scholarly journals Contact with recovered peers: buffering disempowering service experiences and promoting personal recovery in serious mental illness

BJPsych Open ◽  
2019 ◽  
Vol 5 (6) ◽  
Author(s):  
Bronte McLeod ◽  
Denny Meyer ◽  
Greg Murray ◽  
Fiona Foley ◽  
Nev Jones ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Serious Mental Illness ◽  
Self Efficacy ◽  
Process Models ◽  
Future Research ◽  
Involuntary Treatment ◽  
Personal Recovery ◽  
Treatment Experience ◽  
Stigma Of Mental Illness

Background Mental health patients can experience involuntary treatment as disempowering and stigmatising, and contact with recovered peers is cited as important for countering stigma and fostering agency and autonomy integral to recovery. Aims To advance understanding of the interaction between involuntary treatment and contact with recovered peers, and explore hypothesised relationships to mechanisms of self-evaluation relevant to recovery. Method Eighty-nine adults diagnosed with serious mental illness completed items to assess involuntary treatment experience and the extent of prior contact with recovered peers, the Internalised Stigma of Mental Illness Scale, the Self-efficacy for Personal Recovery Scale, the Questionnaire about the Process of Recovery and relevant demographic and clinical scales. Results Contact with recovered peers was found to moderate the effects of involuntary treatment on internalised stigma. Sequential conditional process models (i.e. moderated mediation) then demonstrated that conditional internalised stigma (i.e. moderated by contact with recovered peers) mediated the indirect effect of involuntary treatment on recovery-specific self-efficacy, which in turn influenced recovery. Compared with those with low contact with recovered peers, recovery scores were 3.54 points higher for those with high contact. Conclusions Although study methods limit causative conclusions, findings are consistent with proposals that contact with recovered peers may be helpful for this patient group, and suggest this may be particularly relevant for those with involuntary treatment experience. Directions for future research, to further clarify measurement and conceptual tensions relating to the study of (dis)empowering experiences in mental health services, are discussed in detail.

Acceptance and the Recovery Paradigm in Mental Health Care

2016 ◽  
pp. 17-36
Author(s):  
Lauren Mizock ◽  
Zlatka Russinova
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Serious Mental Illness ◽  
Well Being ◽  
Personal Recovery ◽  
Recovery Processes ◽  
Recovery Movement ◽  
Mental Illness Treatment

Chapter 2 offers an overview of the recovery movement in the provision of mental health care for serious mental illness. Within the recovery movement in mental illness treatment, recovery is understood as a process of living a satisfying life of well-being and autonomy, as opposed to mere symptom elimination. Early theory of the recovery paradigm is outlined, highlighting the process of acceptance of serious mental illness within this model. Applications of the recovery paradigm to mental health care are discussed, as well as the various types of recovery from a serious mental illness. Acceptance is examined as the neglected paradox of recovery. Other parts of the chapter include discussion questions, activities, the “Personal Recovery Processes Worksheet,” and diagrams.

scholarly journals Training Community Pharmacy Staff How to Help Manage Urgent Mental Health Crises

Pharmacy ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 133 ◽  
Author(s):  
Nathaniel Rickles ◽  
Albert Wertheimer ◽  
Yifan Huang
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Pharmacy Practice ◽  
Health Needs ◽  
Future Research ◽  
Mental Health Needs ◽  
Pharmacy Staff ◽  
Stigma Of Mental Illness ◽  
Mental Wellness ◽  
Education Support

Nearly 44 million Americans are affected by mental illness every year. Many individuals, however, are not diagnosed and/or do not receive treatment. The present manuscript reviews the incidence of mental illness, the continuum from mental wellness to mental illness, and the role of the pharmacy staff in helping individuals manage different mental health needs. In particular, there is discussion of stigma of mental illness that those with mental health needs experience by those around them including health professionals such as pharmacy staff. One way to resolve such stigma is through training such as Mental Health First Aid (MHFA). The paper reviews key aspects of MHFA, the evidence supporting MHFA, and how MHFA relates specifically to pharmacy practice and services. A conceptual framework for MHFA and its relationship to individual factors, attitudes, behaviors, and outcomes. Lastly, a discussion is presented that briefly compares MHFA to other similar approaches to helping those in mental health crises, the limits of what is known about MHFA, and what future research might explore to better understand the outcomes of pharmacy staff providing mental health education, support, and referral to care.

