1MENTAL HEALTH RECOVERY According to the American Psychological Association (2019), a combination of social, psychological and emotional wellbeing is the mental health of an individual. Our mental health controls what we think, act or feel, including handling stress, making choices and relating to others. Mental health needs to be essential at every stage in life from childhood to adulthood. Several factors contribute to our mental health wellbeing such as genetic defects or biological factors, past traumatic experiences in life or abuse and family history. A positive mental health and wellness will make a person realize their full potential, allowing people to cope up with their stress, working productively and contributing to the society. People who do not have a healthy mind set need some recovery approaches to get over their mental diseases. Many cultures used to view mental health illness as a type of religious punishment or demonic possession and a personal problem. In the ancient civilization of Egyptians, Indians, Romans and Greek writings mental health illness was known to be a religious issue. Hippocrates in the 5thcentury BC was a pioneer in treating mentally ill people because his prime concern was treating the patient by changing their environment or occupation, or using aids such as medication. In the middle ages, mentally ill patients were meant to be possessed and later the negative attitude towards mental illness lead to the stigmatization and unhygienic confinement (Piat, Seida and Sabetti 2017). Recovery approach or the recovery model is used for treating mental illness or substance addiction and it focuses on emphasizing and supporting a person’s ability to recover. It is a personal journey of the person affected and not a destination, it might involve developing hope, supportive relationships, social inclusion, empowerment, and a sense of self and secure base, coping skills and a meaning (Jacob 2015). Recovery rejects sane-insane dichotomy and it sees the symptoms as an aberration rather a continuum of the norm. The Director of the Boston Center for Psychiatric Rehabilitation, Mr. William Anthony designed a definition for mental
2MENTAL HEALTH RECOVERY health recovery "Recovery is a deeply personal, unique process of changing one's attitudes, values, feelings, goals, skills and/or roles. It is a way of living a satisfying, hopeful, and contributing life even with limitations caused by the illness. Recovery involves the development of new meaning and purpose in one's life as one grows beyond the catastrophic effects of mental illness." The mental health concept emerges as a deinstitutionalization and that results in more people living in a community. The attention is gained as a social movement because of the perceived failures by the society or services to support social inclusion in an adequate manner (Hercelinskyj 2019). A recovery approach has been made into a guiding principle for the treatment of mental health illness and substance dependency legislations and policies in several states. In many cases, practical approaches are being used to base services on the model of recovery, criticisms and obstacles have been raised by both the recipients of the service and the service providers. Many measures of standard have been designed to discover the ways of recovery,butthereisadifferencebetweenthepsychiatricsurvivorsmovementand professionalized models. A recovery approach is an individual’s personal process towards journey of recovery including their relationship with the society and community. The core elements are proposed as a number of signs and features of recovery and they are called CHIME, which is the abbreviation of certain words such as Connectedness, Hope and optimism, Identity, Meaning, Purpose and Empowerment.Connectedness and supportive relationshipsis the most common form of recovery and it is said that the presence of people that help in the recovering process is needed for recovery (Brijnath 2015). Jean Baker Miller developed the theory of Relational Cultural Theory and it says that recovery needs empathy in relationships and mutuality including relationships that fulfils the embodiment of respect, emotional availability and authenticity. Supportive relationships can be enhanced by avoiding shaming, violence and
3MENTAL HEALTH RECOVERY increasing predictability. Mental health professionals can provide a limited form of support such as fostering care and hope but relationship with family, friends and community can be more beneficial in the long term for the recovery approach. Patients with experience of mental health illness can help others who are on the verge of mental breakdown, as they are going through the recovery process. During the practice, recovery can be obtained with the help of interviews with other people who are recovering, peer led support groups and engaging in community activities. Efforts from one way in a relationship can be traumatizing and devaluing for the person who wants to get recovered and relationships with mutual agreements is more beneficial for the self- esteem and recovery.Hopeis found and nurtured, which is seen as a point of recovery, it includes optimism and self-belief in an individual and the will to overcome setbacks and uncertainty (Leamyet al.2011). It is a turning point or will be gradually emerging as a sensitive feeling that might fluctuate with negative feelings.Identityis the durability of sense of self and is considered an essential element. People achieve this with the help of positive withdrawal and negotiating public space or regulating social involvement in order to move towards the safer environmentbutmeaningful.Itnurturesthepersonalpsychologicalspacethathelpsin developing a broad sense of self, understanding of spirituality and interests (Stickley, Wright and Slade 2018). This process is greatly influenced by the experiences of mutuality, interpersonal acceptance, and a sense of social belonging. The ability to move on can include coping up with the feelings of loss, which is mixed with anger and despair, a process of grieving is initiated when a person is ready to accept change. It requires acceptance of lost opportunities or past sufferings and lost times (Sayers and Stickley 2018).Meaningis the processing of coping up with personal problems with the use of strategies such as self-help or self-management, and it is said to be a necessary substance. This involves the use of psychotherapy or medication,
