Health Promotion Well Being Recovery - Nancy Brookes

8/13/2019 Health Promotion Well Being Recovery - Nancy Brookes

1/28

Promoting Health,Well

Being

andRecovery

February 8, 2013

Nancy Brookes, RN; PhD; CPMHN( C)[email protected]

Achieving Certification:

The Psychiatric Mental Health

Review Course

Windhorse Principle

Inherent in every person there is a naturalhealing impulse, a motivation towardhealth & wholeness. This motivation canbe ignited & strengthened in anenvironment where an attitude of hope & abelief in each person's potential for growthis pervasive. At the heart of an individualsrecovery from mental disorder is therestoration of personal, social, &environmental connections

Presentation OverviewA Quick Trip Through:

Health and healing

Mental Health

Environment, culture

The power of language and how words can wound

Stigma, prejudice and discrimination as a barrier torecovery

Recovery Health promotion

Well-being

Resil ience

Self care

Lots of resources


2/28


3/28

Environment As Context Quality of environment has significant impact upon humanQuality of environment has significant impact upon human

healthhealth (CNA, 2000)(CNA, 2000)

Our task is to provide conditions under which people mayOur task is to provide conditions under which people mayheal themselves, or be healedheal themselves, or be healed-- as Florence Nightingaleas Florence Nightingale

remarkedremarked -- by nature or by God.by nature or by God.

People grow up, develop & heal within their many physical,

cultural and social environments contexts: Home, school,

work, social, hospital, health care system..

Environments multilayered including biological, external,

social, cultural, interpersonal

Healing environments work principally by supporting copingHealing environments work principally by supporting coping

with stresswith stress

Environments Nightingale quality of persons environment

holds key to health and healing

Complex relationship btw person andenvironments

Integral person essential part of environment &environment essential part of person

Environments include internal, external, and thesocial and cultural milieus in which person lives. Aperson dwells in multiple environments, often atsame time

Environments & experiences can be healthpromoting and support health, or they can be toxicand detrimental to health

Culture

A word about culture integrated throughout

A number of programs available to enhance

cultural competence see for example MHCC

Cultural Awareness Tool

A caution importance of knowing theperson/family/community, avoid possible

stereotyping based on understanding of the

culture


4/28

MHCC Cultural Awareness Tool

https://kec.mentalhealthcommission.ca/mental_health_tools_and_resources

Tool is designed as a first step to providecomprehensive information on all aspectsof culturally sensitive care. Does notprovide comprehensive information on allaspects of culturally sensitive care.

Based on the use of this tool the hope is thathealth and mental health practitioners willfurther develop their own knowledgeconcerning culturally sensitive care

Mental Health Commission of Canada

Mental Health vs Mental Illness

Mental illnesses are disorders that cause a seriousdisturbance in thinking, emotions or behaviour (onein five; one in three)

Depression, Bipolar disorder, Schizophrenia, Anxietydisorders, Personality disorders, Eating disorders [newDSM V ...]

Mental health often described in negative terms absence of mental illness, or societal norms andregulations

Notice rarely hear mental illness anymore oddterms such as mental health diagnosis oxymoron!

Mental Health

Mental health is defined as the capacity of the

individual, the group and the environment to

interact with one another in ways that promote

subjective well-being, the optimal development

and use of mental abilities (cognitive, affective

and relational), the achievement of individual

and collective goals consistent with justice and

the attainment and preservation of conditions of

fundamental equality.


5/28

Mental Health - human face

Mental health is the capacity of each and all

of us to feel, think, and act in ways thatenhance our ability to enjoy life and deal

with the challenges we face. It is a positive

sense of emotional and spiritual well being

that respects the importance of culture,

equity, social justice, interconnections andpersonal dignity.

