Our text in this course is primarily theoretical, exploring how certain philosophers, thinkers, and practitioners and their theories have shaped the concept of "Recovery." Some of them felt is was necessary to remove people from their everyday lives in order for them to get better, others thought "agency" and advocacy were key, etc.
Theory matters. How we think about "mental illness" and particularly, what causes it, greatly influences what choices are made available for people with mental illness. The fact that I phrased the last sentence this way indicates that people with mental illness "should be provided" with choices, by "normal people." Later we will discuss whether you can provide someone with rights and choices, or if they already HAVE THEM.
In the 1800s there were many prevailing theories of etiology. Benjamin Rush thought mental illness was the result of circulatory disorders...so he created the "spinning" treatment. The text will discuss that other folks theorized that mental illness came about from "problems in living."
What are the prevailing etiological theories in psychiatry today? What do these theories lead us to DO to (and with) people with mental illness?
Answer these questions, and respond, in detail to at least 2 of your classmates' answers.
Hope, Person-Driven, and Respect, are just a few of the things that SAMHSA identified as recovery principles and I believe speak to today’s psychiatric etiology. These theories outline best practices and most common practices utilized when working with individuals with a diagnosed mental illness.
ReplyDeleteI believe that treatment should be driven by the individual themselves and real change will happen if they want to change. But as a mental health provider, by instilling hope, showing respect and truly engaging with a patient/client it allows for a therapeutic alliance to be built and can be very empowering. As a mental health provider I can provide a patient with all the necessary tools and resources to overcome a problem or get to the next step in their recovery but it is ultimately up to them to pick up the tools and put the work in.
Hi Vessa,
DeleteI agree with you completely but specifically for the topic of hope. It is so crucial because of how individuals with long-term illnesses have been treated in the past. Providers knowingly/unknowingly were giving clients the feeling of ‘helplessness’. The idea that nothing good will come out of this disease(s) and to not expect hope where it does not likely exist. That is so not true and I understand why many providers used to/and some who still do not want to give false hope because many can react negatively. But, recovery is possible and even though something may not go away completely, symptoms can absolutely decrease and become better manageable. Our textbook, Davidson et al. (2010), and other readings/video materials talk about how hope is key in helping someone feel like there are possibilities in the world and having motivation. To help overcome a problem, you have to feel like it is possible! That’s where we come in with like you said, showing respect and encouragement to help instill that hope even further!
Morgan
Hi Vessa,
DeleteI really like the use of the work alliance. I think one of the best things we can do for someone is be their ally. Building the trust and respect will show the person that when you offer then hope they believe it and can gain the motivation to make real change in their life. Using tools and resources can help an individual feel like they can make life decisions and have control.
Your response is perfect and pulled out all of the key points that I was also drawn to. I think in a lot of ways hope is the answer and should be something we focus on more and more!
Judi
Morgan & Judi- I'm glad to see we have similar perspectives! Hope is truly a foundation to the work being done today in the mental health/recovery world, in the article 'What Recovery Means to Us' I feel supports our current perspectives, as the individuals who wrote the article compare past treatment today and spoke of hope and empowerment compared to the old mindset. They now have hope and are pursing fulfilling lives.
DeleteVessa,
DeleteFirst off great post. You highlighted one of the most important components between the client and providers; true engagement. A relationship with respect is the foundation to providing a sense of hope. Clients not only need education to support decisions they will make but an understanding of wisdom. Patricia Deegan shared in her article how knowledge of mental illness is not enough. Individuals need to understand and seek what is as well. We are all human first.
Lauren
Hello, Vessa
DeleteI like how you brought up the idea of creating a therapeutic alliance with the patient. Thinking of the relationship between the two parties as an alliance gives agency and power to not just the mental healthcare provider but to the patient as well. One of the points that was brought up many times in this week's readings was the need for the patient to have control and power over their own decisions and fate.
Hello Vessa,
DeleteYour post is very to the point and powerful. It highlights the importance of hope, alongside the other important components. Understanding that individuals are unique and different, and need different treatment plans. Person-centered is extremely vital. Education is also very crucial for everyone all around. Understanding that individuals are human** first, not just defined by their mental illness. This creates hope for the individual, they are being seen as a human not just the disability. You mentioned a therapeutic alliance, this is significant throughout the process. This establishes respect, hope, trust between the professional and individual and can produce positive changes. Instilling the power within the patient is important because they need to make the choices, rather than the provider having all the power. Lastly, you mentioned it is ultimately up to the individual to pick up the tools and put the work in. This is extremely important to highlight as well, because we all in the drivers seat of our own lives.
--Stephanie (still showing as Unknown, will be fixed for next week)
I think you've pretty well covered the current approach to recovery-oriented treatment for people with mental illness, Vessa. Most prominently in your contribution this week is that those with mental illness are people to be treated with wisdom instead of just knowledge, as Patricia Deegan so effectively advocated for 25 years ago.
ReplyDeleteAs a starting point for the current theories for mental illness I think I have to recognize the impact of the DSM. Davidson, Rakfeldt, and Strauss and our own experiences should allow us to simultaneously appreciate the attempt to categorize individuals with mental illness (knowledge), while also understanding that not all diagnoses are expressed and experienced the same (wisdom). It is from this medical/classification starting point that the etiology theory of Adolf Meyer appears to have the most lasting influence on current practices. For instance, his introduction of “adaptation vs. maladaptation,” development of “psychobiology,” and his early creation of “occupational therapy.”
I don’t think we could explore recovery without recognizing the duality between classification and individualism.
Eamon, that was so well said. Relating it to those texts and the common first focus to categorize a diagnosis where that provides us some medical guidance but it is so easy to not be paying attention to individuality. The use of the word wisdom for this was on point! It can be taught everywhere but at the end of the day we are not going to have books in front of us to reference while with a client in the moment. The area of giving proper attention to experiences and differenes in expression; that no two individuals are the same. That is one of my favorite things about this occupation:)
DeleteI really enjoyed listening and reading the etiology of Patricia Deegan. Her first hand experience and preservative was truly insightful with what can be wrong in the mental health field. In my experience, it is always more helpful to "do with" rather than "do for" when working with clients in most settings. Deegan's metaphor of how the heart is studied but we all know "heart" to be connected with bravery, feelings, and love made a perfect connection with how we should view mental illness. Mental illness is a small characteristic of a person. We should learn who we are working with as people before rushing to understand their mental illness. The person centered theories have always been my favorite and ho I like to practice in my professional settings.
ReplyDeleteI believe that I have seen the opposite occurring in my day to day work experience due to insurances needing to be able to "bill" for the time working with someone. So while we are trying to support someone, we then need to prove to an insurance company that we are getting closer to "fixing" the issue. The "issue" being the mental illness. So while in theory, it makes sense to treat people like individuals with their own strengths and needs, you have to turn around and show the insurance companies that something is "wrong" with them and mental health professionals are here to "fix" the problems.
