Learning Objectives
By the end of this section, you will be able to:
- Discuss four dimensions of recovery
- Provide examples of rehabilitative treatments in PMH nursing
- Provide examples of rehabilitative resources in PMH nursing
Recovery and rehabilitation from mental illness are not isolated events, but a process. Depending on each client’s severity of illness and level of functioning, they will need different types of assistance during their recovery. It is a complex journey requiring support from an interdisciplinary team, including nurses, physicians and advanced practice providers, social workers, therapists, behavioral health technicians, peer support, and more. It is up to the nurse to assess the client for their recovery needs and help them develop a plan of care likely to lead to the best outcomes.
Dimensions of Recovery
The process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential is called recovery (SAMHSA, n.d.). The concept of recovery is hopeful and empowering; it is based on the belief that people with mental health conditions have the potential to lead fulfilling lives, and that recovery is possible with the right support and resources. Recovery-oriented treatment approaches focus on the person’s strengths and abilities, rather than on their limitations or diagnosis, and aim to empower individuals to take an active role in their own recovery process.
Recovery is a road that is unique to each individual, involving various factors, such as personal growth, resilience, and self-determination. It does not necessarily mean the absence of symptoms or the return to a previous state of functioning. Instead, it is a holistic and ongoing process that involves addressing physical, emotional, and social needs. Recovery can involve medication, therapy, peer support, and lifestyle changes. It is important to note that recovery is not a linear process, and often involves setbacks. With the right support, though, people with mental health conditions can learn to manage their symptoms and achieve their goals.
The Substance Abuse and Mental Health Services Administration (SAMHSA, n.d.) identifies four major dimensions of recovery in a mental health context: health, home, purpose, and community. These dimensions are interconnected and can have a significant impact on an individual’s overall well-being. By addressing each dimension, individuals can work toward achieving a balanced and fulfilling life in recovery. It’s important to remember that mental health recovery is a unique journey for each individual, so these dimensions may look different for each person.
Health
This dimension emphasizes the importance of maintaining physical and mental health through activities, such as exercise, healthy eating, and self-care. It also involves managing any medical conditions or mental health symptoms through medication, therapy, and other interventions.
Home
This dimension refers to having a stable and safe living environment, whether that be through independent living, supported housing, or other arrangements that meet the individual’s needs. It also includes having access to basic necessities, such as food, clothing, and transportation.
Purpose
This dimension involves finding meaning and purpose in life, such as through work, education, volunteering, or creative pursuits. It also means setting and achieving goals and having a sense of direction and motivation.
Community
This dimension emphasizes the importance of social connections and support systems, whether through family, friends, peers, or formal support networks. It entails building and maintaining positive relationships, as well as contributing to one’s community through social engagement and advocacy.
Rehabilitative Treatments
The holistic and structured process aimed at assisting individuals with mental health challenges to regain or enhance their functional abilities, independence, and quality of life through therapeutic interventions and support is called rehabilitation (World Health Organization [WHO], 2023). Rehabilitation promotes recovery.
Rehabilitative treatments are designed to help individuals with mental health conditions manage their symptoms and improve their functioning. These treatments may include therapies, such as cognitive behavioral therapy, or medication management, as well as other types of interventions, such as group therapy or art therapy. The goal of rehabilitative treatments is to help individuals regain independence and improve their quality of life. In essence, rehabilitative treatments consist of the clinical interventions that are used to address mental health symptoms and take clients on the journey to recovery.
Medication Management
Effective medication management involves careful monitoring of the client’s symptoms, side effects, and medication adherence, as well as adjustments to the medication regimen as needed. Clients attend regular check-ins with health-care providers and receive education and support to ensure they understand the importance of taking their medication as prescribed.
Psychological Support
Psychological support is an essential component of rehabilitative treatment for individuals with mental health conditions. This type of treatment is aimed at improving mental health and overall well-being by addressing the psychological and emotional needs of the client. Psychological support can be effective for a range of mental health conditions, including depression, anxiety, bipolar disorder, personality disorders, and post-traumatic stress disorder (PTSD). It can also be helpful for individuals who have experienced trauma, grief, or other life challenges that may be affecting their mental health.
Psychological support comes in various forms, including individual therapy, group therapy, and family therapy. It involves working with a mental health professional to explore thoughts, feelings, and behaviors that may be contributing to the individual’s mental health challenges. The goal of psychological support is to help clients learn coping skills and strategies to manage symptoms, improve their mood and emotions, and enhance their quality of life.
Rehabilitative Resources
The various programs, services, and interventions that aim to support people with mental health conditions in their recovery and return to their previous level of functioning, or the highest level of function possible for them, are called rehabilitative resources. Mental health professionals, community organizations, or other health-care providers may offer these resources. Nurses should expect to collaborate with those in the health-care field as well as those in the community.
Housing
Stable and safe housing is essential for individuals with mental health diagnoses. A variety of programs aim to provide access to safe and affordable housing, which can help people maintain stability and support their recovery. Federal laws prohibit housing discrimination based on mental illness. Many states offer subsidized housing to low-income and vulnerable populations, such as the chronically mentally ill. These programs include supportive housing, which provides additional services, such as case management, counseling, and medication management. These subsidized and supportive housing programs are often limited by lack of funding and other resources, and can have complex application processes combined with long waits for housing resources.
Job Coaching
Job coaching programs can provide clients with mental health conditions with the training, skills, and support they need to find and maintain employment. This can include help with résumé writing, job searching, and interview skills, as well as ongoing support to help individuals succeed in their jobs.
Educational Assistance
Education and training can provide individuals with mental health conditions with the skills they need to achieve their goals and improve their overall quality of life. These programs include access to training, vocational programs, and educational opportunities that can help people build new skills and increase their employability.
Social Support
Social support programs can provide individuals with mental health conditions access to peer support, counseling, and other services that can help them build social connections and develop a sense of community. This can include support groups, peer mentoring programs, and other resources that can help people connect with others who have had similar experiences.
Cultural Context
Cultural Barriers to Mental Health Treatment
Cultural factors can affect a client’s support system. Existing stigma can cause clients of different ethnicities to be left to find mental health treatment and support alone. Cultural barriers also may result in confusion and misunderstanding between providers and clients. Lack of cultural understanding can lead to suboptimal care, such as misdiagnoses and/or unsuccessful treatment plans.
One example of a situation where lack of cultural knowledge can lead to misunderstandings involves the Hispanic/Latinx community. This population is 50 percent less likely to receive mental health treatment than the White non-Hispanic population (National Alliance on Mental Illness [NAMI], n.d.). One in four individuals in the Hispanic/Latinx community who reported having a mental health condition were categorized as having a serious mental illness, such as schizophrenia, bipolar disorder, or major depressive disorder.
NAMI Compartiendo Esperanza is an initiative founded by and for Hispanic/Latinx communities in order to help address disparities in mental health treatment. It offers resources for individuals, families, and youth on mental health treatment, breaking down mental health stigma among individuals and communities, and incorporating understanding in a culturally relevant and sensitive manner (NAMI, n.d.).