The document discusses rehabilitation and recovery in mental health. It defines rehabilitation as services that facilitate adaptation for people with disabilities. Recovery is defined as the lived experience of overcoming challenges of disability, whether illness is present or not. Key aspects of recovery include hope, personal responsibility, self-advocacy, education, and support. Recovery-oriented services have characteristics like conveying hope, respecting choice, and supporting wellness and community participation.
Patrica Deegan – was a service user who wrote about her journey through mental illness and her recovery to maximize levels of functioning and develop resources within the community to support successful living People with psychiatric disabilities want safe, affordable housing, the opportunity to work for fair wages, the opportunity to learn, time to enjoy social and leisure activities, involvement in the communities where they live and most of all families and friends who love and care about them – by viewing the person as having a psychiatric ‘disability’ rather than a person destined for life long suffering and a decline in functional abilities it creates a sense of possibility for overcoming the challenges of a disability and for living to ones maximum potential Physical rehab focuses on helping people to develop skills that enhance adjustment to their living environment and develop environmental supports that facilitate successful community living- psychiatric likewise focuses on the same areas of intervention – Psychiatrically disabled adults who choose to embark on a recovery process become active participants in their own rehabilitation project – corresponds with the view of the nurse-client relationship as a collaborative partnership ( re Peplau )
Patricia Deegan( a service user) drew a distinction between rehabilitation and recovery Recovery does not necessarily mean being entirely symptom free - to the person who has recovered the illness is no longer the primary focus of their life The Mental Health Commission definition is broad – to the mental health professional recovery might mean absence of symptoms but to the person with mental illness recovery might mean regaining one’s life How could recovery ever take place in an environment where people were isolated from their communities, where power was used to coerce people and deny them choices, and where people with mental illness were expected never to get better Major study demonstrated that the course of severe mental illness was not an inevitable deterioration ( The Vermont longitudinal study of persons with severe mental illness: long term outcome of subjects who retrospectively met DSM III criteria for schizophrenia. (For abstract -American Journal of Psychiatry 144: 727-735 1987) and several first-person accounts by consumers who described their experiences of mental illness and how they managed to emerge intact or recover _ Consumers have been the most active in advancing the concept of recovery from mental illness - Mental health professionals have and are drawing on such accounts to formulate theoretical and practical models of recovery that could be used in psychosocial rehabilitation and other mental health services Important to note that there is no recipe or template for recovery in a persons life as there is no definitive recovery model -the journey is defined by the individual concerned. However research does indicate that there are common themes to peoples stories and that they describe a process of stages that are universal to anyone who has experienced a catastrophic loss including those associated with a mental illness
the onset of acute symptoms and initial diagnosis – shatter the sense of self Perceived symptoms are viewed as a mistake or bad dream. Anger at family and health care providers who attempt to care Overwhelming sense of hopelessness and powerlessness- may last many months years or a lifetime Concerned others who remain hopeful despite the odds provide a source of hope for person who despairs. A spark of hope brings motivation and willingness to try again In accepting personal limitations person discovers and explores new possibilities
Group Exercise – in 4 groups read assigned stories (4 families – MHC series 2) and identify how the service users story illustrates each of the points above Discussion on aspects of the persons life / experience that helped and hindered their ability to move on with her life, (30mins)
Refer to ‘Recovery as a journey of the heart - powerful in getting this message across
Mental Health Professionals need to deal with their own fears/concerns – Baby steps are needed for consumers that have been in the system for some time
Can be seen as non-compliance Negotiation needed around issues with a perceived risk – succeed and fail are key elements of the human experience
They may need to educate themselves about their wellness/illness cycle eg triggers, early warning signs and things that help to get them well They need to know and understand what the medications are that they are taking why they are taking it and what the potential side effects may be
It is extremely difficult for a person to recover without any support of any kind
Personal meaning helps to develop a sense of identity – the opportunity to be able to place ones stamp of uniqueness and individuality on the environment is crucial to recovery
MHC states that recovery – orientated service will be one that supports service users to lead their own recovery
To ensure that the workforce is well equipped to carry the philosophy of the recovery approach forward and make it a reality Handouts– Mental Health Recovery Competencies Patricia Deegan article –Recovery as a journey of the heart 1995 article - A recovery orientated service system: setting some system level standards – William Anthony 2000
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