Research problem identification and methodology

Psychology

Mental Health Recovery Program

Why does evaluation matter so much counseling programs? When one evaluates a program, they can be more certain that what is being done is making a difference. Practitioners have a professional responsibility to show that what they are doing is effective. Evaluation results demonstrate the impact and value of the work to key stakeholders which can help justify the resources that are available for different programs (Dimmitt, 2009).

Although mental health programs have become a global concern, one of the barriers to progress is the amount of evidence about effectiveness and cost effectiveness of these programs. Although it is known that there are effective treatments, there is less evidence about how to effectively the delivery of these programs is. It has been observed that there is variation in the symptoms and severity of the treatment needs of people utilizing mental health programs. This makes evaluation of programs most needed to make sure that everyone is getting the help that they need (Dewa, Hoch, Carmen, Guscott, and Anderson, 2009).

Mental health recovery is a journey of healing and transformation that enables a person with a mental health problem to live a meaningful life within the community, while striving to achieve his or her full potential. There are 10 Fundamental Components of Recovery that have been identified:

Self-Direction consists of patients leading, controlling, exercising choice over, and determining their own path of recovery by optimizing autonomy, independence, and control of resources to achieve a self-determined life. This type of recovery process must be self-directed by the individual as they defines their own life goals and plans the path to achieve those goals.

Individualized and Person-Centered components include multiple pathways to recovery based on an individual's unique strengths and resiliencies as well their needs, preferences, experiences, and cultural background. Individuals also see recovery as being an ongoing journey and an end result as well as an overall model for achieving wellness and optimal mental health.

Empowerment is where patients have the authority to choose from a range of options and to participate in all programs that will affect their lives, and are educated and supported in so doing. They have the ability to join with other patients to collectively and effectively speak for themselves about their needs, wants, desires, and aspirations. Because of empowerment, an individual gains control of his or her own destiny and influences the organizational and societal structures in their lives.

Holistic components consist of a person's whole life, including mind, body, spirit, and community. Recovery includes all aspects of life, including housing, employment, education, mental health and healthcare treatment and services, complementary and naturalistic services, addictions treatment, spirituality, creativity, social networks, community participation, and family supports as determined by the person. It is felt that families, providers, organizations, systems, communities, and society play crucial roles in creating and maintaining meaningful opportunities for consumer access to these supports.

Non-Linear recovery is not a step-by-step process but one which is based on continual growth, occasional setbacks, and learning from experience. Recovery is said to begin with an initial stage of awareness in which a person recognizes that positive change is possible. This awareness enables the patient to move on to fully engage in the work of recovery in their own direction.

Strengths-Based recovery focuses on valuing and building on the multiple capacities, resiliencies, talents, coping abilities, and inherent worth of each individual. By building upon these strengths, consumers leave stymied life roles behind and engage in new life roles. The process of recovery is moved forward through the interaction with others in supportive relationships.

Peer Support is mutual support that plays an invaluable role in recovery. Patients are encouraged to engage other patients in recovery and provide each other with a sense of belonging, supportive relationships, valued roles, and community.

Respect consists of community, systems, and societal acceptance and appreciation of patients. Self-acceptance and regaining belief in one's self is vital to the recovery process. Respect helps to ensure the inclusion and full participation of patients in all aspects of their lives.

Responsibility refers to the personal responsibility that patients have for their own self-care and recovery. Patients must strive to understand and give meaning to their experiences and identify coping strategies and healing processes to promote their own wellness.

Hope provides the essential and motivating message of a better future so that people can and do overcome the barriers and obstacles that confront them. Hope is internal, but can be fostered by peers, families, friends, providers, and others. Hope is the vehicle of the recovery process. Mental health recovery benefits individuals with mental health disabilities by focusing on their abilities to live, work, learn, and fully participate in society. Society reaps the benefits of the contributions individuals with mental disabilities can make, ultimately becoming a stronger and healthier Nation (National Consensus Statement on Mental Health Recover, n.d.).

Self-management is one aspect of recovery which begins to translate the ideas of recovery and turn them into practical tools of everyday living. Although self-management sounds mechanistic it does provide a term that most people can understand and work with across a range of positions within the mental health community. The WRAP (Wellness Recovery Action Plan) is a structured approach to self-management working in groups with each stage of self-management from recognizing what wellness looks like, through identifying early warning signs and triggers to developing a crisis and post crisis plan (Davidson, 2005).

The levels of self-management within WRAP range through:

Increasing awareness at the day-to-day level of what triggers off small changes that can upset a person's equilibrium.

More general ways of ensuring that a person's good health through their lifestyle.

Signs that things are falling apart.

Letting others know what we want to happen and who we want involved if we are in crisis.

Being quite specific about interventions and treatment.

Semi-legal written advanced directives (Davidson, 2005).

Research has found that important factors on the road to recovery include: good relationships, financial security, satisfying work, personal growth, the right living environment, developing one's own cultural or spiritual perspectives, and developing resilience to possible adversity or stress in the future. Further factors highlighted by people as supporting them on their recovery journey include: being believed in, being listened to and understood, getting explanations for problems or experiences, and having the opportunity to temporarily resign responsibility during periods of crisis. In addition, it is important that anyone who is supporting someone during the recovery process encourages them to develop their skills and supports them to achieve their goals (Recovery, 2007).

Putting recovery into action consists of focusing care on supporting recovery and building the flexibility of people with mental health problems, not just on managing their symptoms. There is no one definition of the concept of recovery for people with mental health problems, but the key idea is one of hope that it is possible for meaningful life to be restored, despite serious mental illness. Recovery is often referred to as a process, outlook, vision, and conceptual framework or guiding principle (Recovery, 2007)

WRAP is a self-management and recovery program that was developed by a group of people in the U.S. who had mental health difficulties and were struggling to incorporate wellness tools and strategies into their lives. WRAP is designed to:

decrease and prevent intrusive or troubling feelings and behaviors increase personal empowerment improve quality of life assist people in achieving their own life goals and dreams (Recovery, 2007).

WRAP is a structured program that is used to monitor uncomfortable and distressing symptoms. It helps to reduce, modify and eliminate symptoms that people experience by using planned responses. These can include plans for how an individual wants others to respond when symptoms have made it impossible for them to continue to make decisions, take care of themselves or stay safe. The person who experiences the symptoms develops their personal WRAP, although they may choose to ask the people who support them or health professionals to help them create it (Recovery, 2007). The ultimate goal of the WRAP program would consist of interviewing participants in order to determine if the plan that they developed for planned responses to uncomfortable or distressing situations were indeed effective.