Mental Health and Recovery - Dissertation Example

Mental Health and Recovery Physical and mental health are the primary components of happiness for people who are able to have an easy path towards active, social and successful life. However, people who suffer from physical and mental illness have to face lot of obstacles and challenges of personal and social nature. Particularly those people who suffer from mental illness. History is a witness to the cruel and barbarous treatment that people suffering from mental illness have gone through at the hands of people who were not mentally ill. From the 16th century where people suffering from mental illness were hanged and burnt saying that they were possessed by spirits to the 19th century where science has advanced to the level where people from medical science can learn abut the major mental illness through brain imaging, an approach to mental disorder has come a long way ( History of mental illness). There have been many treatments and practices proposed to cure and prevent the mental illnesses. During the 1960’s and the 1970’s the practice of shock treatment was very common. Shock treatment was used to cause seizure to the brain. It was noted that even though it helped in some cases, people suffering from mental illness were treated to excessive , strong and numerous shock treatments than actually needed. The institutionalization of the patients led to many malpractices and inhuman treatment towards people suffering from mental illness. The advent of drugs and the social awareness about the mental illness led to the process of deinstitutionalization (Ribeiro). Deinstitutionalization during the 1960’s and the 1970’s was a process where the institutions sheltering the people who were mentally ill were closed with the intention releasing the patients and letting them live a life as the people with normal mental condition live. However, things did not work out as intended and deinstitutionalization caused more harm than good. It was because the patients who were released were still ill and were in need of constant supervision and care. Because these people were mentally unstable and had violent behavior patterns, they became a threat to the people and indulged in violent acts that led to physical injuries and murders. This has led to them being treated as criminals than mentally ill patients and hence rather than getting a treatment from a doctor they are being put into prison and hence worsening the condition(Ribeiro) . According to the Washington, D.C., metropolitan area, we estimate that approximately 1,000 homicides a year are committed by the people who are suffering from severe mental illness and are not taking the medicine that they are prescribed to keep their unstable behavior in control. According to a 1992 study, by Bruce Link of the Columbia University School of Public Health, people suffering from serious mental illness are three times more likely to indulge in life threatening violent act that the people who are mentally stable and healthy (Torrey and Zdanowicz). This shows that people suffering from severe mental disorder not only need care but also need to be monitored constantly and are to be kept under the treatment regularly so that they are helped properly during the episodic outburst of the behavior. Since then, number of studies, theories and approaches were introduced in the world of medical and psychological field to help the people suffering from mental illness recover with dignity, respect, confidence and satisfaction. There are many practices that can help people from mental illness recover and lead a normal and healthy life. However, at the same time, there are many obstacles and hindrances also. It is a challenge to professionals and people undergoing recovery from mental illness to come out strong and safe from all the ordeals and the obstacles that they are facing. For that there are many best practices available. The practices to enhance, promote and facilitate the recovery of people suffering from mental illness: Early intervention: People suffering from mental illness suffer a stigma of the disease and that leads to exclusion, unemployment, poor health and family breakdown. It has been found that because of their condition they are neglected and two third of the population does not get the treatment in 12 months. Young people suffering from mental health problems experience sense of heightened stress and worry which lead to increased risk of mental and psychological disorder. Most common problems faced by the adolescents are depression, anxiety, social phobia, personality and eating disorders, and self destructive behavior. This can hamper the social growth, success in education and professional life and also the health of personal relationships. However, if the signs of the mental disorders are taken seriously and the professionals are consulted at the right time, then early intervention can help the young people to become self-reliant, healthy and confident so that they can follow a lifestyle that can help them to grow, achieve consistent happiness and productive relationships. Occupational therapy helps people to maintain a healthy lifestyle by engaging them in meaningful and playful tasks that can help them to maintain productivity, self-care and understanding and enjoy the leisure in the wake of stressful and demanding professional life(Hardaker, Halcomb, Griffiths, Bolzan and Arblaster 3). Life is a balance of professional and personal goals. Professional success is good as long