The Importance Of Relationship In Recovery-Oriented Practice

The Recovery Model and Its Principles

Discuss about the Principles of Recovery Oriented Mental Health.

The Importance of Relationship in Recovery-Oriented Practice Sandy Jeff is an author whose poetry work can serve two main purposes. The first one is encouraging the mentally impaired persons in their journey to recovery. The second one is to provide a real picture of what mentally ill patients go through. In particular, the work of Sandy Jeff can motivate or inspire nurses to implement the principles of recovery model and assist many other patients to have a successful life like Sandy Jeff. The goal of this paper is to demonstrate how nurses can use the real story of Sandy Jeff to implement the principles laid out in the recovery mode.

According to (Australian Health Ministers’ Advisory Council, 2013), the notion of mental health recovery looks at the value of people with lived experience in context of mental recovery and empowers them to promote their lives. The concept of recovery recognizes that people with lived experiences in mental health require equal opportunities as the rest of the members of society to meet their needs and purpose in life. With that, it brings to the lived experience the knowledge, expertise and skills to the mental health specialists enabling them to opportunities for challenging the contemporary beliefs and traditions held about mentally ill persons. According to (Mental Health Commission of NSW, 2018), individuals with lived experiences in mental health problems together with carers have unique understandings into how health services can be tailored to best respond to their mental health desires management. This justification does not only apply to health care but even in other domains.

Recovery in mental health involves gaining hope and maintaining it. It is an acknowledgment of one’s capabilities and the disabilities. Through hope, a person starts to ignore the limits that can come from the disabilities, engages in active life, regains social identity, and personal autonomy. The products of recovery are gaining the meaning, purpose, and an optimistic view of life. Recovery has two requirements. The internal requirements are hope, empowerment, healing, and connection with the society. External requirements are human rights, a culture that promotes recovery, and recovery-focused services. According to (Australian Health Ministers’ Advisory Council, 2013), recovery-focused services exist in five main domains. The first domain is the promotion of culture, hope and optimism. This practice focuses on services that accept diversity and uses a language that communicates hope in the recovery process.  The second domain is holistic care. This requires that health services will pay attention to the whole life of the serssist the service user in all the situations of his life. The third domain require a focus on personally as an intergral part of health services instead of as an additional task. The fourth domain requires organizational commitment and developmental workforce service that provide a conducive environment for recovery. Lastly, the fifth domain requires practical actions taken on the social inclusion and other social factors in patient health and wellbeing.

Domains of Recovery-Focused Services

The report of (The Department of Health, 2010) emphasizes on the principle of the uniqueness of the individual. This principle identifies that recovery in not just about the illness, but it is also about giving people a meaning and a purpose in their lives. Recovery is more about satisfying the patient and his or her carers purposeful life. Drawing from the lived experience of Sandy Jeffs, she now has a different life than the one she had when she was fighting with schizophrenia. Despite the boundaries of the illness, she has been able to defeat the limitations of the disabilities and she is able to live as she wished. Sandy states that she had been in “psychotic hell with nothing happening, no purpose in life, no reason to get out of bed, no hope, no meaning.”

The role of nurses is to accept that recovery is possible, and the outcomes differ from one individual to the other (Rapp & Goscha, 2011). Providing the best care that offers the patient a chance to grow their strengths, overcome the illness, earn value in the community, and improve their quality of life should be the ultimate goal of all practitioners in the mental services management (Jacob, Munro, Taylor, & Griffiths, 2015).

The second principle is the principle of real choices. This principle urges specialists to empower the patients and their carers to make their independent choices (Australian Health Ministers’ Advisory Council, 2013). Professionals should understand that service users understands their needs, and they are the one feel all the impacts of their illness. Sandy Jeffs says that when she disclosed her feelings to the psychiatrist, and the psychiatrist could not help as he/she thought the consequences would be worse than the prevailing situation. This situation demonstrates a practice that could not condemn an inhuman environment which is a threat to recovery. According to (Aggarwal, 2016) nurses should cultivate for an empowering environment is important because it makes consumers believe that their opinions are considered, and the professionals are respecting their decisions and choices.

