Introduction
Psychosocial or psychiatric rehabilitation of people with mental health problems is a complex process that involves various activities and takes a long time as it can span through one’s whole life. Currently, personal recovery-oriented practices are seen as more advantageous for patients than those which are viewed from the clinical perspective (Slade et al., 2014). This shift means that instead of setting particular goals for a patient, rehabilitation facilities and workers are focused on helping patients realize their potential and take on more responsibility in their recovery process. While the previous system valued control over a person’s actions and decisions, the current approach takes one’s strengths and centers on creating and maintaining a meaningful life for the patient.
In managing such an approach that is strongly connected to developing patients’ self-determination and hope, the role of their family becomes less defined. On the one hand, family participation may be presumed to be less significant than before because the individual with a mental illness has to focus on personal capabilities. On the other hand, the family often continues to remain one of the most vital parts of a person’s life, which cannot be overlooked in creating a plan for one’s successful personal recovery. Therefore, it is necessary to assess the role that family can play in this type of recovery not only to see how it can impact one’s mental health but also to find new ways of integrating it into the rehabilitation process.
Self-Determination and Empowerment
In order to evaluate the role of the family in people’s rehabilitation, it is essential to review the main principles of personal recovery. First of all, recovery-oriented practices revolve around one’s individuality and the uniqueness of every case (Australian Government Department of Health [AGDH], 2010). While previous methods may have been interested in finding a cure or creating a process with a specific end goal, personal recovery recognizes that rehabilitation is a journey. Here, the patient is treated to find or create a purpose and a meaning in one’s life that brings satisfaction and allows this person to become a member of the community. The individual becomes empowered because he or she can realize to be the center of such care.
Second, people with mental health problems are encouraged to participate in their recovery process by making decisions, taking on more responsibility, and taking more risks that can help them with their wellbeing (AGDH, 2010). The recovery that is based on patients’ active participation in the decision-making process is a key element of increasing their feelings of empowerment which in turn may positively impact their health (Baumann, 2010). The effects of empowerment may be seen in people’s personal and professional life as well, helping them integrate into society (Blank, Harries, & Reynolds, 2015). Furthermore, as there exist many attitudes of disempowerment in societies, this approach to recovery may weaken the stigma against people with mental illnesses and return some opportunities that were taken away from them (Aggarwal, 2016). As a result, the process of relocating responsibility back to patients can have many effects on one’s recovery.
The next principle relevant to this discussion deals with the attitudes of mental healthcare practitioners towards patients. It states that practices should encourage and support persons to develop and manage social relations, participate in various social and occupational activities and find a particular purpose that gives them hope about their future (AGDH, 2010). In this case, the importance of belonging and occupation is highlighted because it gives individuals a sense of meaningfulness and instills positive emotions that allow one to focus on gradual recovery. The engagement with society and its structures is said to help individuals define themselves and increase their connection to the rest of the world (Blank et al., 2015). Such positive changes may help persons with mental illnesses to have a more positive outlook on their condition and its ability to change for the better.
Finally, one of the important principles mentions individuals’ partnerships. It revolves around people’s need to choose which relationships are meaningful to them and to pursue these relations in order to progress in their recovery process (AGDH, 2010). Here, the essential role of communication is outlined as the basis for successful recovery, including such foundational aspects as honesty, transparency, and positivity. A realistic approach towards recovery and open communication are also valued as integral parts of one’s rehabilitation in the recovery-oriented practice. These characteristics reveal an approach that heavily relies on trusting relationships between the individual and health care providers, carers, and other involved persons.
These principles show that the empowerment of a person includes many aspects, and it can be enhanced by giving more authority and autonomy to individuals with mental illnesses. This argument shows that this critical role of the patient may overpower other participants in the recovery process. However, the importance of relations is also included in the majority of statements, which may mean the patient cannot fulfill all steps of the recovery process alone. Thus, it is vital to assess how can one’s family enter the process of rehabilitation and change its course.
The Role of Family
Family can play a significant part in many aspects of a person’s life. From the very beginning, the family can either positively or negatively affect one’s process of growing up. Families with poor communication, conflicts, and an overall distressed environment can impact children’s ability to socialize later in life and even result in them developing mental health problems connected to neglect and physical or emotional abuse (Pilgrim, 2017). Similarly, different parenting techniques and their socioeconomic wellbeing can also result in various issues with children’s health (Bøe et al., 2014). These connections between the behavior of family members and their mental health show how important family relations and interactions may be. In the same way, individuals with mental health problems can be influenced by their relationships with family before, during, and after rehabilitation.
Apart from having a negative influence on a person’s mental health, the family can also provide him or her with the assistance required to go further in the process of recovery. Family-focused practice and family therapy are valuable approaches to mental health care with reported positive outcomes and many advantages (Foster et al., 2016). While the form of this participation may not be defined clearly, the interaction of an individual with family may provide him or her with a number of possibilities.
Following the main principles of the recovery-oriented approach, it is possible to assess the role of the family in each aspect relevant to the discussion. First of all, the individual approach to patients and the necessity to make them a center of care can be enhanced by incorporating family members into the process. As families are often expected to be an integral part of one’s life, communication with them may be a component of the patient’s everyday activities. Therefore, by educating family members about psychosocial practices that may help individuals feel empowered and move forward in recovery, they can realize personal capabilities faster or with less emotional work. Here, such education may consist of information about the particular mental illness, ways to interact with the individual, available support from the community and the government, and other practices that may be helpful for recovery (Foster et al., 2016). Thus, the family can become a strong supporter of making the person feel valued and capable.
