Articulating Key Concepts of Recovery - Term Paper Example

Articulating Key Concepts of Recovery (Insert Name) (Institution Affiliation) The concept of recovery is a multi- definitional subject primarily because it is an individualised and unique process. This concept emerged from the consumer movement in 1980s and continues to be utilized with an increasing currency in mental health sector. Some people believe that specifying a single definition around recovery concept in a context of mental health will ignore the key value of individuality and community involvement which underpins the entire concept. The definition of recovery and the way various people write or think about this concept is quite personal with a good deal of variability (Slade, 2009). Recovery orientation is acknowledged as being an aim in service delivery both in Australia mental health care and internationally. The purpose of this paper is to articulate and critically examine the concept of recovery. This paper also examines the barriers to recovery and the facilitators of recovery especially the community and suggest the things that ought to be done in order to make genuine recovery oriented service delivery a reality. Furthermore, the paper examines the key features of the Recovery approach; the role of consumer participation within Recovery and; the ongoing implementation of the Recovery approach within mental health settings from a nursing perspective. This paper will treat the concept of recovery as an overarching philosophy encompassing notions of self-management, personal empowerment, self-determination, personal growth, choice and meaningful social engagement. The concept of recovery can be divided into two broad categories. Firstly, recovery is examined as an internal personal process or outcome (Bonney & Stickley, 2008). Secondly, the concept of recovery is viewed as an iterative relationship between the person’s experience of recovery and the organisational or societal conditions that may facilitate recovery. Some authors categorize recovery into clinical recovery and personal recovery. According to them, clinical recovery is defined by professionals in the field of mental health and pertains to cessation or reduction of the symptoms and restoring the social functioning. On the other hand, personal recovery refers to an ongoing holistic process which involves personal healing, growth and self-determination. There are several features that make recovery unique. As an ongoing journey or process, recovery is not focused on treatment of mental illness but it is more of a multidimensional interplay between the experiences of the people with mental health problem. Recovery have been found to be nonlinear process of continuous growth whereby the achievement is determined by the individual’s unique preferences, strengths, experiences, needs and cultural background (Slade, 2009). Thus, recovery can be well understood as a highly personalised process which is unique and led by the person himself. Due to its unique nature, recovery cannot be provides, replicated or standardised within a service context. The unique notion of recovery as an ongoing journey of personal wellbeing and growth does not equate with a particular model of medical care, service setting or phase of care. However, a range of behaviours and practices at both individual and organizational practitioner levels creates an environment that is highly supportive to the recovery of individuals with mental health conditions and that can be of great use in guiding practice across non- clinical and clinical services. Mental health recovery is also unique since it depends on various key concepts which vary from one individual to the other. First is hope which is an essential element to recovery. When the person with a mental condition believes that he or she is fragile or out of control, it proves to be difficult to take a step forward to recovery. The mental health system of increasing staff expectations of de- compensation, disability and services or programs that promote dependency usually contribute to a prognosis of doom and leave the mentally ill persons despaired, demoralized and helpless. On the other hand, hope, support and recovery message and environment are crucial as they make the patients believe that their lives can change for the better. Secondly, personal responsibility makes a huge contribution towards recovery. The power of the people if often relinquished in the rigorous process of psychiatric diagnosis. Personal responsibility in mainly concerned with choice and self-determination and it resembles the first step towards regaining control of one’s personal life of moving from a passive recipient of services, to an active agent in the process of change and recovery. Personal experience accompanies hope and motivation and presents an opportunity for one to make meaningful choices concerning their recovery. The third factor is education which involves learning about what the community supports. Education will also enable an individual to be aware of the available resources, opportunities, professional support and self-help strategies. It plays a crucial role in making informed choices about wellness, recovery and participation in adult roles that are highly valued on top of enhancing personal self-knowledge