Wellness recovery action plan, self management tool - Literature review Example

?Wellness recovery action plan, self management tool Introduction Healthy life is a very important aspect of our everyday life. Piltin observes that “Inappropriate health makes us vulnerable to invasion by dangerous diseases and results in a shortened life span.” Even more serious about our health is the status of our mental health. The mental healthiness of a person speaks a lot about the person’s life in general. This is so because the word ‘mental’ is derived from the word ‘mind’, which has to do with the brain, which scientists tell us controls greater percentage of all our actions. Boyd (2008) notes that the brain is “the wellspring of all human feelings, behaviours, experiences as well as the repository of memory and self-awareness.” The need to have a healthy state of mind should therefore be of great concern to everyone. In ensuring mental health, the role of the individual is very important. This is because each person has a better understanding of himself and how his mind functions than any physician can determine. We are the best interpreters of the functions of our mind as to what makes us happy, what makes us sad and things like that. For this reason, psychologists and other health practitioner with special mention of Mary Ellen have devised methodologies for treating mental health issues that focuses on the sufferer rather than the practitioner. In Ellen’s case, she suggests the use of Wellness Recovery Action Plan to cater for the mental health wellness of people. Forms of mental health issues Mental health is not all about madness or mental retardation. Rather, mental health issues come in diverse forms and ways. The World Health Organisation, WHO (2011) notes that “Mental Health refers to a broad array of activities directly or indirectly related to the mental well-being. It is related to the promotion of well-being, the prevention of mental disorders, and the treatment and rehabilitation of people affected by mental disorders.” Mental health issues include ADHD, eating disorders, obesity, communication, parenting, family relationships, substance abuse, divorce, anger management, anxiety, depression, suicide and a number of other topics (At health, 2011). This means that almost every person at a point in time suffers from one mental health issue or the other. The need to ensure mental wellness is therefore a call of concern for every person regardless of one’s state of physical wellbeing. Effective Application and Value of the Wellness Recovery Action Plan in Inpatient Setting According to Green (2007), “Wellness Recovery Action Plan (WRAP) was originally developed by Mary Ellen is an author, educator and mental health recovery advocate she developed this self-management plan with other like-minded people who wanted to have more control over their illnesses.” The phenomenon has since become widely accepted in helping people deal with their mental health situations. WRAP is a “framework with which you can develop an effective approach to overcoming distressing symptoms and unhelpful behaviour patterns. It is a tool with which you can get more control over your problems (GR/CL, 2004, p.2). The plan is a client-centred approach to ensuring that the sufferer of a particular mental health situation finds solution for himself. WRAP is focused towards the prevention of severe mental health related problems since it is focused on overcoming symptoms of unhealthy mental health situations. This is seen in Green’s description of WRAP as she notes that it is a “structured way of monitoring uncomfortable and distressing symptoms and, through planned responses, reducing, modifying or eliminating those symptoms (2007, p.1).” Though the plan is a self management mechanism, generally focused on the sufferer helping himself, it has been adapted by health practitioners to help clients overcome common mental health issues. One area of health service that has embraced the use of the wellness recovery action plan is the inpatient department of hospitals. An inpatient is a patient who must be hospitalized for at least one night in order to receive medical treatment (Smith, 2011). Most of these patients who would have to prepare their own action plan obviously have mental health related problems. With the use of WRAP at the in inpatient setting, there is the need for the practitioner or mental health care service provider to have a strong command over what the action plan is, how is it developed, how it is used and how the benefits patients. In such a situation, the health practitioner or mental health service provider becomes a facilitator who coaches the patient through the course of the action plan. To effectively use the Wellness Recovery Action Plan as an intervention at the inpatient setting, Green (2007) suggests eight (8) sections of application for both the patient and the health giver. These are wellness, wellness toolbox, daily maintenance, triggers early warning signs, when things are breaking down, crisis plan and post crisis plan. As said earlier, WRAP is a self management strategy and so the action plan is to be prepared by the patient with the surveillance of the health giver. At the first section which is the wellness section, the patient is to give a general description of himself when he is wholly well. This is to say that the patient defines his state of wellness or state of mental well-being. This section is directly linked with the next section where the patient builds a wellness toolbox. This section is a documentation section for what is said at the definition stage. To this regard, the patient makes a general list of things that keep them well and this that alter the stability of their wellbeing. Things that destabilize their wellbeing are thing that they should avoid. A typical example of how to go about this section has been illustrated below: Source: GR/CL, 2004, p.3 Next, the patient is to be guided to build a list of activities and actions to undertake on a regular