as it gives you happiness, satisfaction, health and loving relationships. Mental health is possible only when the balance of life is achieved. Occupational therapy with early intervention can help people to achieve that balance. So early intervention is one of the best practices. Psychotherapy: Psychotherapy is one of the practices that facilitates the recovery by getting the people suffering from mental illness involved in the solutions of their problems. By asking empowering questions during the session and challenging the negative beliefs of the client helps the client to go deep into the root of the problem( Nelon-Jones 72). It helps the clients to understand their own thinking patterns and the point of views that makes them to act and behave the way they do. The interactions mostly end up in the clients realizing that more than anything else, it is their thinking that is responsible for their condition and hence empower them into thinking that they can control their life( Nelon-Jones 86). Psychotherapy is often mistaken for an ineffective treatment for the mentally ill. Psychotherapy is used to treat problems like depression, anxiety, tensions, panic, and phobias. A study revealed that 44% of people who were going through a poor state of mind prior to undergoing psychotherapy said that they felt good after treatment. It was also found that mostly everyone who undergoes psychotherapy enjoys a boost in confidence and increase in self-esteem. This is because psychotherapy helps them to understand their life and helps them to tackle the challenges by changing the beliefs(Ribeiro) The health services and the people involved: People who are old and are suffering from mental or physical illness suffer a great deal of abuse at the hands of the carer. The mental health services by deinstitutionalization has created a great danger for the society (Abel 52). People who are old and are suffering from mental illness live under the care of their wives, daughter and sisters. Being a carer is not an easy job. The relationship with the dependent is always strained as the demands can be grueling. The study has found that the women from white ethnic background are at risk of abuse from their children due to the carer having a drinking problem or as a result of strained and negative relationship from the past((Abel 55). The practice by general practitioners has been criticized regarding the drug prescription. The study has shown that there has been over-diagnosis of depression in old people however, there was no action taken to cure it. Also the concern was raised over the prescription of Bnezodiazeoine which causes confusion and addiction(Abel 56). Although the prescription has fallen the 60% of patients were seen taking it even when it is not needed. People suffering from depression keep contact with health services, however do not receive any formal treatment for their mental condition(Abel 57). Being a carer for people suffering from mental illness is a stressful job. Carers have to take care of the financial aspect, physical needs and emotional needs of the person being taken care of. Society does not take care of the people having mental illness and fail to understand how to behave or interact with them. It is the carer who becomes a communication link between the patient and the society. Moreover, the carer also has to experience the unstable, violent and difficult behavior on the part of the patient. The difficult situations and the interactions that the carer has to go through, create a lot of emotional and physical strain for the carer. Just imagine yourself being with people who have negative attitudes towards life. If you have to interact with them on day to day basis, there are many chances of you becoming negative towards life and we are not talking about people who are mentally healthy but have a negative energy patter. It is evident from studies that carer suffers from deterioration in physical health. There are also chances of carer getting mentally unstable and negative after being in constant service of people who are mentally ill. It is extremely important to train the carer on the caring technique needed for a particular mental condition of the person she is caring for. Not only that but the health services should create awareness programs where the carers can be trained on taking care of their own physical and mental health when handling the responsibility of caring for people who are mentally ill(Abel 99). Services and outcome (Anthony) The services provided by the clinical organizations and the medical fraternities have to go beyond the focus on the disease and help the patients to become aware of the physical, social and the mental conditions related to the mental illness they are suffering from. It will make them capable of becoming interdependent rather than depend on others for their life. Treatment of the disease is not the only aim. There are different ways in which the service can prove to be complete and whole rather than something that treats the disease. People suffering from mental illness have to fight not just their disease but also the treatment they get from society. It is only recently that people suffering from mental illness are getting justice from the scientific world where they are coming up with different services where the user and the carer both can benefit from the services. The practice of releasing the people suffering from mental health from the institutions led to a need of creation of adequate and competitive services from