ASSESSMENT 2 ESSAY PDF

Preview

Summary

Download ASSESSMENT 2 ESSAY PDF

Description

The effects of clinical and personal recovery. The methods of recovery in mental health have rapidly changed over recent decades (Evans, Nizette & O’Brien, 2017). Mental health services have shifted from practicing clinical recovery and moved towards a consumer-focused personal recovery (Glover, 2012). This essay will discuss the differences between clinical and personal recovery in relation to Janet’s two scenarios. The principles of recovery oriented care will also be examined and contrasts will be made between clinical recovery and the principles of recovery. The term clinical recovery in mental health has attracted a damaging stigma. Clinical recovery is based around the medical management of symptoms, and returning a consumer back to their ‘normal self’ (Morrow, 2011). This form of recovery is non-consumer focused; allowing minimal contribution from the consumer and depicts the healthcare professional as the expert on the consumer’s experience (Evans et al., 2017). Clinical recovery alone is disadvantageous because only the consumer who has lived the experience can determine the appropriate recovery (Evans et al., 2017). Clinical recovery is still valid in mental health, and provides a complimentary role alongside personal recovery (Glover, 2012). Scenario one, focused on clinical recovery involving mental health professionals (MHPs) in a clinical setting. This form of recovery resulted in Janet and her mother feeling a lack of support, advocacy, and empathy; along with judgment from MHPs from the beginning of her experience (O’Hagan, 2014). In attempting to seek help, Janet was left with feelings of humiliation and hopelessness for her future, through not been taken serious. The MHPs did not listen to Janet and her mother’s concerns, and left Janet with feelings of powerlessness in planning her recovery. Clinical recovery resulted in detachment of Janet’s social networks and hindered her ability of feeling valid within the community (O’Hagan, 2014). A minor involvement of clinical recovery in conjunction with personal recovery would have supported Janet in this experience.

Personal recovery is the preferred approach in mental health due to its consumer focus (Evans et al., 2017). Only one who has lived the experience can truly define one’s own personal recovery; however, one interpretation is to live a satisfied, hopeful and contributing life regardless of the illness (Anthony, 1993). Personal recovery is non-linear, without timeframes, and focuses on crisis as a time of learning how to thrive in an active recovery space (Evans et al., 2017). This form of recovery allows the consumer to be the expert of their own lived experience and to be involved in the planning of appropriate care (Evans et al., 2017). Scenario two focused on personal recovery involving both MHPs and mental health workers (MHWs) including peer support workers. Janet felt supported by the community and received guidance and acceptance through MHW advocacy (O’Hagan, 2014). Janet was a part of a collaborative team, where her concerns were heard and respected throughout the planning of her recovery. As a result of her personal recovery, Janet’s social networks increased, along with her confidence, self-efficacy, and hopes for the future (O’Hagan, 2014). Janet’s recovery was supported by the principles of recovery that are based around her rights as a consumer (Australian Government Department of Health [AGDH], 2010). The Australian Government Department of Heath implemented six principles of recovery oriented mental health practice to be applied across the entire mental health system (AGDH, 2010). These principles serve to protect the consumer’s rights to an effective recovery and ensure services are delivered to support consumers. The principles outline, understanding the uniqueness of the individual, empowering consumers with real choices, along with supporting their attitudes and rights. The principles also detail the right to dignity and respect, partnership and communication, and the consumer’s ability in evaluating recovery (AHMC, 2013). These principles are heavily focused on the