basis – daily, weekly, month in other to achieve mental wellness. This list is known as daily maintenance. Copeland (2000) observes that “reading through this list daily helps keeps us on truck”. After making a list of what keeps the patient well, he then makes a list of external events or circumstance that may make him feel less well (Green, 2008, p.2). This is known as triggers. Triggers are red lights for the patient, cautioning him on things to avoid doing or things that triggers up suddenly may destabilize his mental wellbeing. Because the triggers bring unpleasant outcomes, each trigger written must be followed by what the patient will do if any of those things happens. Next, the customer defines what must be early warning signs to suggest to the patient that things are not going so well or his wellness had began depreciating. These signs are also listed with action plans as to what the patient will do when such early signs begin showing. The health practitioner must explain to the patient how important this stage of the action plan is. This is because if the action plans that comes with each warning sign is well resourced and adhered to once the implementation of the whole WRAP starts, mental conditions will not grow any where beyond this stage of early warning signs. If on the other hand plans are not put in place to discontinue any negative conditions from going on after the warning sign stage, stages after this level would be devastating and harmful to the patient’s mental health. The next section on the wellness recovery action plan is when things are breaking down. Green (2007) posits that this is a stage in the patient’s mental state when he begins to have “feelings and behaviours that indicate to an individual that things are more serious and that they need to take immediate action to prevent things from worsening” (p.2). At this point, the patient must define how he feels or acts or thinks when situations become uncomfortable, depleting or serious. This section is followed with a crisis plan. Because the stage have reached a crisis level, the patient writes how he should be treated or cared for by others when he can no longer control the situation himself. Copeland (2000) explains why this stage is important in the action plan say “we may find ourselves in a crisis situation where others will need to take over responsibility for our care. We may feel like we are totally out of control.” It is important for the health personnel to know that it is at this point of the action plan alone that there could be a third person and in this case, the health personnel. All this while, the patient would have to be keeping things to himself. This is because of the idea of the WRAP to make treatment self centred and a form of self-management. Following the crisis plan is the post crisis plan. This section will suggest to the health personnel how far he can go with taking responsibility for the patient. This is because at this stage of the action plan, the patient states signs that would show that he is no longer in crisis. At the inpatient setting, it is important for the health practitioner to understand that his role will not be to do things for the patient but only be a supervisor especially from the first section to the point before the crisis plan. The patient is supposed to control the action plan whiles the practitioner ensures that the patient is guided on what to do to constitute the right use of the action plan. If a patient’s condition will grow to the crisis level, then health practitioner are advised to put in place professional methodologies to deal with the mental health situation. Some of these professional methodologies may include counselling, rehabilitation or medication. The type of methodology should be taken from the patient’s action plan as it is included in writing the crisis plan. The values of the wellness recovery action plan lies in two major factors – it is self-oriented and preventive. Because the plan puts the patient ahead of the facilitator, he is able to build an in-depth plan that defines the true him because he knows himself better than any other person. As a matter of fact, there is nothing better than taking charge yourself. Because the plan is prepared and administered by the patient, he develops a deeper sense of trust in it because it is built with himself as the focus. Finally, the action plan is aimed towards preventative healthcare. This is achieved by closely monitoring actions and triggers that are likely to disrupt ones wellness. Copeland (2010) observes that “a WRAP provides a carefully structured system that anyone can use to monitor symptoms and respond to them in a way that reduces or eliminates the possibility of relapse”. Wellness Recovery Action Plan thus keeps the spirit of “prevention is better than cure” alive. REFERENCES At health 2011, ‘Important Mental Health Issues’ Mental Health Touches everyone. Accessed 21 February 2011 Boyd R 2008, ‘Do People Only Use 10 Percent Of Their Brains?’, Scientific American, accessed 21 February 2011 Copeland M E 2000, ‘Guide to developing a WRAP? Wellness Recovery Action Plan’ PsychCentral, accessed 22 February 2011 Copeland M E 2010, ‘Action Recovery Action Plan’ accessed 22 February 2011 Copeland. M E 2002, ‘Wellness Recovery Action Plan’ Peach Press, West Dummerston, USA. Department of Health 1999, ‘National Service Framework: For Mental Health’ Stationary Office, London. GR/CL, 2004, ‘Wellness Recovery Plan’, WRAP Personal Workbook’ accessed 21 February 2011 National Institute for Clinical Excellence 2002, ‘Schizophrenia. Core interventions in the treatment and management of schizophrenia in primary and secondary care.’ National Collaborating Centre fore Mental Health, London. Piltin D 2010, ‘The Importance of Good Health and How to Achieve It’ World Wide Health. Accessed 20 February 2011 Smith S E 2011, ‘What is an Inpatient?’ Wise Geeks, accessed 20 February 2011 World Health Organisation, WHO 2011, ‘Mental Health’ Health Issues, accessed 20 February 2011 Read More