Mental Health: Recovery Principles & Clinical Recovery
The concept of recovery oriented practice has increasingly become a prominent concept in mental health policy internationally. This notion originated from consumer perspectives that challenged traditional beliefs about course of mental health disorders and the effective treatment strategies, and it has become widely conceptualized that recovery oriented care is a deeply unique process that changes a person’s attitudes, feelings, values, goals and skills with the aim of improving life limitations caused by the mental illness (Doran et al., 2015). Using Janet’s case study Version 1 and Version 2, this essay expounds on the concept of recovery oriented care by focusing on recovery principles; and elaborating how mental health recovery principles differ from clinical recovery principles.
Recovery principles refer to the collective approach used to respond to the mental health distress by supporting empowerment, autonomy and retention of hope. Fundamentally, the recovery principles focus on the benefit of acknowledging a person as a whole instead of defining them by their deficits or difficulties (Evans et al., 2017).
In this context, recovery is supported through the implementation of collaborative and consultative treatment strategies to people with mental health issues. These strategies place the client at the center of care and emphasize on individuals strengths to support their self determination.
The recovery principles are core to the professional standards for Australian and New Zealand mental health includes uniqueness of an individual, autonomy, rights and attitude of their carers, treating mentally ill people with dignity and respect, collaborative care enhanced through effective communication (Mental Health Commission, 2012).
Based on recovery principles, helping patients who experience mental health issues with psychotic clinical issues, such as bipolar disorder and schizophrenia, requires a range of skills and attitudes that are developed from sound knowledge foundation as well as inquisitive approach. The core recovery principle in this group of attributes is the ability to establish a respectful support and collaborative relationship (therapeutic alliance) with the client, their relatives, friends and their loved ones (Slade et al., 2014).
The main challenge for clinical practice during the recovery paradigm is the capacity to remain responsive to the patient’s change and family/loved ones concerns. However, this is vital because client’s capacity to exercise autonomy during decision making may fluctuate over time. For instance, the client may change their desired treatment approach frequently or the client’s family may hold different opinions about the best treatment.
Therefore, the recovery principles enable the provider to develop the capacity to ‘be with’ instead of insisting on the standard clinical practice. For instance, in Janet’s Case study Version 2, “the psychiatrist was happy to reduce drugs after 10 days when Janet told her how horrible they were” (O’Hagan, 2014, p.227).
From this analysis, the healthcare provider should understand their own feelings and values to this practice. This is because their personal ethical beliefs and values could make them to inadvertently exhibit judgmental behaviors which could compromise care. The mental health care providers should perform rigorous and regular clinical supervision so as to retain clarity in nursing practice (Evans, Nizette, & O’Brien, 2017).
Clinical supervision is one of the recovery principle recognized as professional standard for Australian as well and New Zealand mental health nurses. In addition, it is evident that recovery principles are based on reflective care that is not influenced by the individual’s personal values or ethics. These principles emphasize on self determination and collaborative partnership.
For instance, in Janet’s case study version 2,Through collaborative treatment approaches, Janet was able to overcome the sexual abuse trauma; she is better, and now works as a mental health nurse, where she uses her experience to guide other mentally ill patient (O’Hagan, 2017, p.228).
The difference between recovery principles and clinical recovery
Recovery can be viewed through different lenses – personal experience (set of workforce competencies/practices) or clinical recovery process. This personal recovery approach is viewed as the post institutional service philosophy because it challenges the bedrock of traditional mental health system (Barder, 2012).
Clinical recovery is a concept that emerged from the expertise of mental health care providers, and it entails treating of psychosocial symptoms so as to restore functioning or to bring back the patient’s life back to normal. Recovery principle differs in clinical recovery in that the concept emerged from expertise of people who have lived the experienced or mental illness (Hapell et al., 2013).