I too have struggled with this very thing in my education and professional work with clients. It is like always walking a fine line of how to please the insurance company, and get the client treatment. There is also the fine line on which diagnosis to choose that will not inadvertently cause more harm than good to the client, but again being able to get the insurance money to treat the client. Showing progress I feel is something that may be easier than it sounds. All clients I feel will show some progress but then have times where they will dip back, and we are there to help them regain that forward progress.
DeleteHi Maxwell!
DeleteI appreciate your last point - that as practitioners, we are often faced with the dilemma of choosing a strengths-based, person-centered approach while at the same time ensuring enough "proof" that the person continues to need services so that insurance will continue to cover. I worked for a few years as a children's case manager, and my agency and department were big on strengths-based practice. That was great except that every 90 days I had to assert for Mainecare that the client still had xyz deficits and still needed services...but I also had to show some progress to prove that services were effective. It's an exhausting balance.
To your point about 'needing' mental health professionals to 'fix' client problems, this is something else that really bothered me. There are a great number of services available for children with special needs, but almost none of them are accessible without a case manager to make and manage the referral. Getting a case manager alone can take months, and then waitlists for other services takes even longer. How is this empowering to the client or the family when we tell them - yes, your child CLEARLY needs help, but no, you can't do anything about it without a certain service provider, for whom you must wait 3 - 5 months..it's absurd!
DeleteHi Maxwell,
As I read your post, I thought about how hard it must be for an individual to access services, receive a diagnosis due to insurance and then have a label to establish treatment goals. The term “fix” gets thrown around more than necessary, as individuals with disabilities do not need any fixing. Building a relationship can help provide insight into who the individual is and support them with their goals of wants and needs. This in turn provides motivation as the counselor is working with them, not for them. Your post highlights how important person-centered theory is, and I could not agree more. The consumer is in the driver seat and should have a say as the decisions being made impact their quality of life.
Great Post!
Lauren Dillon
On the flip side, sometimes a patient/client needs a specific diagnosis to access specific services, which I feel can be just as difficult. My first option is try and work with the patient on a diagnosis and give them the least restrictive diagnosis that will still be covered by insurance and any time a patient/client has questions about their diagnosis I review it with them and do my best to answer their questions and explain my rationale. It's a tough line to walk as you all have mentioned. I've also had to discuss with patients that they don't meet the criteria for other diagnosis even if they believe they have it.
DeleteHello Maxwell,
DeleteI think you've really summed up the theme of the patient's need to have responsibility for their own recovery and actions by saying it's our role as healthcare providers to "do with" rather than "do for". Vessa also made a similar point bringing up the need for a therapeutic alliance. Recovery is a team effort and the patient should be in the driver's seat!
Maxwell- Exactly! The unfortunate way that we are pretty much forced to view as 'fixing' someone in order to get paid is problematic. To constantly have to shift our views to diagnostic symptoms and the severity too regularly for someone to be able to keep coming. For long-term illnesses, there shouldn't be end "fixed enough to release" dates. For a client, something frustrating that everytime feels like they are making progress (which they are at their own individual level, would have to be reminded at how they have no reached their future goals and still needs help due to severity of symptoms. Medicaid especially, for every 90 days (shorter if you want it submitted on time for no gaps in services/reimbursement), going through and making an individual feel like the progress they have made is not enough or has to feel like if they don't continue to say how much a problem it is all the time that services will be reduced. A system problem for sure, but for how those individual yet shared experiences for this population that we should keep in mind the stress that must bring. Even though someone comes to us regularly for help, doesn't mean they always want to be reminded about the big diagnosis labeling wor making some feel less than.
DeleteHope and a person-first/centered approach (as others have noted) were two prominent themes throughout the readings for this week regarding the prevailing etiological theories in psychiatry today. For example, the Psychiatric Rehabilitation Association Core Principles lists practitioners conveying hope and respect, in part, as the number one principle, and principle five states that rehabilitation practices are person-centered. Similarly, in SAMHSA’s working definition of recovery, hope and a person-driven approach to recovery are the first two of the ten guiding principles of recovery which are discussed in detail. Surrounding the person-first and hope approach seems to be an effort to see the person before the illness. Throughout the readings there was an emphasis on engaging a person with a mental illness on a human level and considering their mental illness as a piece of the constellation of factors that create their unique stance in life. This is opposed to having one’s illness be the single defining factor in their life. These theories advocate that we interact with a person who has been diagnosed with a mental illness on a human level. Engaging a person with a mental illness on a human level may involve (in part) empowering this individual to make choices in accordance with their own unique aspirations and values, helping them be heard, cultivating an atmosphere of positive influences, assisting in the development of social support networks, creating an environment of respect and empowerment, and emphasizing personal strengths to foster resilience and hope. This involves the approach of seeing someone as a person, not a patient; talking with someone, instead of talking to them. There were a couple points in the reading that, for me, really highlighted the importance of this theoretical approach. The first was when Dr. Patricia Deegan was talking about her experience early on with a Psychiatrist informing her about her illness, “He was saying that my future had already been written. The goals and dreams that I aspired to were mere fantasies according to his prognosis of doom” (Deegan, 1996, p. 92). The second, was when our text stated, “As we are beginning to learn in the recovery movement, there are ways in which the effects of stigma and institutionalization extend beyond the walls of the hospital or even take up residence in the lives of individuals who have never been hospitalized. Goffman’s understanding of how the institution can be recreated within the person’s own psyche or identity may be useful in contending with what is currently being referred to as ‘internalized (or self) stigma’, which is being reported to pose as formidable a barrier to recovery as discrimination and the illness itself” (Davidson et al., 2010, p. 13). These two passages speak to the importance of the stigma that can be associated with a mental illness diagnosis and the negative impact the stigma can have on a person’s wellbeing. Grasping the idea of the destructive power that stigma holds highlights the importance and necessity of the hope and person-first philosophical approaches in psychiatry today.
ReplyDeleteDavidson, L., Rakfeldt, J., & Strauss, J. (2010). The roots of the recovery movement in psychiatry: Lessons learned. Wiley-Blackwell.
Deegan, P. (1996). Recovery as a journey of the heart. Psychiatric Rehabilitation Journal, 19(3), 91-97.
I really like how you talk about the associated stigma that comes along with a mental health diagnosis. Most of the time when speaking of recovery, one thinks of solely drugs and alcohol use recovery, but in this instance we are speaking along the lines of mental illness recovery and what that looks like. Not many people think about that when they are diagnosed with a mental illness as they just accept what they know and have heard about the diagnosis and like you have said, just reform their life and lifestyle to match. I find that utilizing the principles that have been set forth, recovery from mental illness can and does happen. Really good post and super informative.
