Analyzing Community Mental Health Recovery Model

Community Mental Health "Recovery Model"

What is the recovery orientation/paradigm model of treatment?

A mental health Recovery Model is a treatment alternative in which the service delivery is such that clients have the primary and final decision-making ability over their own treatment. This is unlike the majority of most conventional forms of treatment, in which physicians have the primary control over decisions or clients are just consulted as a formality. The underlying principle of the Recovery Model is that if a client is empowered to have greater choice and control over their service delivery, then he or she will have a greater incentive and drive to take increased initiative and control of their lives (NASW Practice Snapshot: The Transformation of the Mental Health System, 2006).

b. What is the medical model and what are the differences between the medical model and the recovery model of treatment?

A mental health medical model approaches a mental disorder in the same way a broken leg would be treated -- that is as if the disorder was a physical issue. This model is mainly used by psychiatrists and to a smaller extent by psychologists. Those in favour of this service delivery option take symptoms as outward manifestations of inner physical illnesses and argue that if the symptoms can be properly assessed and categorized into a 'syndrome', then the real cause can be ultimately revealed and the proper treatment given. Thus, simply put, the medical approach to service delivery assumes that disorder has a physical cause. This model focuses on neuroanatomy, neurophysiology, neurotransmitters, genetics etc. This model is based on the concept that mental disorders are linked to the structure and functioning of the brain. Behaviours, such as suicidal ideations, depression or hallucinations are regarded as 'symptoms'. The symptoms can then be grouped together into a syndrome, which is then regarded as the true cause of illness (McLeod, 2014).

As expressed earlier, the mental health Recovery Model is a treatment option in which the service delivery is such that clients have the primary and final decision-making ability over their own treatment. The role of psychologists or psychiatrists in this model is to provide education/information on which are the available alternatives and their likely outcomes. The clients are engaged from the onset regarding the care options. Another key point in recovery model is that clients ought to have the right to make decisions and have their decisions respected in the same way any other member of the society would, i.e. the consumer is king -- their choices ought to be respected. If in any case the client's choices don't seem logical to us, then there is a need to inform them about the consequences and possible outcomes of their choices, however, it is the client's right to make the final choice (NASW Practice Snapshot: The Transformation of the Mental Health System, 2006).

c. What are the advantages and disadvantages of the recovery model?

Advantages

Some of the advantages of the mental health recovery model include: increased patient commitment or involvement in treatment; client empowerment; higher compliance and structure; and the use of Wellness Recovery Action Plan (WRAP) as a way of reinforcing coping skills taught in treatment as a way of preventing future reoccurrence of mental health crises (Buckley et al., 2007). The recovery approach focuses on the client's needs and empowering the client to take charge of his or her life. This model involves different life aspects that are common to most people, thus promoting shared concerns. The recovery model also builds positive expectations for clients. Finally, this approach brings hope to the mental health sector (Duckworth, 2015).

Disadvantages

Most of the arguments against the Recovery Model simply reflect the fear of the unknown among opponent of the approach. Studies and literature suggest that this model is relevant in all contexts and settings. Critics have called for a need to have a closer look at the consequences of the Recovery Model on service delivery in clinical situations and in difficult service environments where a client's choice and ability to make decisions is most compromised or in environments where there are few alternatives. If the implications of the Recovery model for practice in difficult environments are not considered and addressed then this model will remain to be mere talk in such environments (National Recovery-Oriented Mental Health Practice Framework Project, 2012). The main drawback of the model is that it is inherently difficult to measure the subjective experience of recovery. In the modern day economic environment of budget deficits, the things that are not measured are usually not sufficiently funded or attended to. There are a couple of steps of the Recovery Model that are currently being used in conventional delivery settings, however, there is no agreement on using them collectively as a model or on the best way to confirm the quality of these practices. Another disadvantage of the model is that some clients with psychosis may be in denial and thus not consider themselves as ill. One can see how such an individual would not be best suited to use the mental health recovery model, which will give him the final say over his treatment options and he will most likely decide he is okay and doesn't need any form of treatment administered (Duckworth, 2015).

d. Given that both treatment models are important, how can they both be used to complement one another while working with a client?

The only way for one to get maximum benefits in a difficult undertaking is to make use of every available resource. Thus, in mental health care, both the recovery model and the medical model can be used together to maximize recovery progress. When used together, these two models can make a huge difference in mental health patients. The mental health recovery model has its own advantages; it clearly caters for the needs of many mental health patients. It also stresses on many things, such as self-management, peer support, hope and empowerment, which to me are the cornerstones of this model. The medical model also has its own advantages. The fact that the model has been used for a long-time, and that it is evidence based and rooted on science makes it to stand out for me (Duckworth, 2015).

Diagnosis is a key part of the medical model. At the same time, diagnosis is important in the drafting of a recovery plan. For instance, if an individual has bipolar disorder, then administering antidepressants will not be of much assistance to the individual during the depressive stage. Taking of antidepressants might actually worsen things through the activation of mania. A medical diagnosis of bipolar will increase the need for self-care: establishing supportive relationships; exercising; managing stress; and getting more regular sleep. These self-care concepts for managing bipolar disorder are critical Recovery approach concepts that have been shown to be effective in controlling the disorder. The recovery plans for various interventions -- metallization and DBT (dialectical behavioural therapy) have been researched -- focus on the development of skills to cope with different emotions. DBT, which is recovery based, has been reported to significantly cut the risk of suicide in different studies. This is a fine example of integration, in that a recovery intervention that was developed by an individual who coped with a condition that now has been clinically proven to help in the prevention of suicide.