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4MENTAL HEALTH RECOVERY moreover if the patient is able to listen and comprehend the adverse effects. The method that fits a certain individual’s life and journey of recovery is given the utmost priority. Management of individual traits by developing problem solving and coping skills can require a person to become their own expert for identifying their possible crisis and key stress points, eventually developing personal ways of coping and responding. Most importantly developing a sense of overall purpose and meaning is necessary for sustenance of the recovery process. It also involves finding, renewing or developing a guiding religion, politics, culture or philosophy. Lastly,Empowerment is about building a positive healing process and culture that is necessary for the process of recovery (Slade and Wallace 2017). Recovering needs a strong sense of support and a strong network for the required help and guidance, which includes appropriate housing, a helpful network, freedom from violence, sufficient income and adequate access to healthcare services. These are some of the important tools to empower ourselves and increasing self-sufficiency. Self-determination and empowerment are important for recovery because it decreases the psychological and social effects of trauma and stress. In practice, building a securing base and empowermentrequiresmutuallyaffectionaterelationshipsbetweenserviceprovidersand survivors, identifying the existing strengths and survivor’s cultural and traumatic context (Slade et al.2014). Psychiatry focuses on functioning and symptoms of the elaborate assessments, rating scale documents, monitor psychopathology and standardized interviews. It also conceptualizes the phases of maintenance and continuation domains including the development of illness into acute. It has concepts such as relapse, recurrence, remission and recovery that is based on the symptoms of the patient (Evans, Nizette and Brien 2019). The psychiatric models view recovery from the perspective of a mental illness that is similar to a physical disease. The recovery
5MENTAL HEALTH RECOVERY approach faced opposition after it started getting the influence, dominance of psychiatric concepts, and power. Evidences suggests that strategies based on self-management on the model of recovery are more beneficial than the physical health models. The main themes are analyzed in a recovery based research that shows that dominant themes from the perspective of the stakeholder was identity, the social domain, control and power, service proposition agenda, risk and responsibility, and hope and optimism (Price-Robertson, Obradovic and Morgan 2017). To conclude this essay, it can be seen that the process of recovery provides a holistic view of people who are suffering from mental illness, which not only focuses on the symptoms but also the person as an individual. The recovery approach is a journey and not a destination, and it is not necessary that a person will return to the premorbid level of asymptomatic phase and functioning. It does not suggest a direct progression to recovery but it has ups and downs just like in life. This process needs optimism and commitment from people suffering from mental illness, concerned families, community, public health teams, mental health professionals and social services. The recovery models focuses on treating people with mental illnesses and despair, which makes them look beyond existence and mere survival.
6MENTAL HEALTH RECOVERY References American Psychological Association 2019.Recovery principles. [online] https://www.apa.org. Availableat:https://www.apa.org/monitor/2012/01/recovery-principles[Accessed26Dec. 2019]. Brijnath,B.,2015.ApplyingtheCHIMErecoveryframeworkintwoculturallydiverse Australian communities: Qualitative results.International Journal of Social Psychiatry,61(7), pp.660-667. Evans, K., Nizette, D. and Brien, A. 2019.Psychiatric & Mental Health Nursing,4th ed. Netherlands: Elsevier. Hercelinskyj, G. 2019.Mental Health Nursing. 1st ed. Melbourne: Cengage. Jacob, K.S., 2015. Recovery model of mental illness: A complementary approach to psychiatric care.Indian journal of psychological medicine,37(2), p.117. Leamy, M., Bird, V., Le Boutillier, C., Williams, J. and Slade, M., 2011. Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis.The British Journal of Psychiatry,199(6), pp.445-452. Piat, M., Seida, K. and Sabetti, J., 2017. Understanding everyday life and mental health recovery through CHIME.Mental Health and Social Inclusion,21(5), pp.271-279. Price-Robertson,R.,Obradovic,A.andMorgan,B.,2017.Relationalrecovery:beyond individualism in the recovery approach.Advances in Mental Health,15(2), pp.108-120. Sayers, T. and Stickley, T., 2018. Participatory arts, recovery and social inclusion.Mental Health and Social Inclusion,22(3), pp.149-156.
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7MENTAL HEALTH RECOVERY Slade, M. and Wallace, G., 2017. Recovery and mental health.Wellbeing, recovery and mental health, pp.24-34. Slade, M., Amering, M., Farkas, M., Hamilton, B., O'Hagan, M., Panther, G., Perkins, R., Shepherd, G., Tse, S. and Whitley, R., 2014. Uses and abuses of recovery: implementing recovery‐oriented practices in mental health systems.World Psychiatry,13(1), pp.12-20. Stickley, T., Wright, N. and Slade, M., 2018. The art of recovery: Outcomes from participatory arts activities for people using mental health services.Journal of Mental Health,27(4), pp.367- 373.