DeleteI think you make a really great point Sarah, Recovery is not just a term used in the substance use community, even though that is where our minds automatically go! I've worked with a lot of patients who have a diagnosis of bipolar disorder or schizophrenia and they have struggled to manage their symptoms for several years but continue to work at every day which I feel really defines what recovery is, never ending progress and steps to a more fulfilled way of living.
DeleteLuke, thank you for developing and focusing on stigma in your responding this week. I feel like it's a large part of the challenge of our work in supporting individuals with mental illness. Either from the individual themselves or those around them (or even the insurance companies as others have already identified). Great use of the readings to back up your points also.
DeleteHi Luke,
DeleteGreat post. The person first approach is extremely important for one's recovery. It gives a person a choice. I know when I am given a choice, I am much more likely to follow through with it as compared to if I am told to do something. I have learned that when I give my clients the power to decide what they want for their life, they usually do much better. It may not always be what I agree with or think they're capable of, but if I don't force my beliefs on someone, I am empowering them to believe in themselves. Working in the field of recovery, empowerment is vital.
The two major theories that prevail in todays mental health treatment are behavioral theories and cognitive theories. Specifically, behavioral theory explained behavior in terms of behavioral patterns that are predictable and malleable. B.F. Skinner used rats to show that operant conditioning can influence behavior. Operant conditioning is where a behavior is reinforced by either a positive reinforcement or negative reinforcement or punishment (Hergenhahn and Henley, 2014). He theorized that behavior was either increased by reinforcing that behavior positively or reduced by punishment or negative reinforcement.
ReplyDeleteIvan Pavlov also has had an influence on today’s behavioral theory. He also used conditioning, but in this instance classical conditioning. Classical conditioning consists of pairing a reinforcement with a behavior (Hergenhahn and Henley, 2014). In Pavlov’s instance he paired food with a bell when feeding his dogs. Each time they were to be fed, he would ring a bell prior to feeding the dogs, causing them to salivate, then gave them the food. Inadvertently he discovered this phenomenon, and then further study was conducted. He also measured the amount of saliva that was produced when the dogs heard the bell and went even further to ring the bell and not give the food and still the reaction was there. This shows, between the two types of conditioning, behaviors are sometimes very hard to change and can be embedded in an individual’s personality.
Another theory base that is prevalent in todays mental health treatment are cognitive theories. Albert Ellis and Aaron Beck are the two main proponents of these group of theories. Cognitive theory is based off the treatment is mainly addressing maladaptive cognitions and emotions the individual is harboring that may be causing behavioral issues (Hergenhahn and Henley, 2014). This brought about the birth of CBT (Cognitive Behavioral Therapy) which is widely used for many mental health issues today.
I talk about these theories in depth because I believe that they are the bases off which most of today’s treatments for mental illness are derived from. The basic understanding of human behavior is vital to effective treatment. When listening to Patricia Deegan’s reading of her paper, the phrase that stood out to me was “To be human is to be a question in search of an answer.” She then went on to talk about when she was diagnosed, the clinician delivered it with such finality that she was unable to see a future for herself as a “normal” thriving individual. This, I feel, is the case with a large amount of people who get their diagnosis and are not assisted through the process, nor have appropriate support to guide them towards new goals. I feel that it is important that we have the base knowledge of how humans work, and how their bodies function to produce certain affective states, as that is important to the treatment process. BUT I also see the merit in the holistic approach as I do have a minor in Holistic Health from undergrad, that the whole person needs to be taken into consideration. What their goals and aspirations are despite or regardless of their disability or mental illness. Our job as clinicians is to be there to help our clients through their mental illness in what ever way is best for them, but always remain knowledgeable.
Hergenhahn, B. R., & Henley, T. B. (2014). An introduction to the history of psychology.
Hi Sarah!
DeleteI am so glad that you used Pat's quote, "To be human is to be a question in search of an answer". I felt like as you mention her clinician gave her no hope for any kind of future, just to be able to cope. Thankfully she did not take that as her only option and has been able to give us great insight into what it means to live and thrive with a mental illness diagnosis. The holistic approach is so important with any dealings with anyone. We need to see the whole person in order to understand that person. Each person is so uniquely different and to not see one aspect of an individual skews the big picture.
I do appreciate your comments about know how humans work to be able to understand and help with treatment. I can see how the science of it comes into play.
Judi
I totally dig this quote and am always taken back when listening or reading anything by Pat. I think this quote speaks volumes to insight and self-awareness. Once a patient has insight and is self-aware of their symptoms and how it impacts it this is where they can really take control of their treatment and begin to advocate for themselves. I always tell patients the person that knows them best is them. Gaining this insight and self-awareness I believe comes from years of experiences, hope and empowerment.
DeleteSarah, thank you for this thorough and efficient review of both Cognitive and Behavioral Theories as they relate to Recovery-Oriented Mental Health treatment. I, too, like the sentiment that "we're all questions." I hadn't heard it before and decided to look up the philosopher that Patricia Deegan was quoting. So now I'm having a hard time repeating it in full knowing that Martin Heidegger was a full-hearted member and supporter of the Nazi Party, Adolf Hitler himself, and wrote expansively of antisemitism. This might get us off-track, but how do I accept the thinking of the philosopher that articulates something I believe to be accurate (we're all questions) while ignoring that same person's other thoughts about the humanness of persons with different religious beliefs?
DeleteHi Sarah, as others have noted, I like how you pointed out Dr. Deegan’s reference to the idea that being human is being a question in search of an answer. This reference stood out to me as well. From her speech, I got the feeling that her psychiatrist caused problems for her because, while acting from a position of perceived authority, he took away her question (of what it meant for her to be human) and replaced it with a label (her diagnosis). Dr. Deegan describes the impact of this as causing a hardened heart. To me, it seemed like her diagnosis robbed her of the open-endedness (like a question) of her future and created a psychological dead-end. The negative psychological impact of the way Dr. Deegan was given her diagnosis really illustrated for me the significance of the way we go about interacting with others and the importance of how we can create an environment of positivity and empowerment during these interactions. I like how you discussed several relevant psychological theories. After reading the material for this week, there were some common themes (like the importance of hope, for example). I’m wondering if these common elements, like those in SAMHSA’s working definition of recovery and the Psychiatric Rehabilitation Association Core Principles, could constitute a standalone theoretical approach, or if they should be incorporated into another theory like CBT?
