Clinical and Personal Recovery
Instructions:
Explore the differences between clinical and personal recovery via the depiction of the lived experience in O’Hagan, Mary (2014): Madness Made Me New Zealand: Open Box Press
What are Recovery principles? How are these different from Clinical Recovery? Give examples from the Stories of Janet Version one and two. (pp221-228). These are available here.
Solution
Clinical and Personal Recovery
Introduction
Mental health care is one of the most valuable services in a country. Australia continue to register a high number of patients who are suffering from mental illnesses such as depression (Jorm, Sawyer, & Gillett, 2012). The finding has prompted the health sector to implement change in mental services. The new reforms are targeting services delivery which is centered on the patient, easily accessible, flexible, and greatly responsive to the needs of patients and those taking care of them (MacFarlane & Stafford, 2016). Noting the contrast between medical and personal recovery is important in learning. Clinical recovery views the process medically whose outcomes include reducing psychotic symptoms, being hospitalized, and use of medication. The recovery approach involves the assistance of professionals in leading valued lives of people with a mental health condition in a survivor-led institution(Council, 2013). As such, this paper will discuss the differences between clinical and personal recovery in regard to O’Hagan Mary text Madness Made Me. Also, a review of the recovery principles will be discussed
Part A: Differences between Clinical and Personal recovery
Recovery is a unique and personal initiative which includes changing attitudes, feelings, and values about one’s surroundings. A mentally impaired person has to be provided with a sense of meaning, purpose, and satisfaction in life since it is one of the fundamental values to recovery (Australian Government Department of Health, 2017). In the first version, Janet goes through clinical recovery which totally breaks her translating to a future of loneliness and drugs. A medical assistant is not available for Janet even when she calls the crisis team. Instead, she is turned down by asking her to make a cup of tea. The second version takes us through the recovery process which is accommodating for patients suffering from mental illnesses. The ability to confide in someone who has heard similar experience and broke away from depression helps Janet see there is life after psychosis (O’Hagan, 2014). Janet’s breakdown is accompanied by emotional feelings like guilt and shame. Struggling with her past and the trauma of being sexually abused at the age of ten years almost seems impossible to live with until she registers with Rock Up (O’Hagan, 2014). A notable difference is how the attendants of Rock Up receive the patient as compared to the doctors at a hospital. For example, when Janet asks what a peer support worker is, Lisa is quick to mention she was once a victim of depression (O’Hagan, 2014). The first impression guides Janet through her expression to Lisa and the clinical worker. The patient tries to make sense of what happened in the past. As such, mental health should enable an individual manage the normal stress of life and work fruitfully without being actively suicidal (Kisely & Lesage, 2014).
Madness made me gives the views of those people who consider recovery as the absence of symptoms and those who believe it is the improvement in the sense of life even with the presence of the symptoms. Version one of the story narrates how doctors and mental health workers continue to feed Janet with psychotic drugs even when she least needs them. The visit to a psychiatrist earns a patient another prescription of mental drugs instead of being listened to (O’Hagan, 2014). The health care system believes recovery is the complete absence of psychotic symptoms failure to which one is locked down and forced to take more medication (Jacob, Munro, & Taylor, 2015). On the other hand, the second version shows continuous focus in the management of the symptoms without the insistence of getting rid of them. For example, at the age of twenty-five, Janet is working as a mental health nurse even though she still hears voices but has learned to deal with them.
Most people refer personal recovery as recovering from whereas clinical recovery is known as recovering in (Oades & Anderson, 2012). Personal recovery is an independent process, and it helps an individual differently depending on the current situation (Oades & Anderson, 2012). When Janet begins her recovery process, the first few sessions go well until she goes back to school and faces other people she considers different. The change in environment takes the patient to a psychotic breakdown where she hears voices of an angel and goes walking on the street in a see-through dress (O’Hagan, 2014). In addition, when Janet begins to experience extreme symptoms of psychosis in version one, she is locked up for days and injected with medication. The police keep her captive as they would a criminal even when they can detect the patient’s mental state (O’Hagan, 2014). Clinical recovery does not work with the system for criminal justice to help those in need of special health services. However, version two of the story shows that the police unit can handle a mentally unstable person without causing harm and ensure they get the required medical attention.
