Recovery — Focused Care in Mental Health in Australia Essay Example

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14Recovery- Focused Care in Mental Health

Introduction

Currently in Australia, the Victorian Government has expressed concern about services given to people with mental health problem. According to the Minister for Mental Health, the Hon Lisa Neville in Australia (2009), the mental health system in many facilities have failed to provide recovery-based care to people who have been labeled with severe mental cases and this has led to dissatisfaction by the patients, their families and also administrators. A fundamental change in the mental health system is important especially in government policies, extensive research on recovery based care, training of personnel and quality of services provided. A recovered-focused care system for mental health should incorporate self determination, meaning roles in the society after recovery, empowering interpersonal relationships based on respect, trust and understanding and lastly, elimination of discrimination and stigma associated with people who have mental health records.  According to the Department of Human Services in Australia (2009), recovery based mental health care should cultivate individuals’ independence and their competence to achieve personal objectives and lead productive lives. Mental illness is caused by a lot of factors that affect people on a daily basis. Some of the causes of mental illness include; drug abuse, post natal stress, unemployment, emotional trauma, schizophrenia, dementia among others (Fisher & Chamberlin, 2006). Personality disorders are also major causes of mental illness (Blennehassett & O’Raghallaigh, 2005). Recovery based care plans include; psychological and clinical rehabilitation, broad health care and finally community living support to obtain jobs, have successful relationships and enjoy life as part of the community.

Model of Care

As a mental health service provider, I have help Neil Jackson, a twenty four years old man from Melbourne into a full recovery from mental illness caused by bipolar personality disorder. When Neil first came into Major Hospital Melbourne, he had severe mood swings and aggressive behavior that caused him so much distress. Neil had broken relationships with family and friends and he could not concentrate on any employment. According to Fisher & Chamberlin (2006), administration of a contemporary form of care includes; care based on uninterrupted therapeutic relationships, customized patients services, shared information and inclusion to community activities.

The first step that I took while treating Neil was to provide mental health services that showed him that recovery is possible through self-help groups who had the same condition. In the groups, he found that there were people who had the same experiences as him and the next step was how to recover as a unit because they are the people who understood what he was going through. Even though there were patients with the same condition as Neil, I provided him with services that suited his needs according to his strengths, values, beliefs and preference. Making mental health recovery customized for patients creates a connection at a personal level and patients and service providers become partners in the health system that is based on trust, honesty and respect (Ahern & Fisher, 2005).

Bipolar personality disorder is a mental condition that has to be maintained for a long time because some people take quite a longer period of time to fully recover (Batman & Tyrer, 2004). Any form of psychosis that requires medications and holistic healing methods to enable patients to recover fully should be extensively treated (Solomon & Draine, 2004). As partners, I consulted Neil and his families on the appropriate forms of treatment especially in cases when the psychosis was at its peak and medication was required to calm his nerves. Lithium was administered in appropriate potions during psychosis phases and Neil underwent through intensive counseling and according to Batman and Tyrer (2004), bipolar disorder makes people suicidal. In the therapy sessions, I created a relaxing environment with comfortable couches and relaxing paintings that made him feel like he is having a friendly conversation. Neil has been to different mental institutions and back with alcohol addiction because other systems did not focus on recovery and independence. As a talented writer, Neil developed his skills by taking his time to write on a note book why he is angry and how many times his mood is changing within a day.

Neil Jackson was included in community based activities such as working for a magazine company, visiting family and friends and also seeking support in difficult times. Inclusion in the community enables a patient to acquire the job of his or her dreams, a self contained house and start meeting new partners for a relationship (PARC 2010). Recovery based model ensures that outpatients are still supported while adjusting to the normal life that was taken away by mental illness. Neil also participated in commenting on his mental health record so that the community would trust in recovery based care for mental health and also give him opportunities in life that other people enjoy.