community(Anthony 521). Recovery not only means helping yourself curing the disease but it also means to recover form the negative treatment that people suffering from mental illness experience like social stigma, exclusion from social interactions, inferior and insulting treatment and neglect. For people suffering from mental illness, recovery means a complete change in attitude, emotional pattern, goals, outlook, values and roles of life(Anthony 527). Recovery means coming out of the illness and also the effects that came with the illness. Recovery based mental health sytem: The Recovery focused mental health system was created with the help of the guidance from people who have gone through the problem and have recovered. The program created for recovery proposes gave the vision of the understandings which can help the person to recover from the mental illness with maintaining respect and dignity for himself (Anthony 531). 1. Recovery can occur without professional intervention : Recovery is a natural process. The real key is with the person who is recovering and not the professional. The professional is just there to help and facilitate the recovery. People providing mental health services should realize the importance of fun, play, music and art in the process of recovery as recovery is not possible only with health services. 2. Recovery is possible with the presence of close relatives and friends who believe in and stand by the person in need of recovery: Recovery is an emotional and human experience. Recovery becomes possible when the person in need of recovery gets support, love, understanding and healing touch from the people who love him and shows their confidence in him. 3. A recovery vision is not a function of one’s theory about the causes of mental illness: The vision does not participate in a debate of whether mental illness is a result of psychological or physical defect. It believes that no matter what is the cause, the recovery is possible even with the worst physical conditions. 4. Recovery can occur even though symptoms reoccur: Recurring episodes of symptoms in no way means that recovery is not happening. 5. Recovery changes the frequency of duration of symptoms: Recovery leads to symptoms interfering with functioning less often and for briefer period of time. 6. Recovery does not feel like linear process: The process, even though have a trend of going upward, is not steady. There are sudden insights, occurrence of intense feelings and so the process feels unplanned. 7. Recovery from consequences is more difficult than the illness itself: People recovering from mental illness have realized that many times it is more difficult to cope and recover from the social and personal consequences of mental illness like stigma, loss of self-esteem, frustration and worthlessness, than the recovery from the illness itself. 8. Recovery doesn’t mean running away from the fact that one was really ill: When people recover from mental illness, sometimes they refuse to accept that they were really ill. They think that they were diagnosed wrong and hence had to go through all treatment. Recovery vision, as it has been created with the help of people who have gone through the process of recovery from mental illness, helps to show how the assumptions can help the recipient of the health services and not just focus on how the health services should be functioned. The tidal model: The tidal model is a practice of recovery that believes in taking a spiritual approach to recovery. It believes that the person undergoing the recovery from the mental illness should be treated as an emotional and living human being rather than only as a patient. By encouraging people to talk about themselves and letting others know their experiences, the tidal model helps people suffering from the mental illness to understand their life from third person perspective. This approach helps them to realize that they are not different from others in any sense but are one of the millions who go through those kind of experiences. It helps them to accept their reality, reduces the conflict and hence make the recovery process easy, steady. The tidal process has the ability to heal the person from deep within. The Tidal Model believes on treating the patient as per the current needs of the patient rather than taking a standard treatment format. It takes into consideration the opinion of the patient and focuses on the issues that are necessary to be tackled at that particular time. While treating a person suffering from mental illness, the professionals try to understand the beliefs and the personal theories of the patients so that the recovery becomes easy by facilitating the treatment which is in sync with their theories. The participation of the common people around the patient is involved and encouraged rather than numerous interactions with the professionals. This helps the recovery to be easy, emotionally satisfying and touching rather than worrisome and negative (Barker 40). Strength based approach: The strength based approach to recovery was proposed to enhance the feeling of positiveness and independence in the people who are undergoing the treatment for mental illness. The approach was designed to enhance and facilitate respect, dignity, self-esteem and self-reliance not only during the process of recovery but also after the person is recovered. In 2006, Rapp and Goscha proposed six recovery principles which were the basis of the strength based recovery (McCormack 8). They were: 1. People suffering from mental illness can recover and transform their lives and so can again lead a healthy, normal and socially active life. 2. Focus is on individual strength rather than weaknesses. 