, 59(5), 236-242.
Gilburt, H., Slade, M., Bird, V., Oduola, S., & Craig, T. K. (2013). Promoting recovery-oriented practice in mental health services: a quasi-experimental mixed-methods study. BMC psychiatry, 13(1), 167.
Hickey, J. E., Pryjmachuk, S., & Waterman, H. (2016). Exploring personal recovery in mental illness through an Arabic sociocultural lens. Journal of Psychiatric and Mental Health Nursing.
Kidd, S., Kenny, A., & McKinstry, C. (2015). The meaning of recovery in a regional mental health service: an action research study. Journal of advanced nursing, 71(1), 181-192.
O’Hagan, M. (2014). Madness Made Me. A Memoir. Wellington, NZ: Open Box.
Park, M. M., Zafran, H., Stewart, J., Salsberg, J., Ells, C., Rouleau, S., … & Valente, T. W. (2014). Transforming mental health services: a participatory mixed methods study to promote and evaluate the implementation of recovery-oriented services. Implementation science, 9(1), 119.
Rapp, C. A., & Goscha, R. J. (2011). The strengths model: A recovery-oriented approach to mental health services. OUP USA.
Slade, M., Amering, M., Farkas, M., Hamilton, B., O’Hagan, M., Panther, G., … & Whitley, R. (2014). Uses and abuses of recovery: implementing recovery?oriented practices in mental health systems. World Psychiatry, 13(1), 12-20.
Tickle, A., Brown, D., & Hayward, M. (2014). Can we risk recovery? A grounded theory of clinical psychologists’ perceptions of risk and recovery?oriented mental health services. Psychology and Psychotherapy: Theory, Research and Practice, 87(1), 96-110.
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