Another great way through which one can integrate the two interventions is through shared decision making. For instance, in clinical settings, the deliberation for a change in medication results in some improvements, but causes some complications in a frequent dilemma. In this case, only through considering the science (evidence) and taking into account what the client knows about their capacity for risk, their stresses and supports can one reach at an appropriate and well thought-out decision. The key to the integration of the medical and recovery models is to take into account the experiential and scientific aspects of all decisions (Duckworth, 2015).

e. What is the benefit to the client when the recovery model of treatment is utilized?

Mental health recovery models highly value the experience and decisions made by the client. This model is based on the idea that there are two experts in the encounter between a service provider and a client. The first expert is obviously the service provider (clinician) with the medical knowledge and the second is the client with experiential knowledge. When the two work together, progress can be made much faster, since the client will feel empowered and committed to the treatment plan. Thus, this model places greater value on the experiences of the client than on the clinically defined best interests of the client. For clients, the delivery of care in line with their own individual choices is likely to result in better outcomes. Working with the clients' choices and preferences has a higher likelihood of enabling them to take charge of their lives (South London and Maudsley NHS Foundation Trust and South West London and St. George's Mental Health NHS Trust, 2010). A more balanced and evidence-founded approach to treatment is offered by the introduction of personal recovery priorities. Recovery-oriented practice could assist in the complementation of typical advances. Placing value on the social outcomes as well as the ways of attaining these could enhance the outcomes for service users, particularly when they should learn how to survive with continuing symptoms and varying conditions. In the past, the interests of individuals with mental sickness in the society have been minor, with resultant collective and personal harm to them. Personal Recovery retackles this and offers a way of empowering service users and re-stating their citizenship and rights. This basically means attending to the rights of individuals having ill mental health, to citizenship, justice and equality, and discrimination and stigma, and to the status of individuals having mental health issues in the society (South London and Maudsley NHS Foundation Trust and South West London and St. George's Mental Health NHS Trust, 2010).

f. How does the recovery model implement or utilize the notions of hope, empowerment, self-responsibility, and the meaning full role?

Recovery refers to the typical adaptational procedure, which follows destruction, similar to the way grief is the normal adaptational procedure which comes after loss. The two processes frequently complement one another (MHALA, 2002).

Hope

In the darkest times of misery, what is required first is simply hope as a light that awaits at the end of the tunnel, some ideas that things could get better, that life shall become more than the present devastation. There is no real chance of positive action without hope. However, so as to be really motivating, hope needs to be more than just an ideal. It should take form as the real image of how things would turn out if they got better. It is not so many individuals who shall specifically meet the vision they form, due to the fact in reality majority of the outcomes are products of opportunity and chance more than cautious planning. Despite this, it seems important to have some clear picture, if individuals are to make hard changes and take constructive steps (MHALA, 2002).

Empowerment

In moving forward, individuals ought to have a sense of their own abilities, a sense of their own power. Their hope should be centred on things that they are capable of doing instead of new curses or fixes that another individual shall discover or provide to them. It is frequently required for another individual to trust in them before they are actually strong enough to trust in themselves and to begin concentrating on their strengths and not on their losses. Also, it frequently takes some actual encounter of success to truly believe that one could become successful. Waiting till someone is ready to move on could frequently be disempowering and stagnating, since "readiness" frequently happens just in retrospect after something has been successfully done (MHALA, 2002).

Self-Responsibility

At a certain point, the majority of the individuals that recover come to the realization that nobody else could do it for them; they have to assume responsibility of their recoveries. Individuals often need support in their recovery efforts; however, they cannot be protected or care-taken into recovery. Taking personal risks, setting of personal goals and paths, and learning personal lessons are important aspects of recovery. The appeals of dependence as well as being cared for could ruin a recovery as could be being very scared or traumatized to actually take the risks (MHALA, 2002).

Meaningful Role in Life

So as to eventually recover, one should achieve some significant role apart from the destruction. Becoming a victim of destruction is not a recovered role, and honestly, neither is it destruction survivor. After attaining increased hopefulness, self-responsibility together with inner strength, these particular qualities are applied to meaningful roles besides the destruction. The darkness of destruction, which once appeared to swallow the individual whole, lessens in significance as the individual's other meaning surfaces. Connection to others, belonging, and the feeling of acceptance, which might have for a while only been possible with other individuals that had encountered related destructions, within their families, or even with kind-hearted helpers becomes possible in several contexts. The destruction inflicted is increasingly broken and life re-entered (MHALA, 2002).

g. How different or similar is the recovery model from any of the main theories of treatment (cognitive behavioural, solution focused, narrative, psychoanalysis, structural ... etc.)?

Recovery is frequently referred to as a procedure, a conceptual framework, a guiding principle, or a vision among many more. There is no one agreed upon definition of the word recovery. The central message, however, is that hope and restoration of a meaningful life are possible, in spite of severe mental sickness. Recovery is not only a conceptual framework for understanding mental sickness, but also a system of care to offer opportunities as well as support for personal growth. Recovery stresses that while people might not be capable of having complete control over their symptoms, they can have complete control over their lives. Recovery emphasizes that people with psychiatric disabilities could not only attain affective stability and social rehabilitation, but also rise above limits inflicted by both mental sickness and social obstacles to meet their greatest goals and aspirations (Mental health recovery model, n.d). Below are major statements of the Recovery Model of mental sickness, which differentiates it from other theories:

A holistic outlook of mental sickness, which concentrates on the individual and not just the symptoms;

Recovery is not a function of an individual's theory regarding the causes of mental sickness;