Delete“Needed to be extracted from their everyday and interpersonal context in order to recover” (Davidson et al., 2010, p.10). In a variety of cases, this is still true today but not for the majority. There was help from Jane Addams who brought about the concept of alternative treatment in someone’s home environment for a community based option. Adolf Meyer brought about the notion that mental illness could be treated like other illnesses with opening up the idea of recovering fully but more importantly that just because someone is ‘not feeling well’ doesn’t mean they cannot still function in areas of life. In other words, multi-tasking with functioning is possible and should be encouraged.
ReplyDeleteThis brings up the ‘problem in living’ topic that it is not just internal that the interaction of the environment is also critical to evaluate. Where if you take someone out of the environment completely where they return to baseline and go back to the same physical place prior, that it is hard to deal with. This is huge for recovery movements today! “Through the process of navigating and negotiating everyday life, rather than escaping from it, that people were able to build on their strengths in constructing satisfying lives” (Davidson et al., 2010, p.12). Adding to why community treatments are so helpful.
Peer support is popular from back in the day to even our current present day on having some staffing that has experienced the recovery process themselves. The idea of using patients as providers to help assist those in connecting with someone to give a sense of hope. “Within this framework is the notion of ‘giving back’, which is frequently cited by people in recovery as an important foundation for their efforts, is given the central role in re-establishing and expanding the person’s sense of self and agency” (Davidson et al., 2010, p.11). To be around those with shared experiences and those individuals are more likely to know better than others on how to interact in relationships with this population.
Other reading materials highlighted the internalized stigma of being scared of the medical system for the horrid prior treatment in the institutionalization days. I absolutely loved how the reading related to the Civil Rights movement not only for mental health and disabled individuals but to people of color, women, LGBTQ individuals, etc. Relating to the current Black Lives Matter movement going on right now is a wonderful example for the similarities of societal treatment regarding stigma, stereotypes, etc. This is important to note because these regular experiences these groups have, has a negative impact on their mental health that has to be taken into consideration for everyone that we work with. This leads into Vygotsky’s principles of recovery-oriented that focuses on how everyone wants to experience the same freedoms in life. That topic of equality with choices in being a citizen just like anybody else.
Davidson, L., Rakfeldt, J., & Strauss, J. (2010). The roots of the recovery movement in psychiatry: Lessons learned. Wiley-Blackwell.
Hi Morgan, I like how you mentioned the importance of peer support, whether it involves former patients helping current patients or peer support groups, or in some other way. This was something that stood out to me as well as a beneficial approach to helping people who are recovering. The beneficial influence of a positive community and positive social support appears to be a common theme in counseling and I was not surprised to see it here. I like how you tied this in with the concept of hope. This positive social support could provide someone with a role model that could instill enough hope which, in turn, could be a catalyst for someone to make a positive change in their life or take a chance on moving forward (to help soften a hardened heart). This made me think of when Dr. Deegan was talking about how she would continuously refuse to help with shopping, but those around her continued to ask and give her the opportunity to go and one day she finally did. This makes me think that having a variety of peer support options for people would provide them with a variety of opportunities to respond in a positive way, therefore increasing the opportunity for a breakthrough or a change of heart to move their lives in a new and positive direction.
DeleteThanks Luke for bringing up the awesome example from Dr. Deegan!
DeleteThe variety of options that we can break down into the smallest tasks can make it so much more positive and encouraging for people. A concept I definitely noticed with hers was individualization. Looking at each case carefully and trying not to compare to other similar ones in the relation of progress.
I love what you wrote stating just because someone doesn't feel well doesn't mean they cannot function. It seems that each generation sees this differently as I have numerous generations living in my home and I am able to see how this works. Old school, they work hard no matter how they feel and that's it. Normal school, they work hard or work and they play hard. If they feel sick they continue to a point. New school, they work or barely work and if they are sick, they stop and become helpless. I wonder were that kind of breakdown happened? Could it be a generational thing or environmental thing?
DeleteYour 'problem in living' topic is very critical to evaluate. Some individuals get better when they are taken out of their environment and are given all the tools needed. Then once they are placed back into their old environment, it seems they tend to lose those skills and go back to how they were. We can give tools, hope and knowledge yet we also need to think about their current living situation. Being a foster parent, I see this all too often where children come into our care, change for the better and then are placed back at home were some things may have changed but they end of going back to what they know.
DeleteI struggle with the idea that people don't need to be taken out of their current environment to start the recovery process. I understand that many people don't and it is possible to work on recovery while in your current environment. However, the population I work with are often homeless or living in toxic situations. They do not have the skills to be in that environment and work on their recovery. The people I work with don't have many positive supports or a safe stable living situation so removing them from their current situation is often key. I know that when I was in a toxic situation I didn't see how toxic and unsafe it was because it was all I knew. Now that I have separated myself from it, I can see the impact it had on my thoughts and behaviors.
Lynn + Dnllrich-
DeleteThe comparissons of past 'schools' is a great analogy that paints a picture of wow there was like this jump from normal to new without any in-between it feels like for helplessness. Literally I wish there was one thing to blame it on but that is unfortunately true for a variety of other large issues going on right now. I love the example of seeing of the environment impacts an individual with being a foster parent where you got to see it firsthand!
What's really a bummer is those people who can't start that recovery process at all without being taken out of the environment completely. I totally see that perspective for those populations and shared experiences that toxicity makes it almost impossible. I wish there was a better transition coming out of treatments where they don't get put straight back into triggers. So right that you don't even see how much it impacts you until you leave, but that makes going back to it that much harder because now you truly know what the other side feels like!
Etiology: the cause, set of causes, or manner of causation of a disease or condition. Mental illness is unique is that there is usually not a physical test or exam that can confirm 100% someone's diagnosis. Most diagnostics are done thorough verbal or written screening measures, self-reports, and provider assessments. Getting a diagnosis can be life-changing for someone, but it's only the first step toward treatment and recovery.
ReplyDeleteI believe there are two big theories on etiology in psychiatry - the first is a biological cause, similar to the Brain Disease Model of Addiction. There is a chemical imbalance within the brain that either causes or triggers a mental illness that has been passed down genetically. Essentially, your disease is not your fault and there should be no burden on the individual to "fix" themselves without appropriate support/treatment.
The other theory is an environmental trigger - likely trauma. There are certainly plenty of diagnoses within the DSM that suggest a certain starting point for the illness, and the point here is the same as with a biological cause - the disease is not your fault.
I believe it's important to invoke SAMHSA's principles no matter the cause of psychopathology. To access the road to recovery, and individual must be 'provided' with the tools to do as much work themselves as is possible and appropriate. Someone else said it's important to work WITH and not FOR, something with which I agree whole-heartedly. Mary Ellen Copeland's experience illustrates the point that recovery is a fluid and ever-changing process, but it doesn't need to last forever. She talks of being medicated for years without also learning coping skills, leaving her extremely vulnerable when her medication stopped working. In my professional experience, practitioners are recognizing that it is far more effective to prescribe medication in conjunction with CBT, talk therapy, or services aimed at building skills that will specifically help the person in their daily life.