consumer’s involvement in their recovery, and deviate from the paternalistic nature that can become of clinical recovery (Slade et al., 2014). The principles of recovery are depicted in scenario two, and enhanced Janet’s personal recovery in contrast to scenario one where clinical recovery was practiced. By allowing Janet her to be at the centre of the care she received, improvements in the therapeutic relationship she had can be attributed to the principles. The stigma of mental health is evolving through mental health awareness attributed to the recovery principles. MHWs advocated for Janet, referred her to the resources that she required; and thus, developing self-efficacy and hope for the future. Establishing the consumer at the centre of their care allows them to feel understood, empowered and a valued member of the collaborative team (Slade et al., 2014). Unlike scenario one, the MHWs in scenario two respected Janet as a unique individual when planning her recovery. Through listening and providing options, Janet was acknowledged as an expert in her own lived experiences (AGDH, 2010). The psychiatrist worked collaboratively with Janet, discussing her medication plan and adjusting dosages according to her feedback (O’Hagan, 2014). The psychiatrist valued the relevant information that she shared, benefiting the progress in Janet’s recovery (AGDH, 2010). Allowing the consumer to be central to recovery assists the consumer in living autonomously and contributing to a satisfying life in the community (Whitely, Palmer & Gunn, 2015). In scenario one, using clinical recovery, Janet was compelled to abide by strict rules set out by MHPs, removing her ability to make choices (O’Hagan, 2014). In scenario two, MHWs applied the principles of recovery, exploring and supporting Janet’s choices about how she wanted to live her life (AGDH, 2010). Janet stayed in a recovery house where residents were encouraged to make their own rules and choose the activities they wished to be involved in (O’Hagan, 2014). By allowing consumers choice, the therapeutic relationship strengthens (AHMC, 2013).

It is important for MHPs to maintain a therapeutic, empathetic relationship with the consumer to reduce the impression of authority (AHMC, 2013). The relationship between the nurse and Janet in scenario one was authoritative an intimidating. Janet was distressed by the seclusion after she was physically and chemically restrained, in which the nurse told her to “be quiet”. The nurse in scenario two showed Janet dignity and respect while sitting with her in a time where she needed support (O’Hagan. 2014). This approach was non-authoritative and de-escalated the situation. Maintaining a therapeutic relationship with the consumer can assist in preventing disturbed behaviour, avoiding unnecessary escalation (Ministry of Health[MH], 2012). Using the clinical recovery method in scenario one, the nurse immediately resorted to seclusion, and both physical and chemical restraint instead of actively listening and allowing Janet to express her feelings of distress (MH, 2012; O’Hagan, 2014). The situation in scenario two avoided the need for seclusion and restraint. The psychiatrist respected Janet’s uniqueness as an individual, calmly explaining why they wanted her to stay in the facility and the benefits of receiving medication (AGDH, 2010; O’Hagan, 2014). Where MHPs engage with the consumer respectfully, in a non-judgmental manner; a positive culture will thrive throughout mental health services and the community. These actions will reduce the stigma surrounding mental health (Fisher, 1993). In recent times efforts have been made within Australia to reduce the stigma of mental health within the community (Evans et al., 2017). Throughout scenario one, MHPs, along with members of the community defined Janet by her mental health challenges, leaving her with feelings of inferiority and worthlessness (O’Hagan, 2014). After Janet’s suicide attempt the doctor spoke condescendingly to her commenting, “That was a silly thing to do”. The police also unnecessarily escalated the incident involving her euphoria and mocked her for being a ‘nutter’. Scenario two promoted mental health awareness within mental health services and the community, allowing Janet to feel accepted. The psychiatrist

accepted Janet’s euphoria with no judgment stating “… you need a complete break from saving people or you will collapse” (O’Hagan, 2014). The police respected Janet’s thought process at the time and asked her questions instead of using physical restraint. MHWs can promote awareness through MHW advocacy and involving the community in consumer recovery. MHW advocacy assists consumers in determining their recovery goals and the ability to connect with the community (Evans et al., 2017). Scenario one portrayed a complete lack of advocacy in the times where Janet required counseling for prior sexual abuse (O’Hagan, 2014). The psychiatrist neglected Janet’s sexual abuse as a contributing factor to her psychosis and failed to arrange appropriate counseling. The lack of advocacy diminished Janet’s hopes for recovery. In scenario two, a peer support worker acknowledged her sexual abuse and arranged free counseling for Janet to deal with her trauma. Janet’s recovery progressed through the support she received MHWs, her family and the community. Advocacy of family and community involvement plays an important role in a consumer’s ongoing recovery (AHMC, 2013). Scenario one discouraged family and community participation, leaving Janet feeling ostracised from her family and friends. Janet’s mother found the psychiatrist evasive and impractical when she tried to seek advice to help in Janet’s recovery (O’Hagan, 2014). The lack of advocacy by MHPs led Janet to lose her residence, unable to cope with her nursing studies, and detaching herself from family and social networks. The peer support worker in scenario two connected Janet’s family with a support group, along with liaising with Janet’s nursing school to surround her with social groups of similar lived experiences. As a result of this support, Janet started to believe there was hope in recovery and she could enjoy her life. Hope plays a central role in the belief that recovery is possible (Jacobson & Greenley, 2001). Janet’s hopes of recovery diminished in scenario one as she felt the MHPs were not interested the