Principles of Recovery-Based Care for Mental Health

1. Informed Choice

2. Recovery Focused

3. Person Centered

4. Do No Harm

5. Free Access to Mental Health Records

6. System Based on Trust

7. Focus on Cultural Values

8. Knowledge-Based

9. A Partnership between Patient & Provider

Informed Choice

According to PARC (2010), informed choice is very essential in recovery based mental health care system. This is when mentally ill patient are given detailed information about the form of treatment programs and options. The information provided to patients will be from professional health care practitioner with the intention of the patient deciding on the best course of treatment either as an individual or collaboratively to foster recovery, independence and advanced quality of life.

Informed choice means that healthcare service provider is open about the conditions faced by the patient and quality treatment whether they are treatment programs or holistic options (Allen & Carpinello, 2010). This principle of informed choice not only allows the patients to have an extensive knowledge on the benefits and duration of treatment programs but also shows possible pitfalls. The knowledge provided will enable patients, their families and health practitioners to choose a treatment option that has minimal risks and recovery based care that will lead to an independent life after treatment. Many health institutions administer forceful medication without giving the patients the information on purpose of the treatment. Mentally ill patients can make good choices with the help of family members when the information provided is accurate. Recovery-based mental health care uses informed choice as its foundation of service delivery. Goal setting for mentally ill patients is top priority but information needs to be provided in intense detail before any decisions to engage in treatment programs is made. Informed choice means that the patients’ support groups who are family members or friends are not only included in the decision making but also treatment programs to give physical and emotional support.

Recovery Focused

Recovery focused treatment programs are individualized. This allows mentally ill patients to recover at their own pace and this means that they will not judged or labeled as social misfits but rather as part of the community who have opportunities for life development and wellness. Patients who are made to believe that recovery is possible have a positive approach on treatment programs that have been decided upon. Traditional model of treatment only focuses on treatment for a short while but recovery based treatment ensures that the patients’ strengths are cultivated hence providing a mutual bond between patients and service providers (Cook et al., 2009). This bond instills hope for a better future and trust. Most patients need to be regarded as human beings first then mentally ill as their second description. This means that recovery based care foundation is being set because patients will feel like they belong in the community with other people the only step they have to take is recover from their mental illness to be fully functional.

Cook et al. (2009) explains further that recovery focused mental health care is not only for patients but also the entire community. There are people in today’s society who need to be educated on the recovery of mental illness as something that happens and they should not discriminate outpatients from the Adult Psychiatric Unit. Coping skills, socialization and recreational opportunities are some of the elements of recovery focused mental health care. Other important topics include; local peer-operated programs, alternative treatment, educational opportunities, empowerment and self-help services, crisis management and also vocational opportunities.

Person Centered

Person centered health care services are delivered in a respectful, validating and valued manner with great consistency. This form of recovery based mental health care focuses on patients as the important factor in the model. Planning should be done to administer treatment depending on the patient’s values, strengths, beliefs, culture, preferences and spirituality (Allen & Carpinello, 2010). Health practitioners who recognize their patients’ values will treat them with respect and the dignity they deserve. Many patients who have been in mental health institutions complain of services they do not prefer as compared to personally planning for their treatment with the help of family, friends and professional practitioners.

Person centered services focuses on the objectives of individuals in regard to benefits, housing, health, jobs, family, relationships, recreational choices and other things that healthy people may need to experience. Person centered treatment that is not restricted to time, or economical status ensures a treatment driven care based on patients’ individual needs, choices and terms (Allen & Carpinello, 2010).

Do No Harm

Mentally ill patients who have been admitted in health institutions more than once complain that they leave these centers in a worst condition as compared to the way they were when they were first admitted. This means that the conditions of treatment left them more traumatized than they were before treatment. Recovery focused treatment aims to make patients feel normal and welcomed in the community. This means that forced treatment is a principle that fails and does more harm than good to patients’ lives.

Restraints and seclusions make patients feel unwanted, discriminated and inhuman (Allen & Carpinello, 2010). These conditions not only further trauma but also create deeper wounds that are unforgettable. Patients want to choose roommates to ensure compatibility and also safety. Family and friends of severely mentally ill patients need to be informed and included in decision making of treatment options and the risks regularly. Local authorities, community members and friends should be educated on recovery process so that they will not react aggressively when handling people with mental health records. If such actions are repeated on a daily basis, relapse of mental illness is possible and it can be very severe.