On the other hand, recovery principle dwells on a deep unique change of a person’s values, attitudes and feelings with the aim of living a satisfactory life within the daily life limitations associated with the illness. It is basically creating a new purpose and meaning in client’s life as she or he grows beyond the catastrophic event associated with the mental illness (Williams et al., 2012).
As depicted in Janet case study Version 1, the traditional healthcare system perceives mental illness with no legitimacy. Most clients experience major mental health issues as frightening, desolate and also destructive. This is because the pain in mentally ill clients is at par with grief and torture of surviving a battle field or that of being accused of heinous crime (Leah, 2012).
The only difference is that the latter experiences have legitimacy and the society has a well defined pathway for their justice and recovery; and surviving them is perceived as heroic and is admirable. On the other hand, mental health is met with fear, reproach and pity.
Unlike clinical recovery, recovery principles recognize the importance of person recovery in that mental illness is perceived as a full human experience; therefore, it does not support justification for segregation, cruelty and coercion. A society that has person recovery mind concepts has place for people with mental health illness because seeks to provide a better pathway to better life (O’Hagan, 2014).
Another aspect of clinical recovery that acts as bedrock of the unfortunate traditional belief is community’s abdication of responsibility for the mentally ill people to the profession and services. In the current society, people seek answers to human problems from state- authorized profession institutions.
Although to some extent this has been of benefit, it is associated with overdependence of deficit oriented institutions and professionals. Their reputed monopoly on expertise has disabled the mentally ill clients by keeping the stuck in the healthcare services as indicated by Janet’s case study version 1, “the mental health system is responsible for the Janet’s terrible state (O’Hagan, 2014, p. 224).
The devaluation of mental illness in conjunction with community abdication has is associated with naïve community consensus around client’s safety, which is based on discriminative assumption that mentally ill people are not responsible of their behavior, and that the mental health institutions and services must take responsibility of their behavior through tightly controlled approaches (Gilburt et al., 2013).
The clinical recovery approach develops unsustainable assumptions that mentally ill persons must be controlled like robots; they lack freewill and those mental health institutions and professionals have magical powers to predict and that the strict measures towards the mentally ill people is meant to establish a safer community.
Unfortunately, the unrealistic demands have led to increase in risk adverse practices such as liberty restrictions, locked doors and compulsory treatment just as those experienced by Janet Version 1 case study (Berglund, 2012; Ivey et al., 2012).
Clinical recovery is important, but focusing on clinical recovery alone makes the patient to feel defined by their mental health problem, thereby exacerbating the problem. This approach also makes a person to neglect other aspects of lives that could be cultivated and potentially lead to improved wellbeing (Evans & Brown, 2012).
Most of the clinicians identify mental illness experiences such as hearing voices a focus of clinical recovery, which not only make it problematic, but also leads to waste or resources in order to get rid of personal idiosyncrasies that otherwise would be the patient’s assets if well understood and work with using the best approaches possible.
On the contrary, the recovery principles of the mental health service seek to design treatment strategies for mental illness is that does not only keeping people out of acute crisis so that they can lessen their dependency and burden to the community. The strategies contemplate the possibility of holistic recovery instead of focusing on clinical issues only, which in most cases could be resolved (Le Boutillier et al., 2015).
Mentally ill people are human beings too; they have rights as other citizens and must be allowed to participate in their local communities. To ensure that the mentally ill patients are socially included in the community’s daily life, the society and mental health professions will be required to change their traditional beliefs and unfortunate assumptions about mental health. In this context, the final frontier is eradicating the barriers that prevent people from experiencing their entitlements as the other citizens.
This involves transformation of “treat clinical symptoms- and recover” world view. In addition, the mental health systems should give priorities to treatments strategies that help the mentally ill patient to continue re-engaging with their life. However, the most important and the broadest challenge is the societal change.
This implies that the mental health professionals should collaborate with people with lived experienced of mental illness to become partners and social activists who challenge the erroneous stigmatizing assumptions associated with mentally ill people which prohibits them from enjoying the same citizenship entitlements as other people in the community.
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