It's also important that no matter the methodology, that practitioners work with clients and not only consider but prioritize their desires, abilities, and goals.
Emily, I feel like we approached this in a similar way in that we explicitly separated the duality of categorizing individuals with mental illness (knowledge) while also understanding that not all diagnoses are expressed and experienced the same (wisdom). It also brought up the age-old sentiments of nature vs. nurture in human development. I really appreciate how you've articulated these points in your response.
DeleteHi, Emily. Thanks for sharing your thoughts. I didn't think to connect the idea of assessment and the lack of a 100% accurate assessment to identify mental illness. This point demonstrates the fluidity of our current way of identifying and categorizing mental illness. Just as it seems so silly to us to "cure" clients with blood letting or chair spinning, it is fascinating to think that one day the idea of hospitalization or even talk therapy might be seen as old-fashioned or ineffective. In addition, I appreciate your mention of the importance of SAMHSA's principles in any situation. Focusing on the client in any situation allows for us as physicians to reinforce the client's value and autonomy in the presence of mental illness. This action also allows us to advocate for the clients to reduce stigma regarding mental illness and those who experience it.
DeleteOne of the major themes that I gained from our readings this week is we should offer hope. Hope for a better tomorrow and hope that anyone with a mental illness diagnosis can do all the things they dream of doing. They do not have limitations. I found myself becoming angry when listening to Pat Deegan describe how she was treated as a teenager. The idea that she "may" be able to cope is not an encouraging message that a doctor should be giving. She may have had a very different experience if someone had of told her that she can still be and do anything she wanted it will just take work. As she mentioned the doctor did not "see" her just the illness. She speaks of how students need to learn wisdom and to learn how to build relationships. I think also we need to learn to see the big picture and not just a tiny part of it. A mental illness diagnosis should not define a person, as is evident with Pat Deegan, Daniel Fisher, Mary Ellen Copeland and Shery Mead a person can go on to be active members in their communities and advocates for those to come after. By being able to use tools and having a voice they show what recovery is for a person with mental illness, they are an example of what can be and shine a light where so many see darkness.
ReplyDeleteWhen looking at SAMHSA's Recovery Principles I was constantly reminded of the work I currently do as an Academic Advisor. We use very similar theories and principles. For example we have a slogan, "I advise, you decide" giving the decision making to the student. Believe me there are times where students will just say "tell me what to do" as I am sure happens with clients in a counseling profession. I think it's important for the student to have a voice, to make decisions, to feel in control of their lives, just like those with a mental illness diagnosis. We have many different advising approaches at our disposal. Some schools focus on just one but we use all of the tools available to us. I have often found in my student meetings that I just multiple approaches in just one meeting, just like looking at many pathways to recovery. Each person is unique and has different needs. I was very excited to read about having support from peers and allies. We are currently working on a program with our students on probation (I hate that word!) to offer peer support groups to help students engage with students who are in the same situation so they do not feel alone and have a support network. Also, one of our founding principles in Advising is to build relationships with students to build a connection to someone on campus who knows them and is an advocate for them. The parallels between what I am currently doing and what I hope to be doing once I finish this degree are numerous.
Whether an advisor or a mental health counselor treating a person with respect, giving them hope and building a relationship are fundamental in their success. Never should a practitioner elude to limitations they might see occurring especially since they do not hold a crystal ball or can read the future.
#7 of the Psychiatric Rehab Assoc. Core principles, outlines something very similarly to what you are speak of. "Psychiatric rehabilitation practices promote self-determination and empowerment. All individuals have the right to make their own decisions, including decisions about the types of services and supports they receive" [https://courses.maine.edu/d2l/le/content/33430/viewContent/2104990/View]
DeleteIt can be difficult to make decisions and advocate for ourselves so I can see where you are coming from when someone comes into your office just says "tell me what to do". I have experienced this with patients as well and have also experienced the patient who doesn't want to make any decision at all and wish they would say "tell me what to do"!
At the end of the day it is completely up to the individual of what direction they want to move in or any at all.
Judi,
DeleteThank you for sharing some insight with your role and how providing hope and choices can impact individuals. I have found in my role as a Transition Counselor that many consumers and students are unable to advocate for themselves. They seek being told what to do and when to do it. A consumer who is on their own road to recovery needs supports for gaining skills and connections with relationships to help navigate opportunities. Counselors need to be mindful of their approach and ensure they are not making decisions for the consumer. It is their role to provide options and support consumers with self-assessment of skills and needs. One of the articles we read this week discussed how to not become desensitized to the work we do. Every consumer and diagnosis is different and consumers need to be treated person-first.
Great post!
Lauren,
DeleteYes! With each reading this week I kept seeing how it connected to the work I am already doing. It's almost like I reset between my appointments with my advisees, and actually sometimes even in the same meeting with a student. There is not one approach or way to help a person. Often we have to use many approaches based on what they are coming to see us for.
Thank you for your response,
Judi
Judi,
DeleteIt is great that you see the value in your approach and how that impacts the students you support. There are some people who struggle with changing their approach and have a one size fits everyone option. Your students are lucky to have you and your awareness of a linear approach!
Thank you Lauren!
DeleteJudi
Regarding all the readings provided for this week, Hope is extremely important. Offering hope can significantly help individuals with psychiatric disabilities throughout the recovery process. Understanding that hope provides a foundation that all things are possible, all dreams, aspirations, etc. Pat Deegan highlighted the importance of offering hope, alongside with her own experiences throughout her ongoing recovery and practices. There should be no room for "false hope" or "false hopelessness". Cutting out hope all together allows for individuals to withdrawal from life and being hard hearted, essentially retreating to helplessness. She explains this through her own experiences and it is very powerful. Deegan also mentions that individuals are more than their illness or diagnosis, they are humans**. Establishing a human relationships is so essential within the recovery process, this allows for room to understand them and their experiences more clearly. Knowing who they were before the diagnosis, because before that they were a human, and still are. I thought her mentioning about how students need to learn wisdom was very important and true. This is vital within the field. You could have all the knowledge and recognition in the world, but at the end of the day there needs to be compassion and hope offered through seeing the individual as a human. Deegan also presents other suggestions for students, and they are very informative and helpful. Environment plays a very important role as well, this is a element that students (future practitioners) can control, when there is healthy environment there is likely for success. I also found her comparison of the statue and recovery interesting. She highlights that everyones recovery is unique and different. Daniel Fisher story/interview was also informative and highlights the importance on hope, love, and respect. Having someone who believes in your increases the recovery process and makes a difference.
