Recovery Model in Mental Health and the Role of Nurses - Essay Example

HNN222 AT2 Mental health and recovery (Student name) (COURSE No.) (Lecturer) (University) (Date) The concept of recovery has become increasing popular in mental health service system. The current mental health services are transforming towards a recovery-orientated care at the governmental, organizational, team and individual levels (Stanton & Tooth 2013). The term “recovery” is defined as individuals living a productive and purposeful life despite having severe mental disorders (Malinovsky et al. 2013). For patients with mental illness, it does not mean a complete recovery like in physical health problems but, involves being in full control of their lives despite their condition (Stanton & Tooth 2013). Under the traditional mental health practice, health professionals focus on solving problems for consumers (problem-focused, protectiveness, compliance) (Malinovsky et al. 2013). On the other hand, recovery-orientated services are directed by consumer’s goal and concentrate on building consumers’ strength to function independently (Onken et al., 2007). There are several definitions of recovery in a mental health context. However, Liberman et al., cited in Malinovsky et al, 2013, suggest that breaking the concept into measurable elements will have better effect on evaluating research findings, directing consumer care and educating of mental service providers. Onken et al. (2007) states that both reestablishment of one’s mental health and social integration are two essential components in recovery. According to Mental health foundation, there is no appropriate definition of the concept of recovery for individuals with severe mental problems but the guiding principle around it is "hope" (Pilgrim et al., 2013). This involves the idea that a person is capable of regaining their meaningful life despite experiencing severe mental problems (Pilgrim et al., 2013). Therefore, recovery is universally defined as a holistic approach to mental illness that focuses not just on the symptoms but on the person (Pilgrim et al., 2013). Adoption of a suitable recovery model/approach in any mental health service provider is primary towards meeting consumers’ needs (Johnson, 2014). The process of recovery for persons with mental illness starts with the belief that recovery from mental illness is possible. It goes through step-by-step stages that require patience, commitment and optimism from all the concerned parties (organized system and dedicated support from professionals, friends, and family) (Park et al., 2014). The process proceeds through acceptance of one's mental condition, understanding their situation, acquiring moral and financial support and creating good relationships in a suitable environment (Johnson, 2014). The whole process is a journey and not a destination, therefore, does not guarantee that the patient will finally return to their previous lives but focuses on improvements (Park et al., 2014). Therefore, it is the nurses role to ensure a patient goes through a suitable recovery approach in order to accept, understand and finally join the road towards recovery (Park et al., 2014). Mental healthcare service providers have therefore achieved various transformations as a result of suitable implementation of recovery approaches (Malinovsky et al. 2013). According to Malinovsky et al. (2013), since 2005, a non-profit psychiatric rehabilitation organization in New Jersey has started its transformation towards recovery model. The change included educating staffs and residents about recovery principles and interventions; increasing residents’ responsibility in their recovery and encouraging residents to participate in self-help and peer support program (Malinovsky et al. 2013). Compared to the year before the recovery transformation, there was a 40% decrease in total number of hospitalization days by all residents in the program. In addition, senior staffs also reported a significant improvement in residents’ functioning through adaptation, health and behavior change (Malinovsky et al. 2013). In this manner, the recovery model helped the patients move beyond mere existence and survival through setting new goals that give meaning to their lives. In treatment of individuals with severe mental illness (SMI), a strong working workforce has been linked to improved outcomes such as greater treatment adherence (both pharmacological and psychosocial), lower treatment drop-out rate, increased duration of participation in treatment, improved global functioning, decrease in symptom, severity improved quality of life and an improvement in the perceived mental problem (Malinovsky et al. 2013). In England, the Institute of Psychology, Psychiatry and Neuroscience, has engaged in the transformation of mental health services from the historical aim of achieving clinical recovery to achieving personal recovery (Pilgrim et al, 2013). Personal recovery is centered on what the patient wants (Pilgrim et al., 2013). Therefore, personal recovery requires that the professionals work in partnership with the patients and determine the appropriate decision on what treatment is best for them rather than forcing treatment on them. In this case, the nurses become a bridge between doctors and their patients (Pilgrim et al., 2013). In personal recovery