Principles of Recovery in Mental Wellbeing - Essay Example

Principles of Recovery in Mental Wellbeing Mental well being is best achieved through comprehensive recovery approaches where the patient’s needs are placed before the need of the program or institution. To achieve and lead a productive life, it is imperative that individuals uphold mental wellness. Individuals with mental illness require support in making recovery (Loat, 2011). Traditionally mental illness treatment approach was clinically based where a diagnosis was made and the individual confined while taking medication and receiving counseling. The goal of this type of treatment was for the individual to fit in socially as well as getting rid of the symptoms of mental illness. The emergence of another approach to dealing with mental illnesses involves the patient identifying that they have a problem and seeking professional help to aid in change of attitude and to manage their lives. This approach is patient-based and decision-making is inclusive of the patient. This approach focuses on empowerment and self-management. Question 1 In Eleanor’s case, both the traditional and recovery approaches were used. The first time she was referred to a “specialist”, she explains that she felt she had gone in a normal individual and came out a schizophrenic. This is a traditional approach given her doctor was quick to make a diagnosis on her on that initial meeting and planning her treatment based on this professional-based assessment (Slade, 2009). Here, her feelings about the way forward did not seem to matter as she was not consulted rather she was just informed of what needed to be done. She claims that the doctor’s focus was on the voices she was hearing and kept referring to this all through the meeting. The fact that this symptom was indicative of mental illness is a traditional approach of looking at symptoms to make a diagnosis and start medication. The reasons for these manifestations meant little to the doctor and her anxieties brought on by the significant changes in her life as well as those brought on by adolescence were not considered (Slade, 2009). She was put on medication and institutionalized in a mental institution for treatment. Although her institutionalization seemed voluntary at first, she later discovered that she had no choice but to comply. The rationale was that she was a risk to herself and possibly others and there was need for supervision. In this case, the staff at the psychiatric hospital and according to Slade (2009), it constitutes a traditional approach. The clinician had already labeled her a paranoid schizophrenic on the first visit and while under sedation she claims to have heard a doctor discussing her issue and felt stigmatized and alienated from the world she new. This approach meant that a diagnosis had been made based on her symptoms and the treatment approach was that of relieving these symptoms (Slade, 2009). During confinement, she felt compelled to admit that she had a problem since failing to admitting this meant that she was not getting any better and this in turn meant continued admission and medication. When she finally accepted that she was troubled, things got better and she was eventually discharged. This approach was program based and the focus was on the disease, meaning that realizing or seeming to realize her illness meant that she was recovering. The practitioners expected a certain response regardless of the state of the patient. Compliance meant progress and that the program was effective in treating the patient. It was later with her visits to Dr. Pat that she was asked about her opinion and reason for seeking help. This was the beginning of her recovery. The doctor further inquired from her about what she thought would be the best approach to help her get better. This is the recovery approach whose rationale was to base the treatment on patient’s needs and include her in decision making on matters regarding her well being. Her right to choose the course of treatment as well as her role in decision-making made her recovery at an individual level. She explains that Dr. Pat encouraged her to open up about her feelings and concerns regarding her mental wellbeing. The Doctor listened to her regarding her struggles with leaving home for college, the pressures of her life in school as well as the voices she was hearing. Here therapy was oriented on recovery as the doctor was trying to understand what she was going through and in doing so help her plan for recovery. Through these sessions, she became more voiced and her confidence increased. She was able to practice her right of choice regarding the way forward and this according to Slade (2009) is the recovery approach to mental well being. She also claims that with Dr. Pat she felt relevant and decisions about her care were based on her needs. She was involved in decision making about her wellbeing and allowed choices on what would make her get better. The rationale here was that of the patient taking the lead in their recovery efforts. This further fostered self-management in that she became increasingly aware of her state, was able to identify what triggered the voice (s) and was able to deal with this effectively. Question 2 Recovery is best achieved where the patient is encouraged to have hope and assisted in planning for their recovery. They should be encouraged to participate in their recovery involving all the areas and aspects of their lives. Empowerment and self management is best achieved through the patient being encouraged and supported to take control of their life. It is the nurse’s and practitioner’s mandate to steer a patient towards activities that enable the patient to make decisions and choices about their lives freely. The patient should be helped to understand that they have rights regarding their lives and no one should make decisions for them. With this understanding, they will be able to then take the necessary actions to enact their choices. This is in order to achieve sustainable change in their mental and physical state (Hafal, 2009). From the beginning of treatment, that is when she first visited a psychiatrist, Eleanor should have not only been advised on the way forward but also involved in establishing goals of therapy as well as planning how to achieve these goals. However, in this case, the interaction was where the doctor just assessed, diagnosed and informed her of her illness and the need for institutionalization. This clearly demonstrates that the approach was not that of empowerment. She was also not permitted any choice regarding treatment and instead confined and medicated. This was an infringement of her right of choice. It also appeared that there were issues with confidentiality in that other students became aware of her “state” and used this to stage personal attacks on her, further worsening the state of her mind. The rights to privacy as well as the ethical standards of the psychiatric nurse are at question here according to Fortinash& Holoday-Worret (2012). The psychiatrists and nurses involved in her treatment with the exception of Dr. Pat, labeled her a schizophrenic a label that attracted discrimination and stigma at school