and awareness. The other key concept in mental recovery is self-advocacy. Recovery is, in part, the experience of regaining one’s voice, of identifying needed resources and supports and advocating for access to those supports and resources. Since mental illness is part of the painful experience of loss of individual’s power and the ability to speak for him or herself, be heard or acknowledged, recovery is aimed at increasing one’s ability to advocate successfully for personal rights. Furthermore, support from professionals, family, community and friends is also a key aspect of recovery. Separated treatment and residential setting do not lead to community integration and satisfying fulfilled lives. Mutual support is based on community integration and usually helps in acceleration of recovery from mental illness. The recovery approach to delivery of mental health services aims at supporting people in building and maintaining a satisfying and meaningful life and personal identity irrespective of whether or not there are ongoing symptoms of mental illness. On the other hand, the medical model suggests that a person qualifies to be detained as an involuntary patient and subjected to involuntary treatment if: the individual shows signs of mental illness and requires immediate treatment which can be administered through involuntary treatment in order to protect the members of the public or prevent deterioration of the individuals mental or physical condition. Involuntary treatment may also be administered if an individual is unable to consent or has refused the necessary treatment for mental illness (Schiff, 2004). Therefore, the recovery oriented approach represents a deviation from the primary biomedical view of mental illness to a holistic approach that is focused on personal wellbeing and builds on the individual strengths rather than the weaknesses associated with the mental illness. While the medical model emphasizes on treatment of the root causes of the mental illness, recovery oriented approach encompasses the principles of personalized care and self- determination and emphasizes on social inclusion, hope, self-management, community participation and personal goal setting. Furthermore, recovery approach promotes partnership relationship or coaching relationship between people accessing mental health services and the esteemed professionals of mental health, whereby people with lived experience are considered experts on their lives and experiences while mental health professionals are considered experts on available treatment services. Also, whereas medical model is value free, control oriented, involves professional accountability, has power over people, pantographic, diagnostic, ill based and involves treatment, the recovery approach is value centered, choice oriented, personal responsibility, awakens people’s power, biographic, has personal meaning, involves growth and development and is strengths based. One of the major reason of moving from medical model to recovery approach is because the current metal health sector is protected by laws and statutes that allow the psychiatrists, nurses, social workers and also the psychologists to make medical assessment order which allows for an adult or a child to be detained for up to 72 hours in order to be assessed by a professional psychiatrist. These regulations governing the mental health sector also establishes the procedures for initiating involuntary treatment and independent review of mental cases (Legislation). Due to this, the lives of majority of the people who have been diagnosed with mental illness are often altered drastically by the medical condition and also the reaction of the society. Secondly, there is inherent discrimination and stigma that is usually associated with the mental disorders that sometimes manifest in a number of subtle and may persists for a lifetime. In many occasions, these stigmas take the form of distrust, stereotyping, avoidance or fear and usually negatively affect the pursuit for treatment of mental illness and employment. Persons with mental illness are frequently labeled as according to their socio- economic status, behavior, and treatment and sometimes due to negative depiction associated with mental illness which is so prevalent in the media. A person with mental illness is commonly stereotyped as unpredictable, dangerous, and unreliable and weak- willed. Apart from the stigma and stereotype faced by the individual, the family and friends of the person may as well suffer from the impacts of associative stigma. Thus there is a need for moving from a medical model to a Recovery approach. Unlike the medical model, the recovery oriented approach is believed to encapsulate a mental health care that (Slade, 2009): Involves personalised, tailored and care that is based on strengths and responsive to people’s circumstances, unique strengths, preferences and needs. Encourages self-management and self-determination of mental wellbeing and health. Involves a holistic approach that addresses the a wide range of core factors that impact on the wellbeing of the people, such as education, housing, family, employment and social relationships among others. Support people in defining their goals, aspirations and wishes. Support social inclusion of the people, citizenship and community