The Human Face of Mental Health and Mental Illness

Mental Health - WHO

Mental health is a state of well-being in which

an individual realizes his or her own abilities,

can cope with the normal stresses of life, can

work productively and is able to make a

contribution to his or her community. In this

positive sense, mental health is the

foundation for individual well-being and the

effective functioning of a community.World Health Organization

Two Continuum Model

Mental health continuum: two poles optimalmental health, poor mental health; respectivedemands & contributions of person, group &environment balanced so they support values andobjectives expressed in definition of mental health

Mental disorder continuum: one end point extreme

severity of symptoms (distress & impairment), otherwould be complete absence of symptoms or effects range of different symptoms present to varyingdegrees Mental health for Canadians: Striking a balance (1988)

Flourishing (CAMH)


6/28

Stigma

Stigma refers to negative attitudes (prejudice)

and negative behaviour (discrimination) Includes: having fixed ideas and judgements;

stereotyping, fearing and avoiding what wedont understand

Mental Health Commission of Canada

National Mental Health Strategy one of two

priority areas stigma among health care

professionals

Stigma is... a complex idea that involves attitudes, feelings &

behaviour

a word referring to the negative mark attached topeople who possess any attribute, trait or disorderthat marks that person as different from normalpeople. This difference is viewed as undesirableand shameful, and can result in people having

negative attitudes and responses (prejudice anddiscrimination) toward another person

Adapted from OGrady, C. (2004). Stigma as experienced by family members ofpeople with severe mental illness: The impact of participation in self-help/mutual aid support groups. Unpublished doctoral dissertation, University ofToronto.

Stigma: The FactsWhat is stigma?

Stigma (or prejudice) describes a negative andunfavourable attitude.

Stigma causes those living with a mental illness to belabelled, stereotyped, and feared.

What is discrimination? Discrimination is the action that results from stigma.

It is how you treat those living with mental health issuesbecause of how you think about them.

Why does it matter? Many people living with mental illness say the stigma is

worse than the illness itself.

Stigma is seen as one of the key barriers preventing peoplefrom seeking help.


7/28

Stigma = prejudice +

discrimination

Beyond the Label Quiz

Recovery Attitudes

Questionnaire

Things you can do to stamp out stigma

(Beyond the Label)

1. Acknowledge the prevalence of mental health and

substance use problems.

2. Try to walk in the shoes of a person who is stigmatized.

3. Watch your language.

4. Monitor media & openly critique stigmatizing material.

5. Respond directly to stigmatizing material with a letter to the

editor.

6. Speak up about stigma to friends, family & colleagues.

7. Be aware of your own attitudes and judgments.

Person-centered alternatives to

commonly used words and phrases

Worn-out language

you're just

Decompensating

Manipulat ive

Crazy

Compliant

Noncompliant

Resistant

Language that promotes

acceptance, respect,

&uniqueness

You are more than

Not him/herself today; he/she isexperiencing symptoms

Resourceful; really trying to get

help Unique

Might not be confident aboutpersonal choices or decisions;afraid

Beginning to think for him/herself;taking personal responsibility

Not open to; chooses not to; hasown ideas


8/28

Alternative Language

Wornoutphrases Frequent flyer

Ent it led

Basel ine

Unmotivated

Helpless

User of system

Recoverylanguage Gives us many opportunities to

intervene and support

Aware of rights

What a person looks like when

doing well

Has other interests; bored;doesnt know how to begin

Unaware of capabilities

Resourceful, good self

advocate

Source URL:

http://www.behavioral.net/article/tools-transforming-language

Its Just Behaviour

My personal favourite of course whatever itis it is behaviour

How might we change our language aroundthis phrase? Suggestions?

