Introduction
The mental health of individuals is one of the major concerns of the modern healthcare sector. The increased complexity of the contemporary world and the high speed of all processes also promotes higher levels of stress among people and the development of undesired symptoms. In severe cases, individuals might acquire a mental disease that will deteriorate the quality of their lives and prevent them from successful socialisation. For this reason, the problem of mental health recovery holds the top priority for specialists working in the healthcare sector. Today, the traditional biomedical models of care are often supported with personal recovery approaches as they might demonstrate improved outcomes due to the focus on specific needs of patients and their current status. Michael’s case study revolves around this issue as it outlines the mental health problem and the use of different approaches to treat it.
Michael’s central problem was the emergence of compulsive thoughts, hallucinations, and aggressive behaviours triggered by the belief that his peers stole his ideas from his brain and used it to achieve success. After the outburst of emotions and violent inclinations, Michael was hospitalised and provided with a standard treatment that presupposed the use of antipsychotics to mitigate his state and ensure that no new relapses would emerge. However, during the next several years, Michael had to go to the psychiatric department again because of the low effectiveness of prescribed treatment. He still suffered from hallucinations and psychosis. The positive outcome and improvement were achieved only by the change of the team working with Michael and alteration of the approach. The implementation of the personal recovery model contributed to the resocialisation of the patient, his ability to cope with symptoms, avoid addictive behaviours, and start living a full life.
Differences Between Recovery Models
First of all, the case demonstrates the critical importance of the personalised approach and the need to look for recovery models that will meet clients’ needs as a traditional biomedical model can be not effective in different situations. The given approach presupposes that mental disorders are specific brain diseases that are triggered by deviations in the work of this body (Deacon, 2013). The inappropriate functioning of some of its parts might precondition the emergence and development of symptoms dangerous for a patient and the people who surround him/her. Under these conditions, it is critically important to restore, or at least try to restore, the normal functioning of the brain and its chemistry by using a pharmacological treatment that is prescribed to target the presumed biological abnormalities and regulate the behaviour of a patient at the physiological level (Yuen et al., 2019). However, today, the effectiveness of this model is doubted because of its outdated nature and reduced efficiency in multiple cases.
As it comes from Michael’s example, the use of antipsychotics was not the best option to deal with his mental problems as there were multiple new cases. It means that the biomedical cannot be considered a universal approach that can be employed while working with all patients, regardless of their unique characteristics and demands. The mental health recovery model becomes a potent alternative to the traditional approach. In accordance with this framework, mental illnesses and distresses can be effectively managed by developing a new vision of the problem and future (“Principles of recovery-oriented mental health practice,” n.d.). It aims at helping people to look beyond survival and existence; also, it encourages them to move forward by achieving new goals and building relationships that will give them a new meaning (Ash et al., 2015). Motivating people to engage in the change process, specialists modify their behaviours and motivations, which is critically important for the functioning of the brain and the ability to manage symptoms or threatening signs. Additionally, the given approach promotes patients’ participation in decisions about the provided care and cultivates improved self-management of behaviours that deteriorate the quality of their lives (Rethink Mental Illness, n.d.). Due to the given peculiarities, the discussed approach becomes advantageous in situations when only pharmaceutical treatment fails to reduce problems and risks of relapses.
In such a way, from the definitions provided above, it is possible to outline several basic differences between the traditional biomedical model and mental health recovery. First of all, there is a discrepancy in the perspectives on how undesired behaviours can be treated. The conventional approach recognises the high potential of pharmaceutical treatment and the use of antipsychotics which are expected to affect the brain’s functioning of biochemical level and depress processes that can be related to the development of the disease (Becket, 2017). The recovery model also acknowledges the power of medication; however, it promotes the idea of patient involvement’s importance for positive outcomes (Lim et al., 2017). This difference can also be seen in the fact that the biomedical model focuses on the achievement of outcomes without clients’ participation or recognition of the problem, while for recovery it is fundamental to motivate a person to move forward, establish new goals, and learn how to manage actions combining medicines and other approaches (Mericle et al., 2015). For this reason, today, there is a shift of priorities presupposing the extensive use of the newest model of care.