Free Access to Records

Outpatients and family members have an easy time when they can get a free access to mental health records. These records are important when applying for employment or other important events. People with mental health records need to be involved when commenting on the records to show their confidence and competence in handling jobs and relationships. Most patients want to change the comments written by doctors, therapists or psychiatrists in creating a permanent and appealing mental health record that will allow them to get opportunities in life that will lead to success and independence (Cook et al., 2009). Mental health records do not have the same effect as medical records because when mental health records have poor comments by practitioners, outpatients will not get good jobs or certifications to specialize in long term careers. Bad mental health records are barriers that instigate discrimination and stigma which prevents people from achieving quality lives.

System Based on Trust

Trust is the key element of creating a setting that fosters recovery. Health relationships are mainly supported by honesty and trust. Mental illness involves more counseling as compared. Health practitioners need to pay more attention to what patients are saying and eliminate controlled response used in traditional model of treatment (Cook et al., 2009). Fear of metal health care service providers hinders patients from full recovery because they do not trust these practitioners. Environments where patients have self-help groups make them feel like a team with a common goal of recovery as compared to seclusion. Most health providers have an attitude of sterility, staleness and are boundary restricted when treating patients. This creates poor relationships that do more harm than good. Open communication between health care provider and mentally ill patient has to be honest, clear and meaningful for recovery treatment to be successful. System based on trust will ensure that patients know whether their medications are long term or short term and their side effects (Johnson, 2005). Patients will also know the type of treatment program customized to meet their needs and also their housing after treatment. Adults who have recovered from mental illness need to be able to find employment that will improve their lives and not return them to the same position they were before treatment. Mental healthcare services based on trust encourage personnel to advise patients on alternative options for treatment that is directed towards recovery.

Focus On Cultural Values

Mentally ill patients in Major Hospital Melbourne come from a diverse cultural background that needs to be preserved while undergoing treatment (Johnson, 2005). There are disadvantage groups in Australia that are non-English speakers who have difficulties communicating with mental health service providers. Some people with different cultures and beliefs feel discriminated especially when they are forced into environments that disregard their culture. In Major Hospital Melbourne, there are mental health care service providers who have open minds in order to ensure successful recovery outcomes. Providers are often trained on culturally competent services and even exposed to adverse beliefs and cultures. The most important thing a mental health care institution needs is to employ personnel that are reflective of the Melbourne community the mental health program is serving. Providers and patients from different cultural backgrounds tend to have poor communication because of language barrier and also beliefs and values (Cook et al., 2009). Major Hospital Melbourne has a program that teaches the workforce the importance of Melbourne’s culture and healing processes that are socially sensitive. Recovery in an environment that fosters and incorporates cultural beliefs helps patients to have a sense of belonging of people who are of high value to the community.

Knowledge-Based

Recovery focused treatment for mental health should be provided by professionals who are accurate and have current knowledge on treatments, holistic healing methods, clinical practices and complementary methods (Cook et al., 2009). Major Hospital Melbourne provides up-to date mental health information that makes patients and their families trust in the form of treatment provided. Knowledge based programs are very important because they give providers the position to be included in making sound decision according to the nature of the mental illness, the appropriate treatment and risks associated with different treatments. Patients always want models of care that have worked before and are recommended by outpatients from the same Adult Psychiatric Unit in major Hospital Melbourne. There are also alternative forms of treatments and holistic ways to ensure recovery based care is achieved. Knowledge does not only come from books and lectures but from lengthy experience with mentally ill patients who have the same goal which is to recover and be part of a productive community. Successes and failures from patients are what mental service providers use to give sound knowledge to new patients. According to Johnson (2005), knowledge of a patient’s strengths, culture, medication and experiences are the foundations of recovery based care in mental health.