Once I became my diagnosis there

was no one left to recover

The language used and the stories and

meanings that are constructed have great

significance as mediators of the recoveryprocess. These shared meanings either

support a sense of hope and possibility, or

invite pessimism and chronicity


9/28

Recovery Knowledge InventoryEncourages conversations about

the recovery process &the meaning of resiliency and wellness

http://www.acbhcs.org/wellness_test/wellness_inventory.htm

Mental Health Commission of Canada,Recovery

Recoveryinvolves a process of growth

and transformation as the person moves

beyond the acute distress often associated

with a mental health problem or illness and

develops new-found strengths and new

ways of being. Mental Health Commission of Canada, 2010

Recovery Transformation Potential to transform the system

People recover we provide recoveryoriented service and care

Not to be mistaken for a passing fad

roots stretch to the birth of psychiatry in the18th century. As its

Reintroduction intended to bring aboutfundamental transformation of mental health -a revolution in care

Not simply a new word to be used indescribing current practices.


10/28

What is Recovery?

SRN recovery is a deeply personal, unique process ofchanging ones attitudes, values, feelings, goals, skills,

and roles. It is a way of living a satisfying, hopeful andcontributing life, even with the limitations caused byillness. Recovery involves the development of newmeaning and purpose in ones life as one grows beyondthe catastrophic effects of mental illness(Anthony, 1993)

SAMSHA - Recovery is a process of change wherebyindividuals work to improve their own health andwellness and to live a meaningful life in a community oftheir choice while striving to achieve their full potential.

Recovery

There is no set time requirement for recovery,

Recognized as an individualized process

Each persons journey of recovery is unique and

Each person in recovery chooses supports, ranging fromclinical treatment to peer services that facilitate recovery

Recovery involves a process of growth andtransformation

Person with a mental health problem or illness developsstrengths and new ways of being

People are empowered and supported to activelyengage in their own journey of well-being.

Four Major Domains Support Recovery

- SAMHSA: Health: overcoming or managing ones disease(s)

as well as living in a physically and emotionallyhealthy way;

Home: a stable and safe place to live thatsupports recovery;

Purpose: meaningful daily activities, such as ajob, school, volunteerism, family caretaking, orcreative endeavors, and the independence,income and resources to participate in society; and

Community: relationships and social networksthat provide support, friendship, love, and hope.


11/28


12/28

National (US) Consensus Statement on

Mental Health RECOVERY

Self direction

Individualized and

person-centred

Empowerment

Holistic

Non-linear

Strength based

Peer support

Respect

Responsibility

Hope

www.samhsa.gov

Principles of Recovery Person-driven;

Occurs via many pathways;

Is holistic;

Is supported by peers;

Is supported through relationships;

Is culturally-based and influenced;

Is supported by addressing trauma;

Involves individual, family, and communitystrengths and responsibility;

Is based on respect; and

Emerges from hope.

Engagement Beliefs

Recovery is possible

Change is inevitable nothing lasts

Ultimately people know what is best forthemselves

People posses all the resources needed to

begin the recovery journey The person is the teacher, we are learners

We need to be curious learn what needs to bedone to help the person now!

www.tidal-model.com


13/28

What People Tell Us Helps Educating oneself about the illness. Identifying symptoms and reviewing

choices for managing those symptoms and making decisions about howto manage those symptoms that works best.

Making choices about medications: find out about the side-effects ofeach, as well as, the effects of withdrawing (stopping use of) certain

medications. Recording symptoms in a notebook while taking medicationand use this to support or oppose continued use of a particular drug.These records can be used to work with doctors regarding the bestchoices for you.

Exploring non-medication and non-medical approaches to managingsymptoms and maintaining mental health.

Learning various coping strategies and activities such as meditation,relaxation techniques, prayer, or hobbies that can help to reduce stress;joining clubs and organizations.

Seeking employment and self-employment support programs.

Seeking mutual aid opportunities such as self-help groups, communitykitchens and food banks.

Learning to make the most of social assistance programs, low costtransportation.