focused services, the nurses and doctors acknowledge the expert opinion every patient have about their illness and symptoms and carefully take into account what they think or feel is important towards their recovery (Amering et. al, 2009). This might involve the setting of goals such as getting a new job, creating new friends, engaging in new activities and living independently for example (Amering et. al, 2009). The role of every nurse working with people with mental illness is to encourage and ensure each patient achieve their recovery goals within a given time period (Amering et. al, 2009). To make quality participation and service delivery to the consumers achievable, the government of England has engaged in the development of research projects since 2009 to enhance recovery from mental illness (Johnson, 2014). One such project was called 'REFOCUS' research programme, specially designed to train frontline staff and ensure their way of service delivery support personal recovery of individuals with mental illnesses (Johnson, 2014). The introduction of training into the recovery model promotes nurses understanding of their patients to ensure care plans are provided based on patient's preferences for treatment (Johnson, 2014). Another recovery project called 'Implementing Recovery through Organizational Change' programme (ImROC) which started in 2011 has seen the employment of peer support workers to work together with mental health professionals (Johnson, 2014). This has helped improve own recovery from mental illnesses by about 40% due to improved understanding of people with mental problems (Johnson, 2014). Current improvements in the treatment and recovery model of mental health issues require the active participation in activities to provide a feeling of care from the society (Stanton et al. 2013). One such improvement involves the development of recovery colleges that provide persons with mental illnesses the opportunity to acquire education and training specially designed to improve their skills while achieving recovery (Stanton et al., 2013). The nurses collaboratively with peer professionals educate the patients. Recovery colleges help people with mental health illnesses become experts in self-care, obtain skills and confidence to work and improve their lives (Stanton et. al, 2013). The greatest strength of recovery colleges is that the patients make new friends and are treated as students rather than patients. It is easier for peer professionals to conduct self-care programmes to mentally ill persons due to their greater understanding of the patients (Stanton et. al, 2013). In the United Kingdom and the United States of America today, most research institutes, and recovery colleges employ peer professionals to work in mental health services (Cooper, 2011). The peers understand what it is like to be diagnosed, experience the symptoms, discrimination, and stigma and get treatment (Cooper, 2011). Therefore, they provide emotional and practical support to fellows who have similar diagnosis and experiences. Most mental health trusts are hiring paid peers to help individuals with mental illness on their journey to recovery. The peers duties and responsibilities complement the role of professionals such as psychiatrists, nurses, and psychologists. In 2014, the National Institute for Health and Care Excellence (NICE) in England recommended the use of peer professionals specifically for people suffering from psychosis and schizophrenia since it improved the recovery of the respective patients effectively (Cooper, 2011). There are several symptoms of mental health related problem that are manifested in various ways (Townsend, 2014). Anybody can experience these symptoms but in most situations they do not want to believe they are suffering a mental illness case. The most common indications of mental health problems include anxiety, stress, bipolar disorders, depressions, personality disorders, eating problems, hearing voices, obsessive-compulsive disorder, loneliness, panic attacks, suicidal feelings, phobia, low self-esteem and paranoia (Townsend, 2014). When the symptoms are experienced, they can take a short period as a day or occur periodically or continue a condition known as psychotic episodes indefinitely (Townsend, 2014). When individuals experience psychotic episodes, they are mostly unaware of their conditions and in most cases feel like their lives are at risk or are being threatened. Untreated psychotic episodes can result in mental health problems such as psychosis or schizophrenia (Townsend, 2014). Psychosis is a mental health problem caused by a set of symptoms that are manifested at the same time. These symptoms include delusions, hallucinations, hearing voices disturbed and confused thinking (Cooper, 2011). In some cases, symptoms of psychosis can occur due to physical damages or diseases of the urinary tract and chest. On the other hand, schizophrenia is mostly characterized by anxiety and depression (Townsend, 2014). The condition can occur at any age, but men frequently develop the condition at early 20's while women develop it at older ages. Mental health problems are not permanent as long as adequate treatment and strategies are put into place (Townsend, 2014). Recovery from mental health issues is possible based on the strengths of recovery as an