consumers’ recovery. The “career psychiatric patients” around Janet made her feel gloomy about her future (O’Hagan, 2014). The peer support in scenario two allowed Janet to gain hope for recovery through their lived experiences (van Gestel-Timmermans et al., 2012). The peer support worker helped Janet develop self-efficacy and plan future aspirations including completing her nursing studies, seeking further education in recovery and joining a photography course. The principles of recovery characterise the importance of maintaining the hope within the consumer to enhance care and recovery (AHMC, 2013). The journey of recovery is both individual and immeasurable (AHMC, 2013). There is a supporting role for clinical recovery in mental health alongside personal recovery (Glover, 2012). In relation to Janet’s scenarios, the benefits of the principles of recovery oriented practice have been compared to clinical recovery. These principles allowed Janet to be at the centre of her care, resulting in a successful therapeutic relationship with MHWs. The stigma of mental health was reduced through awareness and MHWs providing the advocacy that Janet needed. These principles aided Janet in gaining hope for her recovery and for the future.

References Anthony, W. A. (1993). Recovery from mental illness: the guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal 16(4): 11–23. Doi: 10.1037/h0095104 Australian Government Department of Health. (2010). Principles of recovery oriented mental health practice. Retrieved from http://www.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-i-nongovtoc~mental-pubs-i-nongov-pri Australian Health Ministers’ Advisory Council. (2013). A national framework for recovery-oriented mental health services: Guide for practitioners and provider. Evans, K., Nizette, D., & O’Briend, A. (2017). Psychiatric and Mental Health Nursing (4th Ed.). Chatswood, NSW: Elsevier Australia. Fisher, D. B. (1993). Towards a positive culture of healing. In Massachusetts Department of Mental Health (Ed.), The DMH core curriculum: Consumer empowerment and recovery, part, Part I. Boston: Commonwealth of Massachusetts Department of Mental Health. Glover, H. (2012) Recovery, lifelong learning, empowerment and social inclusions: is a new paradigm emerging? In P. Ryan, S. Ramon, & T. Greacen. Empowerment, Lifelong Learning and Recovery in Mental Health: Towards a New Paradigm. London: Palgrave Publishers Jacobson, N. Greenley, D. (2001) What is recovery? A conceptual model and explication. Psychiatric Services, 52(4), 482-485. Doi: 10.1176/appi.ps.52.4.482 Morrow, M. (2011). Recovery: progressive paradigm or neoliberalism. Paper presented at Beyond access: from disability rights to disability justice. Society for Disability Studies: San Jose, CA. NSW Government Ministry of Health. (2012). Aggression, Seclusion & Restraint in Mental Health Facilities in NSW [Policy]. Retrieved from http://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2012_035.pdf O’Hagan, M. (2014). Madness Made Me. New Zealand: Open Box Press Slade, M., Amering, M., Farkas, M., Hamilton B., O’Hagan, M., Panther, G., Perkins, R., Shepherd, G., Tse, S., Whitley, R. ( 2014) Uses and abuses of recovery: implementing recovery-oriented practices in mental health systems. World Psychiatry 13(1), 12–20. Doi: 10.1002/wps.20084. van Gestel-Timmermans, H., Brouwers, E. P. M., van Assen, M, A. L. M., van Nieuwenhuizen, C. (2012). Effects of a Peer-Run Course on Recovery From Serious Mental Illness: A Randomized Controlled Trial. Psychiatric Services 63(1) 54-60. Doi: 10.1176/appi.ps.201000450 Whitely, R., Palmer, V., & Gunn, J. (2015). Recovery from severe mental illness. CMAJ 187 (13): 951-952. Doi: 10.1503/cmaj.141558...