LET'S TALK ABOUT SOLUTIONS

Recovery Conversations

The Recovery Conversation focuses on strengths andthe potential for self-determination instead ofacceptance of limitations that perpetuate feelings ofhelplessness and hopelessness.

begins by focusing on the person instead of the problem.

focus is on empowering the person

includes a dynamic planning phase

Risks and outcomes are held in mutual partnership framed in the context of the person's strengths and action plan

Special attention given to building resilience

concludes with a mutual assessment of the process and progress

Source URL: http://www.behavioral.net/article/lets-talk-about-solutions

What is a Wellness Recovery ActionPlan (WRAP)

The Wellness Recovery Action Plan, or WRAP is

An evidence-based systemUsed world-wide by people who are dealing with mental health and other

kinds of health challenges &

By people who want to attain the highest possible level of wellness

Developed by people who have a lived experience of mental healthdifficulties; people who were searching for ways to resolve issues that

had been troubling them for a long time.WRAP involves listing your personal resources, your Wellness Tools, and

then using those resources to develop Action Plans to use in specificsituations which are determined by you. WRAP is adaptable to anysituation. WRAP also includes a Crisis Plan or Advance Directive.

Wellness RecoveryAction Plan - Mary Ellen Copeland

www.mentalhealthrecovery .com/aboutwrap.php


14/28

Structure of Framework for SupportStructure of Framework for Support

Purpose: To ensure that people with seriousPurpose: To ensure that people with seriousmental health problems live fulfilling lives in themental health problems live fulfilling lives in the

communitycommunity 3 fundamental assumptions & 3 conceptual models3 fundamental assumptions & 3 conceptual models

Provision of services & supports to people with mentalProvision of services & supports to people with mentalillness needs to be reformed & restructuredillness needs to be reformed & restructured(CRB(CRB rethinks nature of services & supports)rethinks nature of services & supports)

Most basic ways we think about & understand MI needsMost basic ways we think about & understand MI needsto be reto be re--examined & changedexamined & changed (KRB(KRB focus on di versefocus on diversekinds of info)kinds of info)

Way consumers seen as people needs to be changed &Way consumers seen as people needs to be changed &enrichedenriched -- focus on capacitiesfocus on capacities (PRB(PRB consumers asconsumers asactors who can direct their own recovery process)actors who can direct their ow n recovery process)

CommunityResourceBaseMapCommunityResourceBaseMap

Self Help &

Consumer

Organizations

Family &

Friends

Mental Health

Services

Generic

Community Services

& Groups

Housing

Education

Income WorkPerson

KnowledgeResourceBaseMapKnowledgeResourceBaseMap

Experiential

KnowledgeCustomary/Traditional

Knowledge

Social Science

Knowledge

Medical/

Clinical

Knowledge

Transforming

Our Understanding

Of Mental Illness

Recognition

Of Diversity

SocialAcc eptan ce

& Inclusion

Enriched Range of

Services & Supports

Mental Health

Literacy


15/28

Purpose &

Meaning

Inclusion &

Belonging

Practical

Understanding of

illness

Positive

Sense of Self

Hope

Well Being

ConfidenceResilience Being in Control ofYour Own Life

Personal Resource Base Map

Social/Determinants of Health

Determinants of health: A range of personal, social,

economic and environmental factors that determine the

health status of individuals or populations

Social environment, social supports networks and social connectedness

Physical environments

Income and income distribution, social status

Gender, age and culture, biology & genetics

Food security

Affordable and adequate housing

Employment, working conditions, unemployment & employment security

Access to health services, personal health practices and coping

Education


16/28

Both Health Promotion & Mental Health

Promotion

focus on the enhancement of well-being rather than on illness

address the population as a whole, including people experiencing

risk conditions, in the context of everyday life are oriented toward taking action on the determinants of health

broaden the focus to include protective factors include a wide range of strategies (e.g.: communication, education,

policy development, organizational change, community development and local activities) acknowledge and reinforce the competencies of the population

encompass the health and social fields as well as medical services

Joubert et al., 1996


17/28

Health Promotion in Mental Health

Mental health promotion actions taken to

maximise the mental health and wellbeing of

populations by:

- improving social, physical and economic

environments

- strengthening the understanding and skills of

individuals in ways that support their efforts to

achieve and maintain mental health

Mental Health Promotion Mental health promotion is the process of enhancing the

capacity of individuals and communities to take controlover their lives and improve their mental health. Mentalhealth promotion uses strategies that foster supportiveenvironments and individual resilience, while showingrespect for culture, equity, individual choice, social

justice, interconnectedness and personal dignity.