Thirdly, there is the principle of attitudes and rights. According to (Australian Health Ministers’ Advisory Council, 2013), this principle looks at the interaction between health professionals and the consumers. The principle advises on professionals’ listening skills. In other words, a good practice is the one that pays attention to the service user’s communications. After listening to them, professionals should then act upon the communication coming from the individuals. The ultimate goal of this interaction is to promote and respect the individuals’ legal positions, human rights, and their citizenship (Kogstad, Ekeland, & Hummelvoll, 2011). Besides, professionals are urged to provide support to the individuals. The support should be aimed at maintaining and promoting developments of their social life, occupational, recreational and their vocational endeavors that will drive or bring meaning to their life (Xie, 2013).

Uniqueness of the Individual

This principle condemns the humiliations meted by Sandy Jeff when she narrates that even the second psychiatrist did not take the time to listen to the contents of her voices or even try to understand what she said in her delusions. She talks of sexual assaults that the first psychiatric had no courage to condemn. In the poem ‘medicated,’ Sandy Jeffs is asking people to understand what she goes through,

“Join me on the medication trolley, I’ve been on it for years,I’ve been Largactiled with bitter syrup, I’ve been Pimozided & Mellarilled & numbed, I was so Stelazined I was like a cat on a hot tin roof, I’ve been Modectated into a shuffle…” (Jeffs , Medicated’ and ‘McMadness’ (Two Poems by Sandy Jeffs), 2012)

This poem is a call for the specialist to understand what mentally ill consumers go through. In her campaign for the mentally people’s rights and positive attitude, Sandy Jeffs states that people should start giving mentally impaired persons some jobs, opportunities, and guiding them through the jobs.

The fourth principle is dignity and respect. The principle advises on courtesy, respect, and honesty while offering mental services. Specialists should handle with care sensitive matters such as patient’s values, their beliefs, faith, their status, culture, etc (Boutillier, et al., 2011). It challenges discriminatory actions and calls for trust and fairness while dealing with clients. A positive perspective of mentally ill persons should come naturally, and professionals should refer to mentally ill patients as people not referring to them through other names in their absence. For instance, the sandy Jeffs found numerous epithets all for madness with only one word for sanity. Besides, all the ‘synonyms’ for madness were all derogatory. She says that,

“Being as I am, mad that is, I must be: bananas, crackers, a camel short of a caravan, a ball short of an over, a pad short of a kit, not in my right mind, bereft of reason, deprived of my wits, as mad as a cut snake, a tinnie short of a slab, diseased in the mind, as mad as a hatter, wildered in my wits, not the full quid, a brick short of a load…” (Jeffs, 2009)

The fifth principle emphasizes on partnership and communication management. This principle acknowledges that mentally ill patients are the best experts for their own lives and their recovery (Boutillier, et al., 2011). The principle urges care professionals to consider working together with the patients and their carers by providing them with the support instead of treating them as just recipients (Anderson, 2012). The support provided should be valuable to the consumers and have relevant information that matches the care needed by the users. In addition, professionals should make their communications clear, positive, realistic empowering, inspiring the consumers towards their goals and hope (Australian Health Ministers’ Advisory Council, 2013).

Principle of Real Choices

This principle discourages sentiments that are diminishing hope like what Sandy reports that a doctor told her that she would never recover. Patient participation remains at the core of nursing professional practice. Care professionals should welcome collaboration and work together with patients (Clarke, Oades, & Crowe, 2012). They should disintegrate themselves from the old traditions that believed that professionals know better than their service users.

There are various rationales for patient partnership and collaboration. Firstly, patient participation is an approach that many people has seen its impacts by improving the quality of life, (Tambuyzer, Pieters, & Audenhove, 2011). Besides, it places the care in the ownership of the patients and the careres, who are also the key beneficially of the care. With this, collaboration is simply assisting patients to manage their care which has a major impact on their economic benefits (Elstad & Eide, 2009).

The last principle is an evaluation. This principle requires continuous care evaluation. Professionals should make it possible for the patients and their carers to track their progress. According to (Australian Health Ministers’ Advisory Council, 2013), services should demonstrate that individual’s experiences in the care can inform quality enhancement activities. The mental health professionals should provide reports through their system on the various outcomes that have come out the care plan (Hayward & Ayres, 2011). They should also indicate the various developments in the recovery process. Outcomes does not only include medical, but they extend to other factors of such as housing, education, employment, family relationships and the entire wellbeing.