ReplyDeleteSAMSHA recovery principles are very important as well. They help highlight recovery and help advance these opportunities. Again Hope is extremely vital, and another extremely important one is that recovery is person-driven. Understanding that each person is unique and have different needs and paths. Building a plan that is focused on each individuals strengths, goals an help gain control over their own lives with choices. I found this principle very helpful in a previous course that was focused heavily on treatment plans that catered each individual. I find all of these principles to be of great importance and help guide. Understanding the importance of the presentation of tools for individuals to access. Working with the individual not for, allowing for them to ultimately make the decisions and choices. We are there for assistance, not to dictate and control the situations and their choices.
This Entree is Stephanie Cushman
DeleteHi Stephanie! That term of hope is something I wish we were able to bill for because it is such a necessary characteristic that everyone needs to have in life in order to survive. Diagnoses that make individuals feel like they have no control over life, is a reason that personal choice(s) are so critical to semi-replace that control. The tiniest of areas like Deegan mentioned to help build a person's confidence that they can believe that they can do more on there own:)
DeleteStephanie I agree that the word hope seems to be a theme in everything that we have read or watched this week. Having someone on our side given us hope can make all the difference in the world. When Pat stated her psychologist stated this would be her life now, she dove into it. Then slowly she realized there had to be more than just this death sentence for her. She was told going to school or even gaining a doctoral would never happen yet she knew she had to do it. She had to prove them wrong and give others back what she never had. Hope. She knew with the hope, this could change treatment and each person. If she could do it with no hope from anyone, others could do it better with hope.
DeleteSide note: At my work we have two windows painted with flowers and the word Hope. One word can be so powerful.
Morgan,
DeleteThank you for your comments back to my post. Your first sentence about there being a bill for hope is so true. This is such a necessary characteristic that everyone needs to have throughout their life to survive. Without hope, your life can come crashing down. With hope, there is a bright light ahead that helps you achieve your goals and aspirations. There is a lot of stigma tied into this as well (as you know from previous classes). This significantly makes it harder for others to see past the diagnosis, but in reality they are human and need to be seen as just a human being with goals and aspirations.
-- Stephanie
Lynn,
DeleteHope was the main theme yes, but it is also very important and plays a significant role in recovery. Having a support system, or even just one person who believes in you makes all the difference. It essentially gives you a reason to hang on. Your mentioning of Pat and her experience with instilling hope within herself is spot on. Her psychiatrit gave her a "death sentence" leaving her with no hope. Rather than playing into it more, she decided to obtain her doctoral and prove them wrong, giving back to others what she was able to receive from her doctors, hope. This powerful word can change treatment plans and recovery of each individual. Also, your side note, love that connection. One word can be so powerful.
-- Stephanie
From this week’s readings, there are many important prevailing etiological theories that impact the consumers as well as the service providers. The environment in which the consumer lives establishes a sense of “hope” for the individual. Patricia Deegan’s article was very empowering to read. “We become experts in our own journey to recovery…The goal of recovery is not to get mainstreamed…The goal of recovery process is not to become normal...” are quotes she used that emphasized how important being aware and unique about individualism is. Having a person-centered approach and understanding a person before their illness can determine the route of success as individuals can have the ability to make a chose.
ReplyDeleteThis relationship can be one of the most effective tools for individuals to utilize as they can be provided opportunities to learn about their illness, treatment, and ways they can increase their quality of life all while being heard and validated. This instills a sense of hope and empowerment as judging is put aside. As counselors we can not choose what the recovery process looks like for consumers or who will and will not recover. Instead, we can establish relationships that open doors for opportunities in providing education, knowledge, and provide a sense of empowerment back to the individual. Overall, it is important for counselors to be aware that recovery is non-linear, holistic, based on supports, environmental from past and present trauma, influenced by life experience and relationships with respect as recovery emerges from a sense of hope. With this combination, services can be coordinated.
This comment has been removed by the author.
Deleteyour statement that "recovery is non-linear" is one of the best summarizations. There is a perception that recovery is a step by step process when in reality it's more of a twisty, turning road with several obstacles. I think this is an important concept to remind patients of who are may be struggling with their mental health and/or substance use and normalize this process as more of journey than a step by step process. I think by normalizing that most don't follow a step by step guide to recovery and individualizing that everyone is on their own journey can be empowering and provide a spark of hope.
DeleteVessa, your point about sharing with consumers how everyone's road is different is very important. I always discuss how non-linear their journey will be. This provides transparency and individualizes their treatment. Empowerment is built from the relationships they establish, on their road to recovery.
DeleteThank you for your comments!
Lauren
Hi lauren,
DeleteYour post highlights a number of important things. First off, the statement "recovery is non-linear" is very spot on. The treatment and recovery process should be catered to each individual, as everyone is unique and has different strengths, weaknesses, goals, and aspirations. This leads to a non-linear process with ups and downs, obstacles, and more. It is essentially a journey not a step by step process, because essentially this journey may never stop. It is an ongoing thing. Empowerment of the individual is important, and it is heavily significant to instill hope.
-- Stephanie (showing up as unknown, will be fixed by next week)
DeleteHi Lauren,
Recovery is certainly non-linear. I get to be a part of people's journeys in recovery from mental health and substance disorders at my current job. I love that it is non-linear because it gives each person a chance to figure things out on their own and it gives each person buy-in. If I could magically grant every client sobriety, no one would want it. Recovery is not something I can hand someone. Each person gets to figure out what it means to them and how they want to take that journey. It is truly a privilege to walk the journey with my people.
Hi Stephanie and Dnllrich,
DeleteRecovery is a non-linear process for all individuals. The journey they take is made for them only and is important for providers to not make decisions and instead empower and support the individual. It truly is a privilege and honor to support and be apart of an individuals journey to recovery.
Thank you both for your great comments!
In this week's videos and readings I saw the themes of hope, personal accountability, and the importance of having supportive relationships.
ReplyDeleteThe first of SMSHA's 10 guiding principals of recovery is hope. It describes hope as the catalyst for recovery. Dr. Fisher echoes this point when he stated that without hope there is no point. If there is hope for recovery, there is a possibility for recovery. It gives people reason to try. The Psychiatric rehabilitation association states in their 12 core principals that hope gives people the capacity to learn and grow. In so many of the stories we read and heard this week the tellers described how their experiences in mental hospitals and their interactions with healthcare professionals gave them not a sense of hope, but of learned helplessness. This is the opposite of what healthcare professionals should be doing. It should be their job to give their patients hope and a reason to try to recover. Once they have hope, they have a drive to recover.