Social Determinants of Health are at the forefront ofhealth promotion

The Human Face of Mental Health and Mental Illness in Canada.Public Health Agency of Canada. 2006.

Mental Health Promotion - Canada

Way back in 1988 Mental Health for

Canadians: Striking the Balance provided

driving force for placing mental health within

a health promotion framework

Ottawa Charter promote individual &collective health; develop healthy public

policy, reorient health services, build

individual skills, create supportive

environments & strengthen community action


18/28

A Word About Prevention

Prevention of mental illness and addictionsfocuses on measures taken to prevent problems

and illnesses, by addressing risk factors as wellas protective factors for individuals, groups andcommunities.

Mental illness prevention actions taken toreduce the impact or prevent the initial onset ofmental illness

Mental illness treatment actions taken toremedy a mental illness or to lessen its illeffects.

Mental health promotion - WHO

Mental health promotion involves actions to create

living conditions and environments that support

mental health and allow people to adopt and maintain

healthy lifestyles. These include a range of actions to

increase the chances of more people experiencing

better mental health.

A climate that respects and protects basic civil,

political, socio-economic and cultural rights is

fundamental to mental health promotion. Without the

security and freedom provided by these rights, it is

very difficult to maintain a high level of mental health.

Protective Factors Childhood: positive early childhood experiences, maternal

attachment

Education: accessible

Empathy

Empowerment and self-determination

Family: resilience, parenting competence, positive

relationship with parents and/or other family members

Personal resilience and social skills

Physical health

Services: accessible quality health and social services

Spirituality

www.health.vic.gov.au/mentalhealthpromotion


19/28

Risk Factors TRAUMA

Alcohol and drugs: access and abuse

Displacement: refugee and asylum-seeker status Disabil ity

Education: lack of access

Family: fragmentation, dysfunction and child neglect,

post-natal depression

Genetics

Physical illness

Physical inactivity

www.health.vic.gov.au/mentalhealthpromotion

Three Most Significant Determinants of

Mental Health

1. Social inclusion

2. Freedom from discrimination & violence

3. Access to economic resources

(Keleher & Armstrong, 2006; Mental Health Promotion in

Ontario: A Call to Action, 2008)

Pathways to RecoveryPathways to Recovery translates the evidencebased practice of

Strengths Model into a selfhelp approach

Before I heard of Pathways, my mental illnessdefined me. When I first beganthe workbook, I realized my recoverydefined me. By the time I finishedPathways, I realized I could define my own life.

What is the evidence base for the Strengths Approach?

The Strengths Approach was the subject of more than 10 formal

research studies. It is considered an evidence-based practicebecause it has been found to promote positive outcomes for peoplewith psychiatric disabilities. The Strengths Approach has beenproven to keep people in the community and helps them meet theirgoals.

[email protected]


20/28


21/28


22/28

Resilience Recovery Well-Being

Most of us find that tough stuff comes at us every day.

You can either let it negatively impact you or you can getthrough the tough stuff and use what you have learned in

those instances to help you in the future. Resiliency is the ability to bounce back from setbacks orchallenges.

Resiliency isn't a "thing," it's a combination of skills and/orabilities that can help you get through setbacks orchallenges. In short, resiliency is something you do.

"Resiliency is individualized. It looks different for each of us

Three most common themes are family, faith andperseverance; act as first line of defense for someone facinga challenge.

http://resiliencycanada.ca/

"Seven Resiliencies."