While looking at Sandy Jeffs situation, the poem of “McMadness” states that the medication killed libido, made someone dribble and constipated, made someone turn into a zombie and sedated someone to exhaustion. Evaluation should be able to look at such side effects that make the patient lose him or herself.

Conclusion

This essay achieved its ultimate goal which was to take a critical look at the principles presented under the framework for mental recovery models. The model serves to provide grounds for the improvement of mental health care services. This paper went through these services by using the poetry work of Sandy Jeffs. This paper noted that the work of Sandy Jeff provides a real picture of what mentally ill individuals go through. Through Sandy Jeffs stories, this paper was able to provide elaboration on how nurses can implement the principles provided on the framework.

References

Aggarwal, N. (2016). Empowering People with Mental Illness within Health Services. Acta Psychopathologica, 2. doi:10.4172/2469-6676.100062

Anderson, H. (2012). Collaborative Practice: A Way of Being “With”. Psychotherapy and Politics International, 10, 130-145. doi:10.1002/ppi.1261

Australian Health Ministers’ Advisory Council. (2013). A national framework for recovery-oriented mental health services: Guide for practitioners and providers. GUIDE FOR PRACTITIONERS AND PROVIDERS. Retrieved from https://www.mhima.org.au/pdfs/Recovery%20Framework%202013_Policy_theory.pdf

Boutillier, C. L., Leamy, M., Bird, V. J., Davidson, L., Williams, J., & Slade, M. (2011). What Does Recovery Mean in Practice? A Qualitative Analysis of International Recovery-Oriented Practice Guidance. Psychiatric Services, 62, 1470-1476. doi:10.1176/appi.ps.001312011

Clarke, S., Oades, L. G., & Crowe, T. P. (2012). Recovery in mental health: A movement towards well-being and meaning in contrast to an avoidance of symptoms. Psychiatric Rehabilitation Journal, 35, 297-304. doi:10.2975/35.4.2012.297.304

Elstad, T. A., & Eide, A. H. (2009). User participation in community mental health services: exploring the experiences of users and professionals. Scandinavian Journal of Caring Sciences, 23, 674-681. doi:10.1111/j.1471-6712.2008.00660.x

Hayward, S., & Ayres, J. (2011). A service evaluation of recovery support from the patient’s perspective. British Journal of Wellbeing, 2, 26-31. doi:10.12968/bjow.2011.2.5.26

Jacob, S., Munro, I., Taylor, B. J., & Griffiths, D. (2015). Mental health recovery: A review of the peer-reviewed published literature. Collegian, 24, 53-61. doi:10.1016/j.colegn.2015.08.001

Jeffs , S. (2012). Medicated’ and ‘McMadness’ (Two Poems by Sandy Jeffs). Retrieved from Centre for Medical Humanities: https://centreformedicalhumanities.org/medicated-and-mcmadness/

Jeffs, S. (2009). Flying with paper wings: refl ections on living with madness. Retrieved from https://journals.sagepub.com/doi/abs/10.3109/10398562.2010.515001

Kogstad, R. E., Ekeland, T.-J., & Hummelvoll, J. K. (2011). In defence of a humanistic approach to mental health care: recovery processes investigated with the help of clients narratives on turning points and processes of gradual change. Journal of Psychiatric and Mental Health Nursing, 18, 479-486. doi:10.1111/j.1365-2850.2011.01695.x

Mental Health Commission of NSW. (2018). Lived experience. Retrieved from https://nswmentalhealthcommission.com.au/lived-experience

Rapp, C. A., & Goscha, R. J. (2011). The Strengths Model: A Recovery-Oriented Approach to Mental Health Services (2 ed.). Oxford University Press.

Tambuyzer, E., Pieters, G., & Audenhove, C. V. (2011). Patient involvement in mental health care: one size does not fit all. Health Expectations, 17, 138-150. doi:10.1111/j.1369-7625.2011.00743.x

The Department of Health. (2010). Principles of recovery oriented mental health practice. Retrieved from https://www.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-i-nongov-toc mental-pubs-i-nongov-pri

Xie, H. (2013). Strengths-based approach for mental health recovery. Iranian journal of psychiatry and behavioral sciences, 7(2), 5-10. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3939995/pdf/ijpbs-7-005.pdf