Patients need to have a sense of agency and responsibility. Responsibility for their own actions gives the person empowerment. Their success and shortcomings become their own, just like anyone else. Responsibility allows the patient to know that they are human and are in charge of their own fate. SAMSHA describes this well in that the individual has responsibility over their actions, but there are some responsibilities that belong to every member of the patient's support network. It is the responsibility of the community to offer work, and it is the healthcare professional's job to give the individual all the tools they need to help themselves recover.
While recovery is the individual's doing and their choice, every patient needs a strong network of relationships. These relationships can and should come in many forms: Family, peer support, health professionals, and so on. Dr. Fisher described the importance of having people who believe in the individual by telling a story of his own. One of the most meaningful people in his recovery was his brother-in-law who told fisher he believed in him and that he could go to medical school and become a doctor. It is the job and responsibility of healthcare professionals to be one of these positive figures in each patients recovery story.
Hi Mackenzie,
DeleteI had a similar reaction regarding hope and its importance; there is so much harm in false hopelessness that a lot of practitioners seem not to consider. I really likes the way Dr. Deegan described the need for hope if the ultimate goal is true recovery.
I think we put too much emphasis on the diagnosis and tailoring treatment to the diagnosis more than the individuals. Then estimations of prognosis are based on statistics of the disease, rather than a holistic view of the patient.
I also appreciate your point about personal responsibility - I found much greater success with clients when I insisted that they had the ability to accomplish their goals, and I was merely the support or the guide. I feel that personal responsibility and hope go hand-in-hand to give the patient the self-efficacy needed for recovery.
Hi Mackenzie, I like how you pointed out the importance of having a sense of responsibility and agency. This was something that stood out to me as well from the readings. It seems that if someone is to move forward in a positive direction with their life, they would need the sense that they have the capacity to make a difference for themself. This seems to be a necessary part of what makes hope so powerful. I think that empowering someone to feel like they have the strength to make progress, along with a sense of hope that their life will move in a positive direction, were two very important points covered this week. One of the ways to help foster a sense of agency from the readings was to give people the opportunity to make choices themselves that impact their lives, whenever possible. I’m wondering if anyone noticed, or has any experience with, helping develop a sense of agency in other ways?
DeleteFrom reading the material and doing some reading I found that Etiology means explaining or finding the cause of a condition or disease. There is a reason this condition or disease is happening, and the source needs to be found. With that information I feel the prevailing etiological theories in psychiatry today are environmental, genetics and psychological. Normally with a condition/ disease there are some underlining layers that very well could be a trigger. Were we live, who we live with, how we are raised, genetics can also create a factor with some other layers. This often time leads to theories of what a professional may think is the issue. Were we usher people in and usher them out needing to gain a certain amount of people daily and meeting requirements. Stories are told yet a theory is already developed, and meds are given without really digging the layers or given these individuals a voice. Time has changed through the years, yes however, some professionals are still rigid and unable to move past the theories. Now most professionals are digging the layers and given the voice back to individuals. This is allowing the breaking of theories and moving past what the old. Normally there are more than one issues that has contributed to the problem. We are learning to listen, take our time and pull each layer slowly. This allows the freedom to be independent or maybe to give hope that life can be better. From the stories being told of this is how their life is and will always be to, being a doctor and given hope back. I am eager to learn and grow from my mental health and want to encourage others, there is hope beyond this moment.
ReplyDeleteThe etiologies of mental health that you identified are interesting, I wonder if you could expand and shine a light on your thinking?
DeleteHi Lynn,
DeleteI found it very interesting when you said "Normally with a condition/disease there are some underlying layers that very well could be a trigger." Your use of the term "tigger" got me thinking about how people can go symptom free for almost their entire lives but one change, whether it be biologically or in their environment, could leave an individual with sudden and scary mental health symptoms they have never had to address before. Triggers could be different for everyone, which makes mental illness, much like physical disability, a possible experience for any one of us! This fact in its self should make us all care about the quality and availability of mental health services we have here in America- unfortunately this is not the case, and many people don't give thought to such things until mental illness effects them directly.
Kailyn Hill I feel environmental, genetics and psychological are the etiologies because if we look around, all of these are a part of who we are and what makes up tick. Without genetics, we could not exist, without the environment, we would not function. With psychological, this has changed through the years of what one perceives is a mental illness or behavioral which are connected. I feel though we all have layers in us that has build since infancy from everything we have gone through or lived through. All of this is connected back to genetics, environmental, and psychological.
DeleteThanks Lynn. I completely agree, and was just curious where your thought process was!
DeleteWhen considering current etiologies that influence psychiatry/mental health treatment today the first thing that came to mind was the “nature v. nurture” debate. In my mind nature v nurture sums up today's etiology theories in their simplest forms. The “nature” theory states that mental illness is influenced by biological factors that result in our brains being pre-wired with mental illness or not. Examples of nature include genetic inheritance and brain defects. Alternatively, the “nurture” theory holds that mental illnesses are the result of external factors that come into play after conception. Examples of nurture causing mental illness includes traumatic events including abuse and neglect, exposure to toxins/infections, insecure attachments, and even poor nutrition.
ReplyDeleteEtiology directly informs treatment. This fact can be displayed clearly when using the medical field as an example- a doctor would obviously use different treatments for a headache caused by a sinus infection, as opposed to a headache caused by a brain tumor. Same symptom, different etiology and therefore different treatment. I think that the nature (or biological)theory is becoming more and more accepted in today's world, evidenced by the popularity of using psychotropic medications to treat mental illness. I believe it is important to discuss how appealing this method of treatment is- who wouldn’t want to simply take a pill to “fix” their mental illness? Unfortunately even with modern advances in medicine prescribing psychotropic medication is still not an exact science. The nurture theory argues that treating mental illness is not always so simple. An example of treatment includes behavioral therapy to address one’s learned beliefs and behaviors, or education (even better when it's preventative!) regarding holistic wellness. For many people it is beneficial to use a combination of these treatments, such as utilizing both medication and talk therapy, or by engaging in treatment such as cognitive-behavioral therapy which addresses the effects of both nature and nurture.
https://www.goodtherapy.org/blog/psychpedia/nature-versus-nurture
Hello! I am glad that you brought up the nature vs nurture debate, because I did not even think about this for my post, however it makes so much sense. In my current job I clearly see how this could absolutely be an etiology of mental illness. For me, nature makes sense but I also wonder if there is any other influence to this factor than just someone's brain chemistry. Nurture makes the most sense to me, because I see it in the children I work with everyday. The way they were raised, food and shelter insecurities, abuse, neglect, etc, those are things that are apparent and that can be directly related to mental illness. Nature it less "tangible" and more difficult to understand, so it is more difficult to connect.