1. Insight

2. Independence

3. Relationships

4. Initiative

5. Creativity

6. Humour

7. Morality

http://www.magellanhealth.com/training/resiliencyM1/index.htm

Hinders Resilience

Making decisions for us

Developing our service plans for us

Reminding us of our limitations

Trying to control us Reminding us of past failure

Viewing us through the lens of our diagnosis

as an illness


23/28

Helps Resilience Be happy to see us

Answer our phone calls and return messages in

a timely manner Get excited about our plans

Help us figure out how to make our plans work

Support us in being accountable for our plans

Help us find resources to carry out our plan

Relate to us as a partner instead of apatient. This will allow you to experience us asa credible participant in our quest for recoveryand resilience.

Resiliency Checkpoin tFor each pair choose the one that best describes you:

A. I tend to view challenges as opportunities.B. Challenges are often a result of bad luck.

A. I can find humour in difficult situations.B. There is nothing funny about difficult situations.

A. I do not dwell on the negative. I focus on the positive.B. All I encounter is negative.

A. I am comfortable with ambiguous or uncertain situations.B. I cant function without knowing what is going to happen next.

A. My struggles have made me a stronger, more insightful person.B. My struggles have been a direct result of other peoples actions.

To score - for every A answer you have selected, give yourself 5 points, and for every Banswer you have selected, give yourself 1 point.Scoring:21-25 ....... You are very resilient.17 ............ You are doing quite well.13 ............ Not bad, but you could benefit from enhancing some of your skills.9 .............. You need more skills!5 .............. We need to get started right away!

http://www.magellanhealth.com/training/resiliencyM1/index.htm

Advice From Experts Resilience. Auth enti cit y: Get to know yourself, and express your uniqueness in ways that

are meaningful to you and can be appreciated by others. Let yourself bounce anyway that works for you. Yes, when it s time to rebound, it really is All about you.

Initiative: This is about us taking the lead in our own recovery, and our own

development of resilience. We need others to help us, but we must take the lead.

Spirituality: Developing spiritual competence helps us sustain resilience. It

provides a way for us to understand our purpose, and to have meaning in ourlive.

Flexibility: This is about rolling with the punches, and being open to new

ideas. The more we can be flexible, the less apt we are to break if we are dealt ahard blow. Rather, well learn to bend and grow in a new way.

Forgiveness: Holding on to grudges and blaming others will never help us

move forward. This uses up too much energy energy that could be spent on

moving forward instead of rehashing the past.

Curiosity: This has to do with being willing to try new things, to take

calculated risks, to move out of our comfort zone and into new ways of being.

www.magellanhealth.com/training


24/28

Burn Bright - Build your own resilience Save energy by encouraging us to manage ourselves, instead of trying to

control us.

Be in a good mood and stay optimistic about our recovery. stay in relationship with us; we can be much better company than the

paperwork!

When we slip and slide, dont see this as a failure on your part or on

ours. This is all part of our learning to be resilient by t rial and error.

If you can, share your own story of resilience with us. I cant tell you what

a valuable step this would be for all of us!

Its practically impossible to engage in these activities if you have a negative

attitude (are resentful, disrespectful, cranky, etc.) So you can see how

supporting us in our recovery may require you to do some recovering of

your own www.magellanhealth.com/training

10 Self Care StrategiesThe art of valuing yourself involves:

1. Taking care of self by trusting own process

2. Being assertive

3. Embracing your polarities

4. Recognizing & dealing with own grief & loss

5. Learning to let go

6. Choosing "nourishing" vs. "toxic friends

7. Dealing constructively with your anger

8. Taking care of your body

9. Making your home a haven

10. Developing meaning & purpose in life

Bunker, 1992

Windhorse PrincipleInherent in every person there is a natural

healing impulse, a motivation towardhealth & wholeness. This motivation canbe ignited & strengthened in anenvironment where an attitude of hope & a

belief in each person's potential for growthis pervasive. At the heart of an individualsrecovery from mental disorder is therestoration of personal, social, &environmental connections