further disabling her mental state (Centre for Addiction and Mental Health, 2011). The doctors should have discussed with her the need for therapy at the same time allowing her to make the choice to accept their help when she had realized that she needed it. Allowing her to identify and sort out her issues regarding her search for identity, homesickness and the everyday struggles instead of dismissing her and attributing her feelings to a diseased mind would have fostered empowerment, self-management, and speed up recovery. After her struggles and several confinements and “treatments”, she finally met Dr. Pat and she claims that this was the beginning of her journey towards recovery. Dr Pat’s approach was a holistic one in that all the aspects of her life were assessed. His approach was that of empowerment and self management. This is clear in that he involved her in decision making regarding her therapy and medication. Her moving back home served to bring stability back into her life. The support of family members kick started her recovery and formed a basis for therapy and further treatment. She accepted that she had a problem and sought professional help on her own terms including practicing her right to choice whereby she told the doctor that she felt the medicine needed to be reduced to get rid of the adverse side effects she was experiencing. She came to understand that the voice she was hearing was a result of her state of mind. In that, they came when she was in distress. This realization has enabled her to anticipate and deal with such incidents in a controlled manner. She is able to practice self-control and not heed the instructions of any of the voices. This demonstrates self management as she is in control of her life both physically and mentally. She is able to plan her life and future given she has hope and aspirations and the feelings of despair and hopelessness have receded. This has enabled her to be more productive and lead a healthy lifestyle where her family is involved in her life and she resumed her studies. This shows that she is control of her life and working towards sustaining her mental and physical well being. She is currently involved with programs supporting and helping teenagers going through what she had experienced. This demonstrates the value that has been added to her life and her progress thus far. Question 3 To enhance sustained recovery, there is need for standards that allow patients to access support groups or programs. This could be individual based or group based therapy. These are national health standards for mental health and are put into practice by Mental Health Services (MHS) (Bucky, Callan, & Stricker, 2005). According to standard 10.1.2, the clinicians should have treated Eleanor with respect and dignity. For example while under sedation she mentions that she overheard a doctor discussing her case as if she was not there. The passivity of the whole affair during her early treatment and before Dr. Pat, was not respectful of her rights, needs or opinions (Bucky, Callan, & Stricker, 2005). Standard 10.1.4 requires that clinicians and nurses should promote self determination and independence in the journey of recovery. In this case and again with exception of Dr. Pat, they did not allow her to voice her opinion nor involved her in the decision making regarding her care. For example, she should not have been forcefully confined when she first visited the psychologist. Tricking her into admitting herself was also an infringement on her rights (Bucky, Callan, & Stricker, 2005). Standard 10.1.5 requires Clinicians and nurses to be in the forefront to encourage social mobility and inclusion of their patients as well as protect them as much as possible from stigma and discrimination through confidentiality. This was not the case for example, when Eleanor explains her ordeal when she went back to college after her 3 months confinement only to find that everyone was aware of the details of her state of mind. She was harassed and ridiculed because of this, further worsening the state of her mind (McQuistion, 2012). Standard 10.1.1 stipulates that clinicians and nurses should use recovery oriented approach in mental health care. This was not the case especially with the practitioners involved in her initial treatment. For example, to encourage personal responsibility, they should have involved her in actions aimed at changing her attitude, examining her feelings and enabling her emotional and mental growth. The hospital should have allowed personal recovery through assigning to her responsibilities on matters involving her issues and act as a guide through the recovery process instead of dominating the whole affair. Standard 10.1.9 requires clinicians to be aware of community services available and use the referral system to avail better care to patients. For example, they should have referred her to programs that dealt with teenage psychosis to provided specialized care in her case. This would have speeded up her recovery and mental well being. Community psychiatry is seen as the most effective approach to teenage mental wellness (McQuistion, 2012). References Bucky, S. F., Callan, J. E., & Stricker, G. (2005). Ethical and legal issues for mental health professionals: A comprehensive handbook of principles and standards. Binghamton, NY: Haworth Maltreatment & Trauma Press. Centre for Addiction and Mental Health. (2011). Girls talk: An anti-stigma program for young women to promote understanding of and awareness about depression : facilitators manual. Toronto, Ont: Centre for Addiction and Mental Health. Fortinash, K. M., & Holoday-Worret, P. A. (2012). Psychiatric mental health nursing. St. Louis, MO: Elsevier Mosby. Firth, Lisa. (2011). Mental Wellbeing. Independence Educ Pub. Hafal. (2009). My recovery: a step-by-step plan for people with serious mental illness. Castell-nedd. Retrieved from http://www.hafal.org/hafal/pdf/publications/My recovery.pdf Loat, M. (2011). Mutual support and mental health: A route to recovery. London: Jessica Kingsley Publishers. McQuistion, H. L. (2012). Handbook of community psychiatry. New York: Springer. Slade, M. (2009). 100 ways to support recovery: Aguide for mental health professionals. (Vol. 1). London: Retrieved from http://www.slhd.nsw.gov.au/MHealth/cms/files/Consumer_Info/Recovery_Resources/100_Ways_to_Support_Recovery.pdf Sutton, A. L. (2007). Stress-related disorders sourcebook: Basic consumer health information about stress and stress-related disorders, including types of stress, sources of acute and chronic stress, the impact of stress on the bodys systems, and mental and emotional health problems associated with stress, such as depression, anxiety disorders, substance abuse, posttraumatic stress disorder, and suicide; Along with advice about getting help for stress-related disorders, information about stress management techniques, a glossary of stress-related terms, and a directory of resources for additional help and information. Detroit, MI: Omnigraphics. Western Australia., & Giles, D. (2011). Mental health 2020: Making it personal and everybodys business : reforming Western Australias mental health system. Perth: Mental Health Commission. Read More