DeleteHi, Mariah! Thanks for sharing your thoughts. I also based my summarization of current etiologies on biology versus social, but I didn't think to use the "nature versus nurture" verbiage. I appreciate that you tied in forms of treatment into your discussion, especially how etiology impacts treatment options. I think you are completely right in your assessment of the desire to "fix" mental illness with a magic pill. I wonder how much the desire to cure mental illness under the guise of ease and speed drives public opinion and perception of mental illness? As you mentioned regarding education, do people who lack basic knowledge on mental illness believe there is a combination of pills that will remedy any symptoms, so individuals experiencing mental illness are choosing not to "get better"? Interesting point to think about!
DeleteTest
ReplyDeleteThe etiology of mental health conditions has been fascinating to me for as long as I can remember. I am also fascinated with the history of what professionals thought would "cure" people with disorders.
ReplyDeleteI have been in the field of mental health and substance use for about ten years. In that time, I have witnessed all kinds of people, disorders and treatment. I see people diagnosed with a mental health disorder, such as Bi-polar. As soon as someone gets that diagnosis, their hope of recovery is lost. The providers I've worked with rarely highlight what recovery looks like, how the disorder can be treated or any sort of hope. This causes my clients to become hopeless. Providers will prescribe medications as treatment, not in conjunction with therapies. There are providers who use a holistic approach, but they are the minority.
The last time i was meeting with the psychiatrist at the local psych hospital and a client of mine, the psychiatrist told my client that she would be back. He said to her "when you return, and you will return because you have a disorder that isn't going away or going to get better, we will have a better idea of what medications work for you." He didn't say anything about treatments outside the hospital that she could access, he didn't take the time to describe to her how her disorder impacts her brain and behaviors. He didn't paint a hopeful picture. He told her she would have a relapse of condition and be back in the hospital. This kind of treatment does give someone autonomy or put the power back in their hands. It takes power away.
As human beings, we need connection with other living beings in order to flourish. Peer support programs have proven to instill hope of recovery for people.
I am so sad to hear that any person is treated like that by a service provider. While I do believe that it is extremely important to notify an individual that the recovery process will not necessarily be easy, and that relapses are common and completely normal. No where in this interaction should there be a stripping of hope or making them feel like success is not possible for them. If I were the person that that service provider were speaking to I would not have gone back, I would have either stopped any interaction with providers or found a new service provider that would treat me how I felt I should be treated. Unfortunately, not all individuals have the education that I do and this could be extremely detrimental to the field of mental health and the clients themselves.
DeleteIn today’s world of mental health there are a few theories, that I tend to hear very often, on why individuals deal with mental health struggles. These include brain chemistry, environment, and lack of availability of services. Brain chemistry is one of those topics that have been around forever, and always tends to get touched upon for service providers who push or want to try medications. The environment is most definitely a plausible reason that individuals have mental health struggles. Stresses from work, school, and home can be extremely difficult to deal with and if not dealt with can cause more intense issues for individuals. While stress is an easy issue to pick out, there are plenty of other experiences that can negatively affect an individual’s mental health. Relationships with kids or significant others, money problems, unstable housing, loss of a job, divorce, are among some of the many things that people can face. Lastly, lack of services. Individuals tend to go untreated for mental illness due to the lack of services available to them. This is the most unfortunate cause of severe mental illness problems, because there is no control over this barrier. It is not that these individuals do not want help in dealing with their mental illness, it is that they simply do not have access to it.
ReplyDeleteWhat do we do for these identified individuals which mental health struggles? For the service providers who have a strong belief that brain chemistry is the most important factor in mental illness, typically the solution is medication. For those who’s mental illness stem from the environment or lack of services, they are told to go to therapy and take medications. As a children’s case manager, it is the most frustrating thing when a child could benefit from counseling, therapy, or medication management but there is a waitlist or no service available in their area. The child continues to wait, while there becomes a struggle in the family function, and there is nothing to do except supporting the family while waiting for the services to begin. Most of the times, if there is a lack of available services these individuals are just “swept under the rug” and without a service provider, like a case manager, to help them this is how they will continue to be.
-Kailyn Hill
Hi Kailyn! I'm so glad you brought up lack of services in your etiology discussion. I believe you made an excellent point about how when individuals are forced to wait for services their mental health symptoms only worsen in the meantime, whereas if it was possible for their symptoms to be addressed immediately following their outreach for services(the assumption is that this outreach indicates their readiness and willingness for change) they would be more likely to "recover." Waitlists are certainly not an ideal part of our mental health system and they do a disservice to our society on a big picture level. I think that this point you brought up about lack of services could be taken a step further to discuss preventative services which work to "treat" mental illness before symptoms even arise by means of providing education, resources, and opportunities. As we discussed in depth a previous class you and I took together, HCE 640, prevention methods are statistically proven to be not only extremely effective in reducing future mental health symptoms before they occur, but they are also very cost effective and have the capability to reach many individuals at once. Thank you for sharing Kailyn, nice to see a familiar name on the blog :)
DeleteThanks for the input, you are completely correct. Unfortunately, sometimes access to these preventative resources are just as hard to get as other services. There are many barriers, things like the cost, lack of services in the area, and lack of time. I am specifically thinking about services for children, these may not be barriers for adults, or they may be.
DeleteWhen discussing mental illness, popular etiologies seem to consist of biological and social factors, possibly stemming from the biological and social models of disability. On one hand, the theory of a biological cause for mental illness focuses on genetic predisposition and brain chemistry as primary causes. On the other hand, the theory of a social cause for mental illness focuses on the social aspects affecting a person’s mental health, such as upbringing, trauma, stress, and experiences. While these theories seem to focus on a wide spectrum of causes, I suspect the answers lie somewhere in the middle, compiled of a blend of the two depending on the individual client.
ReplyDeleteIn reaction to these prevailing theories of mental illness, society has created a system of avoidance and stigma. If the cause is assumed to be biological, the client should seek medical help and assumes the role of the helpless invalid. In addition, the parents are criticized for their role in the client’s illness, possibly expanding to include ideas of religious punishment in some cultures. For causes assumed to be social in nature, the stigma can be even more oppressive. Instead of the possibility of a genetic lottery of sorts causing illness, the client is seen as lazy or lacking emotional and physical control, allowing mental illness to take over due to a lack of initiative. Social causes open up opportunities for the client to receive the blame.
To combat these incorrect reactions to current knowledge regarding mental illness, a focus on widespread education is imperative. Instead of reacting to the possibility of mental illness after symptoms present themselves, educate the public as a whole on mental illness just as information is given on cancer or heart disease. By educating the public on the effects of mental illness, understanding can begin to chisel away the stigma built on ignorance.
-Emily Thomas