Differences Between Personal and Clinical Recovery
The case also outlines Michael’s experiences regarding personal and clinical recovery and helps to conclude about their effectiveness. After the emergence of the first symptoms, the development of hallucinations, and aggressive behaviours, the patient was provided with the traditional biomedical treatment presupposing the use of antipsychotics to mitigate his state and achieve desired levels of socialisation. However, according to the client’s words and experiences, he did not feel significant improvement. The treatment took several years and included new hospitalisations because of the aggravation of the situation, deterioration of symptoms, progression of hallucinations, and the need for stronger interventions (Wade & Halligan, 2017). Michael was not able to socialise and enjoy the high quality of his life, which also preconditioned the emergence of addictive behaviours, such as the use of alcohol.
From the case, one can see that the treatment scheme selected by the psychiatrists was not sufficient, and the selected medication was not able to improve the patient’s state. On the contrary, the absence of progress and the inability to recover and socialise hurt Michael and served as demotivating factors (Wade & Halligan, 2017). Because of the absence of clear goals and his inability to contribute to his own recovery, the patient started to drink, or engage in self-destructing behaviours as the only way to avoid suffering. For this reason, the clinical recovery that was not supported by the focus on Michael’s unique aspect failed to contribute to the significant improvement. On the contrary, it preconditioned the deterioration of the situation and the constant re-emergence of symptoms.
The change in the team working with the patient and the employment of the personal approach became an essential factor in Michael’s case. The central difference was in the attitude to the client and the utilisation of the individualised method to treat his disease. As against the clinical approach presupposing standard schemes and prescription of drugs that are known for their effectiveness in mitigating certain symptoms, the personal care model selected by a new psychiatrist acknowledged the uniqueness of the case and the significance of opportunities and choices available for a client to live a meaningful life (Wade & Halligan, 2017). Michael outlines that shift in priorities and his out positive attitude to it. The patient’s involvement became the central component that differentiated the two discussed models. The new team provided him with real choices and goals regarding his future life and the ability to struggle with the disease, which is one of the fundamental aspects of recovery focused care (Nicholas-Holley, 2016). The paradigm change helped the client to socialise, continue his studying and stop drinking.
In such a way, the major difference between Michael’s personal and clinical recovery is in their focus and the ability to promote desired outcomes. The adherence to standardised treatment schemes and medication did not result in the desired outcome because of the lack of flexibility. At the same time, the personal recovery presupposed the focused on the current needs of the patient and contributed to the achievement of positive dynamics and the decreased number of replaces or aggressive behaviours.
Recovery Focused Care for Nurses
Nurses working with mental health patients often face a high risk of being attacked or aggressive behaviours. The acute setting presupposes clients with complex conditions, hallucinations, obsessive thoughts, and dangerous decisions. For this reason, mental health nurses should possess a set of interventions and strategies that might help to reduce aggression levels and avoid being attacked or hurt by patients (Sellin et al., 2019). The modern approach to the delivery of care presupposes that collaboration and development of trustful relations with consumers is one of the most effective ways to remain safe and, at the same time, provide patients with care in the most effective ways (Nicholas-Holley, 2016). Under these conditions, the recovery-focused models acquire the top priority as they acknowledge the increased importance of factors mentioned above and their vital role in treating mental health patients.
One of the basic assumptions of the given paradigm is the uniqueness of individuals and consideration of their current states and needs. The existing body of evidence shows that the employment of recovery-focused care when working with this category of patients reduces risks and contributes to better outcomes (Sellin et al., 2019). For this reason, the improved knowledge of this approach becomes critically important for health workers who remain in direct contact with patients who might have aggressive behaviours. Another important aspect is the focus on a client, not just on his/her undesired signs or health issues (Saraf & Newton,2017). In accordance with clients’ feedback, the given attitude helps them to realise the fact that they are viewed not as patients, but as individuals with their peculiarities and unique features, which is vital for the development of trustful relations and positive outcomes.
