Relationship Between Clinical and Recovery

‘Madness Made Me’ by Mary O’Hagan depicts her journey where she illustrated the myth about madness and people’s customary response through the lens of her lived experience (O’Hagan, 2014). Her journey started from a psychiatric mental hospital in United States and ended when she became the leader in the International Mad Movement. The book uncovers the widespread injustice that occurs in the mental health system where the people are treated in an irrational manner and develop irrational fears about the mentally ill people. The book end with hope and envisions the world where the mentally distressed people are treated with respect and humanity. As a young woman, Mary O’Hagan had experienced mental breakdown in her late 1970’s and was admitted to a mental health institution at the age of 18 because of psychotic depression. Until the age of 26, she experienced traumatic episodes and was told by the mental health institution that she would never recover. However, she did recover and currently, she is the international consultant and social entrepreneur in mental health working for the people with mental distress in United States. She was a key initiator in the New Zealand made movement in 1980’s and was the first chairperson of World Network of Users and Survivors of Psychiatry.

Her experience led to the creation of her own social enterprise, Peer Zone that provide peer made resources for the people with mental health distress and the supporters. Through her book, she made a fundamental message that madness is a disruptive, but a full human experience.  Her entrenching life experience had made her formed strong opinions about the mental health system and the society about how they react to the mental crisis. This is regarded as the personal recovery where a person is able to live a satisfied and hopeful life by changing one’s values, attitudes and feelings despite of the limitations posed by the illness (Fortinash & Worret, 2014). She mentioned that there prevails a lot of stigma and discrimination within the mental health system. Her book depicted that core of every problem is that the system and society have a poor attitude towards the mental disorders. There is wide knowledge gap and lack of perspective and understanding about the mental illness and that gives rise to social stigma. As depicted through her lived experience, there is a need to change the attitude of the people towards mental illness. Her lived experience shows that talking about one’s experiences openly and public discourse gives a clear picture about the working of the service system and the attitudes of the healthcare professionals. Madness Made Me is a memoir that helps to know the things required to have helpful attitudes from the people in treating mental illness.

Clinical recovery is based on the idea that the mental health professionals help in getting rid of the disease symptoms and restoring of the social functioning that helps a person to lead a normal life. This kind of recovery is acknowledged by the mental health services to fulfill the goals of the clinical recovery. However, personal recovery deals with the development of new purpose and meaning in one’s life where the person grows beyond the catastrophic effects f the mental illness (Gaffey, Evans  & Walsh, 2016).

The book by Mary depicts both the clinical and personal recovery where she learnt to reframe her life through personal recovery along with the clinical recovery provided by the mental health services. In her book, she illustrated that the mental health services consider mental illness as a stigma and discriminate them. The recovery of mental health is only possible when people change their attitude towards the mental ill people in the society and system (Newman-Taylor et al., 2015). However, personal and clinical recovery both is important for the complete recovery. Through the lived experience of Mary, it shows that personal recovery played an important role in her recovery after which she found a new meaning in her life. Apart from the clinical recovery that she received while staying at the psychiatric mental hospital in United States, she also underwent personal recovery that played an important role in shaping her life. Despite of the traumatic journey she experienced from the age of 18 until 26 years, she became the leader of the Mad Movement in New Zealand. Clinical recovery restricts people within the limits like medications, mental health symptoms and other related problems. In contrast, personal recovery provides potential to the people with mental distress to recover based on their own resilience power despite of the effects of the illness.

Mary identified and utilized her strengths and resilience power to build her own relationships and skills and in improving her relationships to become self-sufficient and supportive. By taking part in Mad Movement and chairperson of World Network of Users and Survivors of Psychiatry and by developing Peer Zone, she gave meaning to her life and increased feeling of wellness. It also helped her to eliminate the psychiatric symptoms and negative outcomes through adoption of personal recovery. Through her life, it can be concluded that in a mental health system, the importance of personal recovery should be recognized, supported and honored (Leamy et al., 2016).

The principles of recovery in mental health practice means gaining hope and resilience where a person understands his or her abilities, active engagement in life, social identity, personal autonomy, positive sense and purpose to life. The principles also refer to the internal conditions that are experienced by a person where they describe themselves as healed, empowered, and hopeful and connected to themselves and to the external world (Bird et al., 2014).

The principles of recovery are uniqueness of an individual, real choices, attitudes and rights, respect and dignity, partnership and communication and evaluation of recovery (Smith et al., 2016). In the principle of uniqueness of individual, recovery is not only related to cure, but also provide opportunities for the individuals to make their lives meaningful, purposeful and valued. This principle emphasizes on the quality of life and social inclusion focusing beyond the mental health services. The real choices principle encompasses the empowering and supporting of the individuals so that they are able to make their own choices and lead their lives in a creative and meaningful manner. The individuals are able to build their strengths and take responsibility to live their own life. There should be a balance between the support provided to the individuals and duty of care and make ways for new opportunities (Macpherson et al., 2016).