25/28

Resiliency and Recovery E-Learning

Center

www.magellanhealth.com/training

RecoveryECoursesRecoveryecourse1:RecoveryisRealRecoveryecourse2:SelfdeterminationFuelsRecoveryRecoveryecourse3:TheLanguageofRecoveryRecoveryecourse4:PlanningthatPromotesRecoveryRecoveryecourse5:Let'sStartLivingLargeRecoveryecourse6:TheResiliencyFactor

ResiliencyEcoursesResiliencyecourse1:GettingPasttheToughStuffResiliencyecourse2:ThePowerofResiliencyResiliencyecourse3:GrowingYourResiliencyResiliencyecourse4:RecappingResiliency

Recovery ResourcesMental Health Commission of Canada -

https://kec.mentalhealthcommission.ca/mental_health_tools_and_resources

Scottish Recovery Network [email protected] www.scottish recovery.netSubstance Abuse & Mental Health Services Administration SAMHSA -

[email protected] Center for Psychiatric Rehabilitation , www.bu.edu/cpr

NAMI: National Alli ance on Mental Illness 800-950-NAMI (6264), www.nami.org National Empowerment Center, 800-POWER2U or 800-769-3728,www.power2u.org(Patricia Deegan)

The National Mental Health Consumers Self-Help Clearinghouse,800-553-4539,www.mhselfhelp.orgRecovery Knowledge Questionnaire -

Resiliency Canada http://resiliencycanada.ca/http://www.acbhcs.org/wellness_test/wellness_inventory.htm

Tools for transforming language. Behavioral Healthcare Source URL:http://www.behavioral.net/article/tools-transforming-languageanother source on the respectful use of language see

http://uspra.org/files/public/langGuidelines.pdfChallenging the Public Stigma of Mental Illness: A Meta-Analysis of Outcome Studies.

http://bit.ly/KenPopeMetaAnalaysisReducingStigma104 Studies of reslilience publish ed in 2012 (citations & excerpts):

http://bit.ly/KenPopeResilienceResources

ResourcesMental Health Commission of Canada www.mentalhealthcommission.caChanging directions, changing lives. Mental Health Strategy for Canada Toward Recovery and Well-Being: A Framework for a Mental Health

Strategy for Canada

Voluntary National Standard of Canada for psychological health and safetyin the workplace releasedhttp://www.mentalhealthcommission.ca/SiteCollectionDocuments/January_2013/MHCC_Standard_MediaRelease_ENG.pdf

Centre for Addiction and Mental health www.camh.caCAMH Knowledge Exchange http://knowledgex.camh.net

Canadian best practices portal for health promotion and chronic diseaseprevention www.phac.gc.ca/cbpp

CMHA Mental health promotion tool kithttp://www.cmha.ca/mh_toolkit/intro/index.htm

Evidence-based mental health promotion resource (VicHealth)www.health.vic.gov.au/healthpromotion/downloads/mhr_social.pdf

Gottlieb, L. (2013). Strengths-Based nursing care. Health and healing forperson and family. New York: Springer

Interactive Domain Model of Best Practices IDM Best Practices website atwww.idmbestpractices.ca

National Network for Mental Health (NNMH) http://www.nnmh.ca/


26/28

Some Principles Governing Person-

Environment Transactions Persons genotype or genetic make-up determines

responsiveness to environment Persons biology, stress level, moods, and

emotional states affect and are affected byinteractions with environments

Environments are modifiable

Environment & specific experiences of person canalter biological structures, such as brain

Persons reliance on environment related tohealth, age, & vulnerability

Quotes"A community is commonly understood to be about

relationships; its not a place. A neighbourhood is aplace, but community is about peoples relationships.John McKnight, 1990