The process of transferring more responsibility onto the patient may also be encouraged by family members. Many activities in family-oriented therapy may be connected with sharing the burden of dealing with mental illness (Caqueo-Urízar, Rus-Calafell, Urzúa, Escudero, & Gutiérrez-Maldonado, 2015). However, the same activities can be used to let the person know that he or she has the ability to handle appropriate decisions independently. For example, the decision-making process of choosing suitable treatments can be shared with patients and their families through a meaningful discussion that allows individuals with mental illnesses to voice their opinions and establish their needs. This choice of making a family not a decision-maker but an advisor removes some of the burdens from it and empowers patients at the same time (Heller, Gibbons, & Fisher, 2015). Moreover, a discussion can facilitate patients’ participation and develop the means of stating their needs which may stay undefined otherwise.
Family can also help individuals reconnect with their social life by becoming the first community with which a person with mental illness can communicate. The importance of socialization mentioned earlier creates many advantages for patients’ further integration into the lives of a bigger community. The sense of belonging allows one to become more empowered and confident in personal capabilities to overcome the illness and lead a fulfilling life (Haine-Schlagel & Walsh, 2015). As mentioned by the AGDH (2006), although receiving information from professionals is vital to one’s recovery, peer support also plays an important role by serving as a source of exemplary behavior, encouragement, and advocacy. Therefore, the interaction of individuals with mental illnesses with their families can become a significant part of one’s support network leading to them having more possibilities to integrate into society with success.
The connection of people with mental illnesses with the rest of the world is one of the recovery-oriented practices’ key goals. By engaging the individual’s family in the process of rehabilitation, the speed and success of these practices can be enhanced. Close connections and shared friends of the family may also serve as additional levels of one’s supporting network. The informal environment of the family may be more comfortable for the individual to adjust to, which is also why communication with family members may be a starting point in creating more meaningful relationships.
The need to find an occupation, for example, can also be assisted by family members who can help individuals relearn or acquire necessary communicative skills to search for a job or go through everyday interactions. Many individuals with mental illnesses want to work (Blank et al., 2015). However, as many jobs have a rather challenging process of choosing suitable candidates, it may be difficult for some persons to follow through with it and complete all requirements without losing a significant amount of energy. In this case, the family can become the support that can reach an individual in a situation where professionals may lack knowledge. For instance, if a person with mental illness fails to acknowledge some personal talents or characteristics, a family member may point out these aspects, while mental health care professional may be unaware of them.
The role of communication in the recovery process cannot be overstated. Similar to the way interaction with peers and adults can affect one’s childhood and adolescence; it can also help persons with mental illnesses to find their footing at the start and in the process of their recovery. Also, different family dynamics can impact the adaptability of a person to future situations and his or her decisions connected to creating new meaningful relationships (Ell, 2018). Thus, successful integration of family members into one’s rehabilitation may influence his or her thoughts about family and relationships as a whole.
Conclusion
Although the process of rehabilitation that values empowerment and self-determination seems to be focused solely on the individual with mental illness, its methods require the participation of other persons, including one’s family. Family members can interact with an individual in many ways, allowing him or her to create and maintain meaningful relationships. Moreover, the family can empower their relative to be more independent in making personal choices about mental health, offering an opportunity to discuss concerns and needs from a bystander’s point of view. Family can help a person to find strengths and talents that may be difficult for one to recognize. The bond that family members have with each other often surpasses the level which professionals caretakers can reach, which makes a family a vital part of rehabilitation.
References
Aggarwal, N. (2016). Empowering people with mental illness within health services.Acta Psychopathologica, 2(36). Web.
Australian Government Department of Health. (2006). Empowering consumers and their families and carers through participation and partnerships. Web.
Australian Government Department of Health. (2010). Principles of recovery oriented mental health practice. Web.
Baumann, A. E. (2010).Empowerment in mental health. Web.
Blank, A. A., Harries, P., & Reynolds, F. (2015). ‘Without occupation you don’t exist’: Occupational engagement and mental illness. Journal of Occupational Science, 22(2), 197-209.
Bøe, T., Sivertsen, B., Heiervang, E., Goodman, R., Lundervold, A. J., & Hysing, M. (2014). Socioeconomic status and child mental health: The role of parental emotional well-being and parenting practices. Journal of Abnormal Child Psychology, 42(5), 705-715.
Caqueo-Urízar, A., Rus-Calafell, M., Urzúa, A., Escudero, J., & Gutiérrez-Maldonado, J. (2015). The role of family therapy in the management of schizophrenia: Challenges and solutions. Neuropsychiatric Disease and Treatment, 11, 145-151.
Ell, K. (2018). Families and health care: Psychosocial practice. New York, NY: Routledge.
Foster, K., Maybery, D., Reupert, A., Gladstone, B., Grant, A., Ruud, T.,… Kowalenko, N. (2016). Family-focused practice in mental health care: An integrative review. Child & Youth Services, 37(2), 129-155.
Haine-Schlagel, R., & Walsh, N. E. (2015). A review of parent participation engagement in child and family mental health treatment. Clinical Child and Family Psychology Review, 18(2), 133-150.
Heller, T., Gibbons, H. M., & Fisher, D. (2015). Caregiving and family support interventions: Crossing networks of aging and developmental disabilities. Intellectual and Developmental Disabilities, 53(5), 329-345.
Pilgrim, D. (2017). Key concepts in mental health (4th ed.). London, UK: Sage.
Slade, M., Amering, M., Farkas, M., Hamilton, B., O’Hagan, M., Panther, G.,… Whitley, R. (2014). Uses and abuses of recovery: Implementing recovery-oriented practices in mental health systems. World Psychiatry, 13(1), 12-20.