The principle of attitudes and rights where there should be empathetic listening and effective communication between the individuals and their care givers. Moreover, they should protect and promote legal rights of the individuals and instill hope where they are able to look forward towards their future and add meaning to their life. Dignity and respect is the principle where they should be courteous, honest and respectful towards the individuals and in all interactions. The caregivers should be sensitive and respectful for the individuals and their cultural beliefs. They should challenge discrimination and stigmatization if it exists in the organization. In the partnership and communication principle, the mental health practice should acknowledge the individuals as they are the expert of their own life and working in partnerships with the carers and individuals so that they are able to support and make sense to them (Slade & Wallace, 2017). It also involves the valuing of the sharing of the relevant information so that they are able to communicate clearly with each other and promote effective engagement. They should work in realistic and positive partnership with the carers and individuals so that they are able to realize their own aspirations, hopes and goals. The sixth principle is the evaluation of recovery. This enables and ensures continuous evaluation of the recovery based practice. The carers and individuals are able to evaluate and track their progress. It also encompasses services and demonstrates where the individual care experiences to inform the improvement of quality in the activities (Tew, 2013). The mental health system should also report on the key outcomes that involves recovery in terms of employment, housing, social and education along with family relationships with well-being of the individuals. These principles are adapted by The Department of Health in the Australian Government.

The principles of recovery are different from the clinical recovery that involves traditional way of recovery. From the story of Janet it is evident that the mental health services provided by the traditional services are different from the recovery based services (Perry & Pescosolido, 2015).

From the version one of Janet’s story, it is evident that the mental health services did not follow the principles of recovery and provided her support so that she is able to live a hopeful life after the treatment in the mental health services. She was left helpless, lonely and struggling with the catastrophic effect of her mental illness. She expressed that the mental health system is unre3liable and incompetent as she was just asked to take her medication and avoid stress. The nurses put her in a locked room, injected her and she was left alone in the room screaming and abandoned. In the first version, she was estranged for her family with no friends and help. She lived in a staffed room where she was abandoned and left alone (O’Hagan, 2014).

In the second version of Janet’s story, she and her friend Emma contacted an online support group Rock Up where she was welcomed and was provided support by the peer support group. She got family support from the Rock Up and also provided her student support service for her nursing school. Finally with their support and extended help, she was able to recover and believed that she can have a good life. Finally after the recovery based service, she was able to start her new life afresh and overcame adversity. She had new friends and became a mental health nurse in a peer support service group like Rock Up. Finally, her life is meaningful putting away all her fears and intrusion. This shows recovery based principle and services plays an important role and is different from clinical recovery (Wunderink et al., 2013).

References

Bird, V., Leamy, M., Tew, J., Le Boutillier, C., 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, 0004867413520046.

Fortinash, K. M., & Worret, P. A. H. (2014). Psychiatric mental health nursing. Elsevier Health Sciences.

Gaffey, K., Evans, D. S., & Walsh, F. (2016). Knowledge and attitudes of Irish Mental Health Professionals to the concept of recovery from mental illness–five years later. Journal of psychiatric and mental health nursing, 23(6-7), 387-398.

Leamy, M., Clarke, E., Le Boutillier, C., Bird, V., Choudhury, R., Macpherson, R., ... & Slade, M. (2016). Recovery practice in community mental health teams: national survey. The British Journal of Psychiatry, 209(4), 340-346.

Macpherson, R., Pesola, F., Leamy, M., Bird, V., Le Boutillier, C., Williams, J., & Slade, M. (2016). The relationship between clinical and recovery dimensions of outcome in mental health. Schizophrenia research, 175(1), 142-147.

Newman-Taylor, K., Herbert, L., Woodfine, C., & Shepherd, G. (2015). Are we delivering recovery-based mental health care? An example of co-produced service evaluation. In Clinical Psychology Forum (Vol. 268, pp. 50-54).

O’Hagan, M. (2014). Madness Made Me. A Memoir. Wellington, NZ: Open Box.

Perry, B. L., & Pescosolido, B. A. (2015). Social network activation: the role of health discussion partners in recovery from mental illness. Social Science & Medicine, 125, 116-128.

Slade, M., & Wallace, G. (2017). Recovery and Mental Health. Wellbeing, Recovery and Mental Health, 24.

Smith, J.C., Hyman, S.M., Andres-Hyman, R.C., Ruiz, J.J. and Davidson, L., 2016. Applying recovery principles to the treatment of trauma. Professional Psychology: Research and Practice, 47(5), p.347.

Tew, J. (2013). Recovery capital: What enables a sustainable recovery from mental health difficulties?. European Journal of Social Work, 16(3), 360-374.

Wunderink, L., Nieboer, R. M., Wiersma, D., Sytema, S., & Nienhuis, F. J. (2013). Recovery in remitted first-episode psychosis at 7 years of follow-up of an early dose reduction/discontinuation or maintenance treatment strategy: long-term follow-up of a 2-year randomized clinical trial. JAMA psychiatry, 70(9), 913-920.