3. Community can help to be a productive area of resources. 4. The client decides the way the helping and the recovery process should go. 5. The relationship between the professional and the person who is undergoing recovery should be given immense importance. 6. The primary setting of the work is community and not institute. These are some of the best practices that can be utilized to heal and help the patients suffering from mental illness completely. However, the recovery does not end with the end of the recovery process. When people suffering from mental illness come out of the medical treatments and sessions, they have to face another obstacle and that is the stigma that they get of being mentally ‘retarded’ person. People suffering from mental illness have to go through lots of challenges in life. They not only go through the pain of experiencing mental instability and inconsistent behavior patterns but also have to face the stigma of being ‘mentally ill’. They suffer exclusion from their friends, relatives and all the social activities as if they are not human beings and are some people who are punished with the inabilities (Repper and Perkins 25).They are hated, blamed or are pitied for their condition. They are considered helpless and so not fit to perform any personal or social duty. (Repper and Perkins 29).The discrimination is especially faced by people who are diagnosed mentally ill. In the year 1996, a survey found that 34% people suffering from mental illness were either dismissed or were forced to leave, 69% were discouraged from applying for the job with the fear of unfair treatment, 47% experienced public abuse and harassment and 26% had to move from their locality because of harassment (Repper and Perkins 33). There are severe and ghastly abuse people having mental illness have to face like being spit at, called by insulting names and getting eggs thrown at. These violent and insulting treatment from the other people make the people suffering from mental illness fearful and lonely. They avoid contacts and social involvement. It can even lead to people not coming out of their house. The effect is unemployment, poverty, lack of access to educational and training institutes and disrupted and disharmonious personal relationships. This in turn can result in drug addiction and worsening of the mental illness rather than recovery and cure. It was also found that people who try to befriend the people who are mentally ill are targeted and are devalued for being with the them. They also bear the stigma of being with the mentally challenged people and hence become the victim of doubt and exclusion. So even if there are people who want to help the mentally challenged people, they are not encouraged by others to do so and hence even this hope is lost. Racism also is a major obstacle in the path of recovery for people suffering from mental illness (Repper and Perkins 4). The discrimination that people from certain ethnic background like black or Hispanic experience make them feel like an outsider and have a feeling of not belonging anywhere. Harmony, peace of mind and feeling of belonging is extremely important for a healthy and happy mind. People suffering from racism, discrimination and exclusion lack this feeling. They feel unwanted and lose the meaning of life. Social support has been associated with many benefits like improvement in functioning, motivation for leading a active and successful life, increase in self-esteem and recovery. However, when people suffering from mental illness experience exclusion it results in feeling of worthlessness, reduced potential for self of belonging to the community, negative gloominess and passivity(McCorkle, Rogers , Dunn, Lyass and Wan). It becomes a responsibility of the therapists and common people to help the people recovering from mental illness by providing friendship, support, love and understanding towards them. They should be included in all the social activities and should be given opportunity to enjoy the social rights equally. The therapists should encourage political voting among the people who have recovering from mental problems (Nash). It was found that people recovered from mental illness are capable of handling the responsibilities of the job if their attitude and belief about themselves is changed. They had the skills and the resources to be a part of team but what they lacked was confidence to come in open and promote their skills. The therapists need to help them maintain their confidence and mental health by regularly helping them to do self assessment and boost their confidence. This will lead to employment and hence will increase confident in leading a normal social life (Woodside, Schell and Allison-Hedges). Tackling Learnt helplessness: Learnt helplessness is the process where the people suffering from mental illness become dependent on the professional carers even after recovering and becoming capable of handling the personal chores on their own (Watkins 91). The challenges and the difficulties of life make them to take the shelter of helplessness and thus crate problem in their path of complete recovery and self-reliance. Deegan, in 1992, has stated that the lack of confidence and the despair the people going through recovery makes them to take the aid of helplessness. He says that learnt helplessness