Bettelheim: The physical environment is theBettelheim: The physical environment is thehouse of thehouse of thespiritspirit and it is theand it is the spirit underlying the physicalspirit underlying the physicalstructures and their furnishings which is of the greateststructures and their furnishings which is of the greatestimportanceimportance (In Cotton & Gerty, 1984)(In Cotton & Gerty, 1984)

The limits of my language . . . mean the limits of my world.- Ludwig Wittgenstein (1963)

Especially at times of great personal crisis, people needEspecially at times of great personal crisis, people needto retire from everyday life. It is as if they are retiring toto retire from everyday life. It is as if they are retiring tosome quiet, & often distant place, to review theirsome quiet, & often distant place, to review theirexperiences; to prepare for the time when they will reexperiences; to prepare for the time when they will re--enter the arena of lifeenter the arena of life (Deegan, 1990; 1996)(Deegan, 1990; 1996)

What People Tell Us Helps Educating oneself about the illness. Identifying symptoms and reviewing

choices for managing those symptoms and making decisions about howto manage those symptoms that works best.

Making choices about medications: find out about the side-effects ofeach, as well as, the effects of withdrawing (stopping use of) certainmedications. Recording symptoms in a notebook while taking medicationand use this to support or oppose continued use of a particular drug.These records can be used to work with doctors regarding the bestchoices for you.

Exploring non-medication and non-medical approaches to managingsymptoms and maintaining mental health.

Learning various coping strategies and activities such as meditation,relaxation techniques, prayer, or hobbies that can help to reduce stress;joining clubs and organizations.

Seeking employment and self-employment support programs.

Seeking mutual aid opportunities such as self-help groups, communitykitchens and food banks.

Learning to make the most of social assistance programs, low costtransportation.


27/28

Recovery Notes The language used and the stories and meanings that are

constructed have great significance as mediators of therecovery process. These shared meanings either support a

sense of hope and possibility, or invite pessimism andchronicity.

The development of recovery-based services emphasisesthe personal qualities of staff as much as their formalqualifications. It seeks to cultivate their capacity for hope,creativity, care, compassion, realism and resilience.

Family and other supporters are often crucial to recovery andthey should be included as partners wherever possible.However, peer support is central for many people in theirrecovery.

Adapted from Recovery Concepts and Application by Laurie Davidson, the DevonRecovery Group.

What is discrimination?

Discrimination is a prejudicial act, such as denying

someone employment, housing, accommodation or

other services because of the persons race, colour,

citizenship, culture, ethnic origin, marital or family

status, sexual orientation, disability, age, gender,

economic situation and so on. It may be covert or

systemic, intentional or unintentional. An act of

discrimination is a violation of an individuals

human rights and may be prosecuted under

the Ontario Human Rights Code.

Effects of stigma

prejudice & discrimination (in medical care, housing,employment)

negative feelings about self (self-stigma); for example,believing the negative stereotypes generated by society andmedia messages

tendency to avoid seeking help, and to keep symptoms &

substance use a secret

social isolation and/or constricted social support network poverty

depression

loss of hope for recovery

suicide. Adapted from Pompili, M., Mancinelli, I. & Tatarelli, R. (2003). Stigma as a cause of

suicide. British Journal of Psychiatry, 183(2), 173174,


28/28

Sets of Value SystemsSetsofvalues Personal/cultural

Ethical/moral

Political/religiousDoctrinal/ideological

Examplesofvalues Always do the right thing

There are rewards in working hard People have the right to make

choices related to care

People have right to be treatedwith respect & dignity

health is a right, state shouldprovide & pay for it

Health care a privilege; people areresponsible for taking care ofselves Gottlieb (2013)

Collaborative Relationships

FROM focusing on deficits TO working with personsstrengths

FROM doing for the person TO working with theperson

FROM focusing on disease and its treatment TOfocusing on living and coping with challenges andadverse events

FROM the nurse as teacher TO both person & nurseas learners

FROM measuring set of specific outcomes TOallowing person to determine own goals & ownmeasures of success Gottlieb (2013)