A Partnership between Patient & Provider

According to theVictorian Government Initiative (2009), a partnership between patient and service provider builds trust and hope because of equality. Patients with mental illness need to be treated with respect as valuable people in the mental health care system so that recovery will be faster and individualized. The same way therapists or psychiatrists ask their patients questions is the same way patients need to ask these providers personal questions to feel at ease. The sharing of information based on the form of treatment is very important between partners because for patients to become independent after treatment they should be able to decide the best form of treatment they need and prefer. Recovery based mental health in the contemporary society is fostered when the patient feels safe and respected by health practitioners. Partnership includes patients in community based recovery whereby, they are included in making decisions that are important in life and this means that when they recover, they will be able to make mature decisions about employment, housing and health care.

Conclusion

Recovery based mental health care is very important in Australia in creating a community that is competent when handling jobs, families or relationships. Patients who are in recovery based system are nurtured to become independent, strong, competent and valuable people in the community. The fact that discrimination and stigma associated with mental health is a concern in Melbourne, the community is being educated on recovery based care that makes outpatients more valuable the same as people who have never been admitted into a mental health institution.

REFERENCE

Ahern,L. and Fisher,D. (2005). Recovery at Your Own PACE. Journal of Psychosocial Nursing.

Allen J, B. & Carpinello S, E. (2010). Infusing Recovery-Based Principles into Mental Health Services.
New York State Office of Mental Health

Australian Health Ministry (2009). Background on mental health and mental health reform in Australia. Journal of The National Mental Health Plan 2003-2008.

Batman, A & Tyrer, P (2004), Psychological treatment for personality disorders. Advances in Psychiatric Treatment. 10: 378-388. Royal College of Psychiatrists.

Batman, A & Tyrer, P (2004), Services for personality disorders. Advances in Psychiatric Treatment. 10: 425-433. Royal College of Psychiatrists.

Blennehassett, R & O’Raghallaigh (2005). Dialectical behavior therapy in the treatment of borderline personality disorder. The British Journal of psychiatry. 186: 278-280. The Royal College of Psychiatrists.

Cook, J, A, Copeland, M, E, Hamilton M, M, Jonikas, J, A et al. (2009). Initial outcomes of a mental illness self management program based on wellness recovery action planning. Psychiatric Services, 60 (2)246-249.

Fisher, D & Chamberlin, J. (2006). A Consumer/ Surivor Led Transformation of Today’s Institutionary-Based systems to tomorrow’s Recovery-Based systems.

Johnson E, (2005). Recovery Principles: An Alternative for Individuals Who Experience Psychiatric Symptoms. META Services, Inc. Phoeniz.

PARC (2010). Adult prevention and recovery care (PARC) services framework and operational guidelines 2010. Published by the Mental Health, Drugs and Regions Division, Victorian Government, Department of Health, Melbourne, Victoria

Solomon P. and Draine, J. (2004). The state of knowledge of the effectiveness of consumer provided services. Psychiatric Rehabilitation Journal, 25.

Victorian Government Initiative. (2009). Because mental health matters – Victorian mental health reform strategy 2009–2019. Pg 2-19

Appendix 1: Neil Jackson’s Personal Information

Neil was suffering from bipolar personality disorder. This is a form of psychosis that makes the moods of an individual change rapidly from bad to good and vice versa in a short period of time. Neil suffered from extensive mood swings that drove friends and families away and isolated him in a world full of opportunities.

In his attempt to seek for medical health, Neil was admitted in different mental institutions but he did not fully recover. He started drinking as a way to forget his troubles but a person with bipolar personality disorder who engages in alcohol drinking will become an addict because of control issues.

Neil’s personality disorder and alcohol addiction lead to his unemployment days after he refused to go to work on a daily basis. He would go to work when he felt like working; an action unacceptable in the community.

Neil’s family members who did not understand his condition cut all connections with him. His fiancé left their home when she could no longer handle his mood swings, alcohol addiction and unemployment.

Bipolar personality disorder made Neil have suicidal thoughts and he attempted to commit suicide before he was brought into Major Hospital Melbourne. In the therapy sessions, Neil expressed his concerns about life with a mental disease and no support from his family.