Individuals who are mentally unstable can undergo complete remission of depression symptoms (Evans, Nizette, & O’Brien, 2017). Research done in the past has confirmed that people suffering from serious mental illnesses can recover to a point where they do not need medication to function. To achieve this, the involvement of forensic mental health unit is required (Evans et al., 2017). These are mental health wards attached to general hospitals to meet the needs of those suffering from mental and emotional instabilities. These facilities assess the process that will assist each patient to recover (Evans et al., 2017). Some patients require rehabilitation while other people need socio-cultural related treatments. Forensic units should work with the criminal justice system since mentally impaired patients are subject to criminal justice legislation. Alleged offenders should be referred for psychiatric assessment and treatment by the police or any member of the criminal justice system (Evans et al., 2017). In both versions of Janet’s story, she is captured by the police for public disturbance even though both cases are handled differently. When the patient wishes to leave the mental care premises, a nurse tells her she is under the care of the Mental Health Act at which point where she contacts a lawyer who turns her down because she belongs in the mental ward.
Recovery Principles
Helping an individual develop uniqueness in recovery is essential. As mental health care grows beyond clinical recovery, few elements should be considered. Hope is the primary principle in recovery. Without the belief in a better life, an individual cannot make the first step of hope (Bird et al., 2014). Janet needed hope from Lisa to face another day and believe in recovery. Additionally, the presence of a welcoming feeling from her new home gave her hope and eventually the belief that she could recover and have a good life. In the course of her stay at the house, the staff members helped Janet find meaning in going back to nursing school and enrolling in a local photography course (O’Hagan, 2014). Therefore, finding a sense of meaning is important in developing a strong interpersonal link. Every recovery step requires the conviction that every individual has a potential to change. The potential for change element challenges professionals in mental facilities against the pessimistic approach of believing some extreme cases of mental illnesses cannot be cured (Department of Health, 2017). For example, in the first version of the story, the psychiatrist does not see potential in Janet’s recovery and opts to prescribe her to more medication instead of giving her hope. Also, the nurses lock her up in a dark room for days because she went down the street saving people. However, the second version elaborates on her such a scenario should be handled to the benefit of the patient O’Hagan (2015).
Another principle of recovery is making real choices. It is crucial for a patient to experience control over their lives (Department of Health, 2017). In most health facilities, mentally impaired patients are denied the experience of being involved in their treatment. Enabling a patient to make real choices in recovery supports them to build on their strengths as they take the next step to recovery. It is important for care givers to ensure there is balance between the services they offer and the needs of the patients. When Janet attends her appointment at the community mental health center, the psychiatrist gives her more medication pointing out they are like insulin for a diabetic patient. Also, when Janet speaks out of the effects the medication is having on her, the psychiatrist refuses to reduce the dosage saying she cannot survive without them (O’Hagan, 2014). Active participation is important in the recovery of a patient unlike being a passive recipient (Lee et al., 2014). Patients should be allowed to take responsibility for their treatment with the help of family and friends. Janet’s mother goes on training for two years so that she can be able to help her daughter in recovery.
Environment affects recovery both negatively and positively (Kidd, Kenny, & Mckinstry, 2015). Recovery needs the support of peers and allies. As such, mental health practices should acknowledge that a patient is an expert on their lives and form a partnership with the care giver. To recover, one needs to work a team to provide the needed support which plays a valuable role in recovery since it allows other members to give a sense of belonging (Knight, Caesar, Ford, Coughlin, & Frick, 2012). Also, the presence of people who believe in the patient’s ability to overcome the illness by offering hope and encouragement is an essential factor in recovery (Rieck & Pettigrew, 2013). The attitude displayed by care givers determines the recovery of some patients. The personal process involves learning from others and being able to communicate. A patient also needs to feel legally protected as a citizen of a country regardless of their health condition.