participation. Since the recovery oriented approach involves promoting the choice of the people, self-management and recovery agency, a degree of risk tolerance in service provision becomes necessary. People should thus be empowered to be able to decide the level of risk in which they are prepared to undertake as part of the recovery journey (Davidson et al, 2006). In supporting recovery efforts of the people, it is necessary for services to articulate the threshold of risk appropriate to the particular recovery service setting. Accordingly, services should consider providing training, guidance and support to staff on how to reconcile flexibility and responsiveness to people’s unique preferences and circumstances with appropriate risk management obligations. All the territories and states in Australia have initiatives underway related to recovery. The consumer groups have been the main drivers of the recovery approach movement. The non- governmental sector has also been on the frontline in applying and promoting use of recovery in mental illness cases. The national mental health strategy which was endorsed in 1992 contains plans that placed mental illness at the core of service provision and provides directives for restructuring the Australian mental health services into the mainstream health services. This has greatly contributed to the improvement of mental health care services. Despite various success of the recovery approach, it faces some barriers at individual, clinical, systemic and collective consumer level. Discrimination and stigma still stands as a pervasive barrier to recovery. Other barriers include self-stigmatization, relapse of illness, medication side effects, loss of friends and family, self-esteem and lack of support (Schiff, 2004). For some individuals, medication is the key to recovery, while for others the deliberating cognitive, emotional, and psychiatric side effects of their medications. Consumer’s right to contribute to their own care and planning means that they can actively participate in policy and recovery strategy formulation. This process builds the consumer’s confidence in the healthcare system and makes it easy for them to strongly support a good provider of health care and above all ensure an excellent provider- consumer relationship. Furthermore, the consumer rights support and emphasizes on the importance of the role of the consumer in ensuring they have the responsibility with regard to Recovery improvement. Within a Recovery approach, the mental health care nurses will play a critical role. Their knowledge and experience in community mental health services is also of key importance. The recovery oriented approach means that the mental health care nurses must be able to work alongside people and be able to support the mentally ill individuals to enable them live satisfying and meaningful lives as defined by them both in absence and in presence of symptoms of mental illness. Since the experience of mental health recovery and problems is a entirely personal process which is unique to a given person, the mental health nurses need to work in ways that shift their goals and emphasis from professionalism or expert to working in a way that recognize and maximize the individuals own strengths and expertise (Jacobson & Curtis, 2000). Lastly, the recovery approach requires the mental health nurses to adopt new working ways including new set of values and skills that are aimed at enabling people’s self-management, social inclusion and self-direction and also focus on providing health care that is person- centered with a shared responsibility for positive risk taking. In conclusion, recovery- oriented approach increasingly becomes popular in mental institutions and is being embedded in service delivery. The Victorian specialist mental health service system continues to evolve towards a recovery approach as other mental health care professionals are being encouraged to embrace and utilize the recovery approach. Despite various challenges and barriers, there are evidence of some people who have successful resumed their normal lives after being diagnosed with mental conditions through the help of the recovery approach. References Bonney, S., & Stickley, T. (2008). Recovery and mental health: a review of the British literature. Journal of Psychiatric and Mental Health Nursing, 15(2), 140-153. Davidson, L., O'Connell, M., Tondora, J., Styron, T., & Kangas, K. (2006). The top ten concerns about recovery encountered in mental health system transformation. Psychiatric Services, 57(5), 640-645. Jacobson, N., & Curtis, L. (2000). Recovery as policy in mental health services: Strategies emerging from the states. Psychosocial Rehabilitation Journal, 23(4), 333-341. Legislation, V. (1986, August 24). Mental Health Act. Mental Health Act , 058 (098) . Victoria State. Schiff, A. C. (2004). Recovery and mental illness: analysis and personal reflections. Psychiatric Rehabilitation Journal, 27 (3), 212-218. Slade, M. (2009). Personal recovery and mental illness: A guide for mental health professionals. Cambridge. Whitley, R., Gingerich, S., Lutz, W. J. & Mueser, K. T. (2009). Implementing the illness management and recovery program in community mentalhealth settings: facilitators and barriers. Psychiatric Services, 60 (2), pp.202-209. Read More