intervention in mental health setting. This method of intervention is person-centered and based on self-direction (Mollica, 2011). Every patient's pathway to recovery must take into account their resiliencies and unique strengths based on their needs, treatment and preferences (Mollica, 2011). Therefore, every patient can define individual life goals and design a concrete path towards achieving their objectives. Moreover, recovery aims at empowerment of people with mental illnesses (Shives, 2008). It provides a platform to the patients to take authority and be part of the decision-making in matters concerning their health, diagnosis and treatment (Shives, 2008). As a holistic approach, it encompasses all aspects of an individual's life required to achieve a meaningful life. These elements include family, friends, peer support, mental health professionals and organizations involved in the activities of a given patient (Shives, 2008). The important guiding principles of recovery are responsibility and hope (Stanton et al. 2013). Every patient must handle their self-care and take adequate steps towards achieving recovery (Stanton et al. 2013). It is the responsibility of nurses to establish social mechanisms and set communication pathways in which the patients can receive moral and religious messages of hope from friends, family and religious leaders (Stanton et al. 2013). Recovery also provides a motivating and essential message of brighter future (Townsend, 2014). Mental recovery not only provides benefits to the patients but also improve the development of society since they can be able to resume their normal lives. However, some limitations are also experienced in the implementation of recovery as an intervention to mental health problems (Townsend, 2014). Many modern definitions of recovery have been seen as vague and inconsistent, which makes it hard to evaluate the efficacy of recovery model. (Malinovsky et al. 2013). Furthermore, most friends, families and health professionals are overly pessimistic or protective and tend to underestimate the ability of persons with mental health problems. Therefore, they discourage or undermine personal growth and self-discovery (Elder, 2009). Diagnosis of mental illness is very difficult since most symptoms are similar and requires several therapeutic processes for psychologists and psychiatrist to come to a conclusion on the exact type of conditions (Elder, 2009). In this case, nurses and peer professionals provide an excellent linkage towards determining the exact causes and type of mental illness (Elder, 2009). In conclusion, there is a definite link between a suitable recovery approach/recovery and mental healing process (Boardman, 2010). The primary role of nurses is to support the people with mental illnesses to regain and fit back in their places in the community to mainstream opportunities and activities in the society. A cooperative workforce of nurses and an effective recovery model are, therefore, very vital in the recovery process of individuals with mental health problems (Elder, 2013). Nurses provide a unique position in helping the patients assessing personal health status and integrating healthy behaviors into their recovery plans (Walker et al., 2013). The integration of assessment tools, recovery planning, and motivational interviews are capable of improving patient’s decision making about their preferences on diagnosis and type of treatment. Therefore, nurses help patients to achieve self-awareness and be able to make decisions on what works best for them following an appropriate recovery approach (Copeland, 2011). Empowering patients to come up with decisions about diagnosis and treatment of their conditions is the most important role of nurses and the first step towards achieving mental recovery (Copeland, 2011). Reference Amering, M., & Schmolke, M. (2009). Recovery in mental health reshaping scientific and clinical responsibilities. Chichester [England], Wiley-Blackwell. http://public.eblib.com/choice/publicfullrecord.aspx?p=437480. Boardman, J. (2010). 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Park, M, Zafran, H, Stewart, J, Salsberg, J, Ells, C, Rouleau, S, Estein, O, & Valente, T 2014, 'Transforming mental health services: a participatory mixed methods study to promote and evaluate the implementation of recovery-oriented services', Implementation Science, 9, 1, pp. 1-21, Health Policy Reference Center, EBSCOhost, viewed 7 August 2015. Pilgrim, D., & Mccranie, A. (2013). Recovery and mental health a critical sociological account. http://lib.myilibrary.com?id=816678. Shives, L. R. (2008). Basic concepts of psychiatric-mental health nursing. Philadelphia, Wolters Kluwer / Lippincott Williams & Wilkins. Stanton, V& Tooth, B 2013 ‘Recovery as the context for practice’, in Elder, R, Evans, K, &Nizette, D (eds), Psychiatric And Mental Health Nursing, Elsevier Australia, Chatswood, NSW, pp. 14-34. Townsend, M. C. (2014). Essentials of psychiatric mental health nursing: concepts of care in evidence-based practice. http://search.ebscohost.com/login.aspx?direct=true&scope=site&db=nlebk&db=nlabk&AN=642489. Walker, C, Emmens, A, & Simpson, H 2012, 'Integrating the recovery approach into everyday clinical practice',Mental Health Practice, 15, 6, pp. 19-22, CINAHL Complete, EBSCOhost, viewed 7 August 2015. Read More