Conclusion
Helping mentally impaired people to access medical services easily and offering professional support removes barriers that were previously making the process hectic. Actively engaging an individual in recovery-oriented processes within the mental health clinics is the key to a fully functional system (Jacob et al., 2015). Offering services designed and operated by people who have recovered from mental health issues will help patients. The Australian government should take responsibility for implementing and promoting an affordable and effective framework all over the country. Facilities should also do a follow up after a patient successfully recovers from mental health issues to prevent a fallout. Evaluating recovery is the most important step after managing the illness. Care givers should be able to track their progress on a patient and improve on quality of their services. Key outcomes that portray recovery such as employment, education, and housing should be reported in the system.
References
Australian Government Department of Health, P. and M. H. C. D. (2017). National framework for recovery-oriented mental health services. Retrieved April 27, 2017, from http://www.health.gov.au/internet/main/publishing.nsf/content/mental-pubs-n-recovfra
Bird, V., Leamy, M., Tew, J., Boutillier, C. Le, Williams, J., & Slade, M. (2014). Fit for purpose? Validation of a conceptual framework for personal recovery with current mental health consumers. Australian and New Zealand Journal of Psychiatry, 48(7), 644–653. https://doi.org/10.1177/0004867413520046
Council, A. H. M. A. (2013). Practitioner guide to recovery principles that support recovery-oriented mental health practice: journey of hope and new beginnings. Retrieved from http://www.health.gov.au/internet/main/publishing.nsf/content/mental-pubs-p-recovpra
Department of Health. (2017). Principles of recovery oriented mental health practice. Retrieved April 27, 2017, from http://www.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-i-nongov-toc~mental-pubs-i-nongov-pri
Evans, K. (Psychiatric nurse), Nizette, D., & O’Brien, A. J. (2017). Psychiatric and mental health nursing (4th ed.). Chatswood, NSW, Australia: Elsevier.
Jacob, S., Munro, I., & Taylor, B. J. (2015). Mental health recovery: Lived experience of consumers, carers and nurses. Contemporary Nurse, 50(1), 1–13. https://doi.org/10.1080/10376178.2015.1012040
Jorm, A., Sawyer, M., & Gillett, J. (2012). Australian Rotary Health: a major contributor to mental illness research and mental health awareness in Australia. Australasian Psychiatry : Bulletin of Royal Australian and New Zealand College of Psychiatrists, 20(4), 318–21. https://doi.org/10.1177/1039856212447968
Kidd, S., Kenny, A., & Mckinstry, C. (2015). Exploring the meaning of recovery-oriented care: An action-research study. International Journal of Mental Health Nursing, 24(1), 38–48. https://doi.org/10.1111/inm.12095
Kisely, S., & Lesage, A. (2014). Mental health services in Australia. Sante Mentale Au Quebec, 39(1), 195–208 14p. https://doi.org/10.7202/1025914ar
Knight, A. W., Caesar, C., Ford, D., Coughlin, A., & Frick, C. (2012). Improving primary care in Australia through the Australian Primary Care Collaboratives Program: a quality improvement report. BMJ Quality & Safety, 21(11), 948–55. https://doi.org/10.1136/bmjqs-2011-000165
Lee, S. J., Collister, L., Stafrace, S., Crowther, E., Kroschel, J., & Kulkarni, J. (2014). Promoting recovery via an integrated model of care to deliver a bed-based, mental health prevention and recovery centre. Australasian Psychiatry : Bulletin of Royal Australian and New Zealand College of Psychiatrists, 22(5), 481–8. https://doi.org/10.1177/1039856214545979
MacFarlane, B., & Stafford, A. (2016). Hear this: Patient-centred care. AJP: The Australian Journal of Pharmacy, 97(1154), 76–77.
O’Hagan, M. (2014). Madness made me: a memoir. New Zealand: Open Box/Potton & Burton.
Oades, L. G., & Anderson, J. (2012). Recovery in Australia: marshalling strengths and living values. International Review of Psychiatry, 24(1), 5–10. https://doi.org/10.3109/09540261.2012.660623
Rieck, A., & Pettigrew, S. (2013). How physician and community pharmacist perceptions of the community pharmacist role in Australian primary care influence the quality of collaborative chronic disease management. Quality in Primary Care, 21(2), 105–111.
