A lived experience is defined as any incident that a person encounters directly by enduring it and later discloses about it. The similar context can be applied in case of mental illness, people who have suffered for a long time in mental illness and recovered as well as lived to tell the truth (Van Manen, 2016). Mental illnesses are probably the most stigmatized of all known clinical condition that patients go through. According to the factsheets provided by World Health Organization (WHO), one out of four people in this world have some form of mental illness which needs to be clinically diagnosed. 300 million people all over the world are affected by depression, 60 million people have bipolar disorder, 50 million people have developed dementia and about 23 million people are affected by schizophrenia and other associated psychoses (Mental disorders, 2018). This kind of health issues directly affects other physical abilities and can lead to deeper and severe clinical conditions, which is why the government of Australia is trying their best to overcome the issues regarding mental health and create awareness amongst the general population regarding the treatment of such condition (Department of Health | A National framework for recovery-oriented mental health services: guide for practitioners and providers, 2013).
In any form of illness or ailment, recovery can be possible with the help of medical science. Physical illnesses are a little easier to handle than mental illness, as mental illness is a complex form of ailment, which is associated with psychological and neurological complications that have influence on one’s altered behaviour (Insel & Wang, 2010). Therefore, the approach to these illnesses are sometimes more psychological than pharmaceutical. The aim of such recovery procedures are aimed to achieve their mental health mainly, as well as teach them to lead to a self directed life and achieve their complete potential. The concept of recovery-oriented approach in mental illnesses, is different from other variants of treatment, which takes into the account the personal experience of the patient as well their family’s experience to provided a more personalized patient care (Slade et al., 2014). It is essential to address the unique condition of the patient and recognise the problem in a personalised care form. It is also a duty of the caregiver to provide the choices for the patient to make them feel as a same part of the society and give them confidence to return to the sanity (Tondora et al., 2014). It is essential to make the patient feel empowered so they can take reality-based decisions in life, which would be a step further in the recovery procedure. The patients need to encouraged and supported to help them take creative decisions and take up opportunities, which would expose their uniqueness. The third essential aspect of recover-oriented care, is addressing the basic right and improve their attitude in life (Tondora et al., 2014). It is important to listen to the patient’s concerns and learn from their experiences, which would help to actively participate in communication processes and gather knowledge about every patient individually. It is important to make them aware of their basic human and citizenship rights so that they are not violated and taken advantage of their vulnerabilities. This will help the patient to secure their future and self-protection from unjust violation (Drew et al., 2011). Fourthly, it is important to maintain dignity and respect the patient regardless of their mental condition. The caregiver is expected to be respectful, courteous and provide honesty in their duty for treatment. It is important to respect the socio-cultural beliefs of the patient and showing any such discrimination or stigmatisation is considered unprofessional concerning ethical values (Martin, 2010). The fifth important point in the recovery oriented health practice is considering the patient-caregiver relationship as a partnership in which both parties will have equal rights and importance. This form of partnership is important to establish patient centric communication, which will establish the platform for the treatment. It is important to consider the patient as a master of their life and the professional can only offer advice and support their lifestyle choices without judgement (Thompson & McCabe, 2012). Clear communication is important to provide a solution which will make sense to the patient and sharing relevant information to include them in the decision making process to engage the patient and provide positive environment to help the patients realise their own worth and develop a sense in independence. Lastly, it is important to evaluate the complete process of the care plan for mental health recovery, which enables the caregiver to assess and analyse the clinical decisions, and adhere to the patient issue in an effective form of evidence-based practice (Hibbard & Greene, 2013) .
The National Framework for Recovery-Oriented Mental Health Services was provided by the government of Australia that provides an insight to the concept of lived experience and guidelines for healthcare providers, which will help them, tailor clinical treatments focussing on the recovery orientation of mental health patients. The outlines of the framework are provided below:
The framework initially introduces the concept of mental health recovery, recovery orient care and recovery oriented delivery system for mentally ill patients, to ensure a clear understanding for the caregivers. The report describes a number of domains which help care givers assess the treat of the patient in a step by step manner. The first domain they addresses was promotion of “Promoting a culture and Language of hope and optimism”, which aims to focus on the sociological and cultural background of the patient’s and take into consideration of their beliefs in a respectful manner and help the person recover by showing positive support (Corrigan et al., 2014). The second domain shows the “Person first and Holistic approach”, this domain helps caregivers approach the health services in a holistic manner and provide care, rehabilitation and psychological therapy based on the person-centred needs of the patient (Townsend, 2013). The third domain the report shows the importance of “Supporting personal recovery” by promoting autonomy and self-determination, focussing on strengths and personal responsibility, collaborative relationships and reflective practice (Slade et al., 2014) . Domain 4 depicts that “Organizational commitment and workforce development by recovery” by having a vision for better understanding and acceptance of cultural differences and valuing the experience of patient and their families and governance of a workforce that follows these guidelines (LaMontagne et al., 2014). Domain 5 describes the “action on social inclusion and the social determinants of health, mental and well being”, which supports the activity of inclusion of thee patient in society and minimize the stigmatisation to promote understanding and communal acceptance (Allen et al., 2014).
