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Regaining touch with reality mental disorders essay

Received 2009 Feb 18; Accepted 2010 Jan 26. This article has been cited by other articles in PMC. Abstract Background A new evidence base is emerging, which focuses on well-being. This makes it possible for health services to orientate around promoting well-being as well as treating illness, and so to make a reality of the long-standing rhetoric that health is more than the absence of illness.

  1. Discussion The WHO declaration about mental health is also clear.
  2. Is the concept of a chemical imbalance beneficial? There is no right way for a person to recover.
  3. This article examines religious beliefs and activities among non-psychotic persons in the United States, Brazil and other areas of the world; discusses historical factors contributing to the wall of separation between religion and psychiatry today; reviews studies on the prevalence of religious delusions in patients with schizophrenia, bipolar disorder, and other severe mental disorders; discusses how clinicians can distinguish pathological from non-pathological religious involvement; explores how persons with severe mental illness use non-pathological religious beliefs to cope with their disorder; examines the effects of religious involvement on disease course, psychotic exacerbations, and hospitalization; and describes religious or spiritual interventions that may assist in treatment. Summary If health services are to give primacy to increasing well-being, rather than to treating illness, then health workers need new approaches to working with individuals.

The aim of this paper is to support the re-orientation of health services around promoting well-being. Mental health services are used as an example to illustrate the new knowledge skills which will be needed by health professionals. Discussion New forms of evidence give a triangulated understanding about the promotion of well-being in mental health services. The academic discipline of positive psychology is developing evidence-based interventions to improve well-being.

This complements the results emerging from synthesising narratives about recovery from mental illness, which provide ecologically valid insights into the processes by which people experiencing mental illness can develop a purposeful and meaningful life. The implications for health professionals are explored.

In relation to working with individuals, more emphasis on the person's own goals and strengths will be needed, with integration of interventions which promote well-being into routine clinical practice.

In addition, a more societally-focussed role for professionals is envisaged, in which a central part of the job is to influence local and national policies and practices that impact on well-being. Summary If health services are to give primacy to increasing well-being, rather than to treating illness, then health workers need new approaches to working with individuals. For mental health services, this will involve the incorporation of emerging knowledge from recovery and from positive psychology into education and training for all mental health professionals, and changes to some long-established working practices.

Background The World Health Organisation WHO declares that health is "A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity "[ 1 ]. However, creating health-oriented rather than illness-oriented services has proved rather more difficult than the clarity of this declaration would suggest.

  1. The first signs of schizophrenia typically emerge in adolescence or young adulthood. Australasian Psychiatry 10 1.
  2. How does one differentiate "normal" religious or spiritual experiences from psychotic symptoms? In the last decade or 2, biogenetic attribution of all mental disorders, having acquired a hegemoneous status 10 has been used primarily to inform campaigns for reducing stigma and promoting better acceptance of mental illness and the people with mental illnesses by society.
  3. The primary focus of therapeutic interventions in mental disorders is helping the patient to feel better and interact more adaptively with his or her social and physical environments.
  4. Well-being is becoming a central focus of international policy, e. Taking a careful spiritual history, supporting non-psychotic religious involvement, and considering spiritual group interventions for patients who are so inclined seem like reasonable next steps.
  5. Spiritual interventions that take a more individualized approach have also been described.

Efforts to generate a science of illness have been very successful, with shared taxonomies to identify types of illness, established and validated interventions to treat and manage these identified illnesses, and clinical guidelines and quality standards available to increase efficiency and equity.

These successes have not been mirrored by equivalent advances in applying the science of well-being within health services. The typical health worker will know a lot about treating illness, and far less about promoting well-being.

In this article we use mental health services as an exemplar of the issue, and explore how mental health services could more effectively promote well-being. Our central argument is that mental health workers will need new approaches to assessment and treatment if the goal is promoting well-being rather than treating illness.

Well-being is becoming a central focus of international policy, e. Canada [ 2 ] and the United Kingdom [ 3 ]. In the same way that tertiary prevention is an important health promotion strategy, well-being is possible for people experiencing mental illness. We will discuss two new emerging areas of knowledge which are highly complementary, and provide a counter-balance to the traditional focus of mental health services on deficit amelioration.

We will identify how they link and differand then explore their implications for mental health workers.

Specifically, we will argue that assessment and treatment of the individual will need to change if the goal is promoting well-being rather than treating illness, and that there are also broader challenges for mental health professionals to become more outward-looking in their view of their role, and to construct their job as more than working with individuals.

We will conclude that a focus on improving social inclusion, becoming social activists who challenge stigma and discrimination, and promoting societal well-being may need to become the norm rather than the exception for mental health professionals in the 21st Century. Discussion The WHO declaration about mental health is also clear: A relative lack of workforce skills in promoting well-being is particularly important in mental health services, since mental disorders directly impact on personal identity and ability to maintain social roles.