Stigma resistance is associated with advanced stages of personal recovery in serious mental illness patients enrolled in psychiatric rehabilitation

2020 ◽  
pp. 1-11
Author(s):  
J. Dubreucq ◽  
J. Plasse ◽  
F. Gabayet ◽  
M. Faraldo ◽  
O. Blanc ◽  
...  
Keyword(s):  
Mental Illness ◽  
Serious Mental Illness ◽  
Satisfaction With Life ◽  
Psychiatric Rehabilitation ◽  
Clinical Severity ◽  
Personal Recovery ◽  
Promising Target ◽  
Stigma Resistance ◽  
Stigma Of Mental Illness ◽  
Advanced Stages

Abstract Background Stigma resistance (SR) is defined as one's ability to deflect or challenge stigmatizing beliefs. SR is positively associated with patient's outcomes in serious mental illness (SMI). SR appears as a promising target for psychiatric rehabilitation as it might facilitate personal recovery. Objectives The objectives of the present study are: (i) to assess the frequency of SR in a multicentric non-selected psychiatric rehabilitation SMI sample; (ii) to investigate the correlates of high SR Methods A total of 693 outpatients with SMI were recruited from the French National Centers of Reference for Psychiatric Rehabilitation cohort (REHABase). Evaluation included standardized scales for clinical severity, quality of life, satisfaction with life, wellbeing, and personal recovery and a large cognitive battery. SR was measured using internalized stigma of mental illness – SR subscale. Results Elevated SR was associated with a preserved executive functioning, a lower insight into illness and all recovery-related outcomes in the univariate analyses. In the multivariate analysis adjusted by age, gender and self-stigma, elevated SR was best predicted by the later stages of personal recovery [rebuilding; p = 0.004, OR = 2.89 (1.36–4.88); growth; p = 0.005, OR = 2.79 (1.30–4.43)). No moderating effects of age and education were found. Conclusion The present study has indicated the importance of addressing SR in patients enrolled in psychiatric rehabilitation. Recovery-oriented psychoeducation, metacognitive therapies and family interventions might improve SR and protect against insight-related depression. The effectiveness of psychiatric rehabilitation on SR and the potential mediating effects of changes in SR on treatment outcomes should be further investigated in longitudinal studies.

scholarly journals Therapeutic Social Control of People with Serious Mental Illness: An Empirical Verification and Extension of Theory

2017 ◽  
Vol 8 (2) ◽  
pp. 108-122 ◽  
Author(s):  
Brea L. Perry ◽  
Emma Frieh ◽  
Eric R. Wright
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Social Control ◽  
Serious Mental Illness ◽  
Mental Health Treatment ◽  
Structured Interview ◽  
Ethical Challenges ◽  
Therapeutic Goals ◽  
Contraception Use ◽  
Client Behavior

Mental health services and psychiatric professional values have shifted in the past several decades toward a model of client autonomy and informed consent, at least in principle. However, it is unclear how much has changed in practice, particularly in cases where client behavior poses ethical challenges for clinicians. Drawing on the case of clients’ sexual behavior and contraception use, we examine whether sociological theories of “soft” coercion remain relevant (e.g., therapeutic social control; Horwitz 1982) in contemporary mental health treatment settings. Using structured interview data from 98 men and women with serious mental illness (SMI), we explore client experiences of choice, coercion, and the spaces that lie in between. Patterns in our data confirm Horwitz’s (1982) theory of therapeutic social control but also suggest directions for updating and extending it. Specifically, we identify four strategies used to influence client behavior: coercion, enabling, education, and conciliation. We find that most clients’ experiences reflect elements of ambiguous or limited autonomy, wherein compliance is achieved by invoking therapeutic goals. However, women with SMI disproportionately report experiencing intense persuasion and direct use or threat of force. We argue that it is critical to consider how ostensibly noncoercive and value-free interventions nonetheless reflect the goals and norms of dominant groups.

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