The story of Sandy Jeffs will put the issues regarding lived experience of mental illness and its recovery into perspective in this essay. The woman battled with schizophrenia for seventeen years, since she was twenty-three years old and was under psychiatric review for the same time. She recovered at the age of forty after publishing her first book describing her experience as a mental health patient and the stigmatisation as well as mistreatment she received from people as well as her caregivers. Sandy managed to focus on her creativity and overcome schizophrenia and wrote the book “Poems from the Madhouse”. In 2010 she wrote her memoir called “Flying with paper Wings” and won book of the year award in sane Australia. The difficulties of mentally ailing patients are deep rooted and disturbing that needs to be understood and sympathised to provide care for them (Rogers & Pilgrim, 2014). Quoting a few lines from Sandy’s poem, will help the readers reflect on the experiences, these patients feel, “My mind’s eye too vivid or too clouded either too many butterflies in it or do I only have a half- mind to do anything, I’m head over heels with a screw loose but cheer up because every mad clown has a sane lining or does every sane cloud have a mad lining, the mad boggles...”
Patients with mental illness are often treated badly and adverse treatments are enforced upon them without consent, this is a violation of human rights. In her poem called Medicate Sandy says,“ roll up, roll up, join me on the medication trolley; I had been on it for years, I was like Act alt but bitter syrup, I was him, I sided and mellow and numbed , I was on stelazine, I was like a cat on a hot tin roof, I’ve been motivated into shuffle and clozapine into a stupor, our serenade- drowsiness ...” (Drew et al., 2011).
The general community fails to understand the impact of stigmatisation on mental health battling patients, from Sandy’s book “Stories of Madness”, she recalls on the treatment, judgement and stigmatisation she received, “being the madwoman, I am also a lunatic, a maddy, a mental-case, a bedlamite, a screwball and nuts a loon, a loony, a madcap, a mad dog, a psychopath, a manic, a lysteric, a psychotic, a manic-depressive, a megalomaniac, a pyromaniac, a kleptomaniac, a crackpot, an eccentric, an oddity...” It is important to remember that patients like this need to feel secure to return to sanity and occupational judgement and any form of personal violation will take them from civilization even more.
Allen, J., Balfour, R., Bell, R., & Marmot, M. (2014). Social determinants of mental health. International Review of Psychiatry, 26(4), 392-407.
Corrigan, P. W., Druss, B. G., & Perlick, D. A. (2014). The impact of mental illness stigma on seeking and participating in mental health care. Psychological Science in the Public Interest, 15(2), 37-70.
Drew, N., Funk, M., Tang, S., Lamichhane, J., Chávez, E., Katontoka, S., ... & Saraceno, B. (2011). Human rights violations of people with mental and psychosocial disabilities: an unresolved global crisis. The Lancet, 378(9803), 1664-1675.
Hibbard, J. H., & Greene, J. (2013). What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs. Health affairs, 32(2), 207-214.
Insel, T. R., & Wang, P. S. (2010). Rethinking mental illness. Jama, 303(19), 1970-1971.
LaMontagne, A. D., Martin, A., Page, K. M., Reavley, N. J., Noblet, A. J., Milner, A. J., ... & Smith, P. M. (2014). Workplace mental health: developing an integrated intervention approach. BMC psychiatry, 14(1), 131.
Martin, J. M. (2010). Stigma and student mental health in higher education. Higher Education Research & Development, 29(3), 259-274.
Rogers, A., & Pilgrim, D. (2014). A sociology of mental health and illness. McGraw-Hill Education (UK).
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.
Thompson, L., & McCabe, R. (2012). The effect of clinician-patient alliance and communication on treatment adherence in mental health care: a systematic review. BMC psychiatry, 12(1), 87.
Tondora, J., Miller, R., Slade, M., & Davidson, L. (2014). Partnering for recovery in mental health: A practical guide to person-centered planning. John Wiley & Sons.
Townsend, M. C. (2013). Essentials of psychiatric mental health nursing: Concepts of care in evidence-based practice. FA Davis.
Van Manen, M. (2016). Researching lived experience: Human science for an action sensitive pedagogy. Routledge.
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