is a result of dampening of the spirit (Watkins 101). Learnt helplessness can be tackled by making the relationship between the carer and the patient meaningful and interdependent by steadily helping and encouraging g the person to take part in decision making, problem solving and day to day activities. Learnt helplessness creates a behavior pattern and habit of being passive towards the daily activities of life. People who adopt the behavior of learnt helplessness enjoys very few positive experiences in life. People are trained to gain confidence in life when they experience victory, reward and a pat on the back. These positive reinforcements makes them to repeat the performance positively and creates a pattern of success oriented behavior. However, people who are passive do not think and act and hence do not gain any skill or confidence. Learnt helplessness can be a response to the repeated negative reaction from people and torture. When people come to know that they cannot come out of the bad situation no matter what they do, they adopt a passive and dependent behavior pattern. A happy and nurtured background do not indulge in learnt helplessness (Waller, Mahony and Mahony 34). Pactices and approaches: Fritjof Capra has been quoted saying that “To reincorporate the notion of healing into the theory and practice of medicine, medical science will have to transcend its narrow view of health and illness” (Bennett 11). Meditation can help in preventing depression, anger and mania (Bennett 9). Spirituality can help people focus on strength and positive aspects of life by creating and following their own path. Doing the activities that help you connect with your inner peace and inner self facilitates happiness and fulfillment. Prayer and meditation gives you strength and mental stillness that helps one to deal with daily challenges and stress with confidence and calmness ( Spitrituality). Spirituality is an approach that can help the people suffering from mental illness to have a social and a ‘whole’ perspective about their life. The discrimination and the prejudice they go through makes their life miserable and unbearable. Faith is an aspect of life that can heal and give a belief that everyone has a reason to be in this world. The challenges and the obstacles that come with the diseases can be overcome with prayers and meditations. However, the question remains, are we giving the people suffering from mental illness a support and love they deserve. Society is responsible for their discouragement and despair. If we give them space and the right to live a normal and respectful life, they will be more willing, effortful and happy to recover from the mental illness. However, if we hate them and treat them as helpless people, they will not feel like coming out of their despair. The Society and team of professional practitioners can work together to make this world a better place for the people suffering from mental illness. They have a right and the ability to lead a successful, happy and complete life. References : History of mental illness http://www.mentalwellness.com/mentalwellness/history.html (last updated October 3 2007) [Accessed on May 22, 2009] Ribeiro, C., Deinstitutionalization of the Mentally Ill. August 01, 2006 Retrieved from http://www.associatedcontent.com/article/47201/deinstitutionalization_of_the_mentally.html?cat=17 [Accessed on May 22, 2009] Hardaker, l., Halcomb, E., Griffiths,R, Bolzan , N and Arblaster,A. The role of the occupational therapist in adolescent mental health: A critical review of the literature Australian e-Journal for the Advancement of Mental Health (AeJAMH), Volume 6, Issue 3, 2007 Anthony , W. Recovery from Mental Illness: The Guiding Vision of the Mental Health Service System in the 1990s Psychosocial Rehabilitation Journal,1993, 16(4), 11–23 CHANGING TOWARD THE FUTURE Beginners guide. Tidal mode; Retrieved from http://www.tidal-model.com/Beginner's%20guide.htm [Accessed on May 23, 2009] Barker, P. The tidal model: a guide for mental health professionals Psychology Press, 2005 McCormack, J. (2007) Recovery and Strengths Based Practice. SRN Discussion Paper Series. Report No.6. Glasgow, Scottish Recovery Network. Repper , J and Perkins, R Social inclusion and recovery: a model for mental health practice Elsevier Health Sciences, 2003 McCorkle, B., Rogers,S., Dunn,E., Lyass,A. and Wan. Increasing Social Support for Individuals with Serious Mental Illness: Evaluating the Compeer Model of Intentional Friendship Community Mental Health. Nash M. Voting Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12472823 [Accesses May 23, 2009] Woodside, S and Allison-Hedges. Listening for Recovery. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/16570840 [Accesses May 23, 2009] Watkins , P. Mental health nursing: the art of compassionate care Elsevier Health Sciences, 2000 Waller, D., Mahony, J., and Mahony, J. Treatment of addiction: current issues for arts therapies Routledge, 1999 Bennett , B. Mental Illness: A Guide to Recovery Trafford Publishing, 2004 Spirituality and mental illness, Rethink Retrieved from http://www.rethink.org/living_with_mental_illness/everyday_living/spirituality/index.html [Accesses May 23, 2009] Torrey E, and Zdanowicz, M. .The Wall Street Journal, Why deinstitutionalization turned deadly August 4, 1998 Retrieved from http://www.psychlaws.org/generalresources/Article2.htm [Accesses May 23, 2009] Abel, K. Planning community mental health services for women: a multiprofessional handbook Routledge, 1996 Read More