This distinction between mental illness and mental health is empirically validated, with only modest correlations between measures of depression and measures of psychological well-being, ranging from -0. Why is this distinction important?

Regaining touch with reality mental disorders essay it points to the need for mental health professionals to support both the reduction of mental illness and the improvement of mental health. This will involve the development of further skills in the workforce. These skills will be based regaining touch with reality mental disorders essay two new areas of knowledge, each of which have emerged as distinct scientific areas of enquiry only in the past two decades.

New area of knowledge 1: Recovery People personally affected by mental illness have become increasingly vocal in communicating both what their life is like with the mental illness and what helps in moving beyond the role of a patient with mental illness. Early accounts were written by individual pioneers [ 7 - 12 ]. These brave, and sometimes oppositional and challenging, voices provide ecologically valid pointers to what recovery looks and feels like from the inside.

Once individual stories were more visible, compilations and syntheses of these accounts began to emerge from around the especially Anglophone world, e. The understanding of recovery which has emerged from these accounts emphasises the centrality of hope, identity, meaning and personal responsibility [ 132425 ]. We will refer to this consumer-based understanding of recovery as personal recovery, to reflect its individually defined and experienced nature [ 26 ].

Psychotic Depression: Losing Touch With Reality

This contrasts with traditional clinical imperatives - which we will refer to as clinical recovery- which emphasise the invariant importance of symptomatology, social functioning, relapse prevention and risk management. To note, this distinction regaining touch with reality mental disorders essay been referred to by other writers as recovery "from" versus recovery "in" [ 27 ]; clinical recovery versus social recovery [ 28 ]; scientific versus consumer models of recovery [ 29 ]; and service-based recovery versus user-based recovery [ 30 ].

Opinions in the consumer literature about recovery are wide-ranging, and cannot be uniformly characterised. This multiplicity of perspectives in itself has a lesson for mental health services - no one approach works for, or 'fits', everyone. There is no right way for a person to recover. Eliciting idiographic knowledge - understanding of subjective phenomema - is an important clinical skill.

Nonetheless, some themes emerge. A first clear point of divergence from the clinical perspective is that recovery is seen as a journey into life, not an outcome to be arrived at: It is about seeing people beyond their problems - their abilities, possibilities, interests and dreams - and recovering the social roles and relationships that give life value and meaning " [ 31 ].

Many definitions of recovery have been proposed by those who are experiencing it [ 818 ]. It is a way of living a satisfying, hopeful, and contributing life even within the limitations caused by illness.

Recovery involves the development of new meaning and purpose in one's life as one grows beyond the catastrophic effects of mental illness " [ 32 ]. It is consistent with the less widely-cited but more succinct definition that recovery involves "the establishment of a fulfilling, meaningful life and a positive sense of identity founded on hopefulness and self determination " [ 13 ].

One implication of these definitions is that personal recovery is an individual process.

Schizophrenia And Other Psychotic Disorders Essay

Just as there is no one right way to do or experience recovery, so also what helps an individual at one time in their life may not help them at another. If mental health services are to be focussed on promoting personal recovery, then this means there cannot be a single recovery model for services.

This is a profound point, and challenging to established concepts such as clinical guidelines, evidence-based practice and care pathways. A recurring feature in recovery narratives is the individual engaging or re-engaging in their life, on the basis of their own goals and strengths, and finding meaning and purpose through constructing or reclaiming a valued identity and social roles.

All of this points to well-being rather than treatment of illness. There is now a scientific discipline - positive psychology - devoted to the promotion of well-being. New area of knowledge 2: Positive Psychology Positive psychology is the science of what is needed for a good life. This is not a new focus - proposing qualities needed for a good life is an activity dating back to Aristotle's investigation of eudaimonia, and builds on seminal work in the last Century by Antonovsky [ 33 ], Rogers [ 34 ] and Maslow [ 35 ].

But the emergence of a scientific discipline in this area is a modern phenomenon. Martin Seligman, often identified along with Mihaly Csikszentmihalyi as the founders of the discipline, suggests a definition [ 36 ]: The field of positive psychology at the subjective level is about valued subjective experiences: At the individual level, it is about positive individual regaining touch with reality mental disorders essay At the group level, it is about the civic virtues and the institutions that move individuals toward better citizenship: Research centres are developing internationally e.

Academic compilations of the emerging empirical evidence [ 3738 ] and accessible introductions to the theory [ 3940 ] and its applications [ 41 ] are becoming available.

Findings from positive psychology are important to mental health services because its focus on a good life is as relevant to people with mental illness as to people without mental illness.

One key advance is in relation to empirical investigation of mental health.