The use of recovery model can also help to improve goal-setting and select the appropriate approach to every case. The need to consider the existing requirements of a client is central to the modern healthcare sector, and this idea can also be applied to working with mental diseases. The combined effort of care providers and patients guarantees the creation of relevant goals and the provision of choices for clients. It serves as a factor needed to facilitate the recovery or reduce the frequency and severity of attacks (Rosén et al., 2017). Finally, the recovery focused care provides patients with an opportunity to manage their cases on their own, which is also important for motivation and the emergence of the desire to change life and achieve success (Owen et al., 2019). Using only medications, clients might feel helpless and unable to control their own lives, which also increases the risk of the development of addictive behaviours.
The given factors demonstrate that nurses who have an improved understanding of the recovery-focused model hold an advantageous position when working with mental health patients. They benefit from the reduced risks of being attacked or harmed by aggressive inclinations. At the same time, they can deliver care more effectively and ensure that patients will be able to control their emotions by using the basics of the paradigm, which is also vital for outcomes.
Conclusion
Altogether, the analysis of the case shows that today there is a need for new, more effective approaches to treating mental health patients than the traditional one. The use of medications without any additional measures cannot be effective if it is not supported by the in-depth assessment of patients’ current needs. They should serve as the basis for goal-setting, and a client should be an active participant in the recovery process. It will motivate him/her and guarantee that the motivation levels will increase and better outcomes will be attained.
References
Ash, D., Suetani, S., Nair, J., & Halpin, M. (2015). Recovery-based services in a psychiatric intensive care unit – the consumer perspective.Australasian Psychiatry, 23(5), 524–527.
Becket, J. (2017). Evaluating some of the approaches: Biomedical versus alternative perspectives in understanding mental health. Journal of Psychiatry and Psychiatric Disorders, 1(2), 103-107.
Deacon B. J. (2013). The biomedical model of mental disorder: a critical analysis of its validity, utility, and effects on psychotherapy research. Clinical Psychology Review, 33(7), 846–861.
Lim, E., Wynaden, D., & Heslop, K. (2017). Recovery-focussed care: How it can be utilized to reduce aggression in the acute mental health setting. International Journal of Mental Health Nursing, 26(5), 445-460.
Mericle, A. A., Miles, J., & Way, F. (2015). Recovery residences and providing safe and supportive housing for individuals overcoming addiction. Journal of Drug Issues, 45(4), 368–384.
Nicholas-Holley, J. (2016). Auditing the needs of recovery room staff providing care for the child in an acute hospital. Journal of Perioperative Practice, 26(5), 102–105.
Owen, G., Gergel, L., Stephenson, L., Hussain, O., Rifkin, L., & Keene, R. (2019). Advance decision-making in mental health – Suggestions for legal reform in England and Wales. International Journal of Law and Psychiatry, 64, 162-177.
Principles of recovery oriented mental health practice. (n.d.). Web.
Rethink Mental Illness. (n.d.). 100 ways to support recovery.
Rosén, H., Persson, R. G., & Persson, E. (2017). Challenges of patient-focused care: Nurses’ descriptions and observations before and after intervention. Nordic Journal of Nursing Research, 37(1), 27–32.
Saraf, S., & Newton, R. (2017). Care or recovery? Redefining residential rehabilitation. Australasian Psychiatry, 25(2), 161–163.
Sellin, L., Kumlin, T., Wallsten, T., & Wiklund Gustin, L. (2019). Experiences of a recovery-oriented caring approach to suicidal behavior: A single-case study. Qualitative Health Research, 29(14), 2084–2095.
Wade, D. T., & Halligan, P. W. (2017). The biopsychosocial model of illness: a model whose time has come. Clinical Rehabilitation, 31(8), 995–1004.
Yuen, W. W., Tse, S., Murray, G., & Davidson, L. (2019). ‘From my point of view, my wife has recovered’: A qualitative investigation of caregivers’ perceptions of recovery and peer support services for people with bipolar disorder in a Chinese community. International Journal of Social Psychiatry, 65(4), 305–312.