Mental Health Ireland Annual Conference 14 - Prof Agnes Higgins - Recovery a positive message for...

Recovery: a positive message Recovery: a positive message for the future????for the future????

Prof Agnes HigginsProf Agnes Higgins

School of Nursing and MidwiferySchool of Nursing and Midwifery

Trinity College DublinTrinity College Dublin

Something about meSomething about me

A Higgins TCDA Higgins TCD

Recovery a positive message Recovery a positive message for futurefor future

Background to recoveryBackground to recovery

Recovery for who and from what?Recovery for who and from what?

Positive message? Positive message?

Are we making progress? Are we making progress?


RecoveryRecovery


Recovery: Irish policyRecovery: Irish policy

2006Recovery 1 of the16

guiding principles

2007Recovery-focussed approach

is a standard

2008 Recovery Framework

2005Recovery discussion

paper

55Agnes Higgins Trinity College DublinAgnes Higgins Trinity College Dublin

2013What

should you expect?

Recovery: who is defining?Recovery: who is defining?


Recovery for All: who recovers Recovery for All: who recovers and from what?and from what?


Recovery for AllRecovery for All


Multiple recoveriesMultiple recoveries

Impact of the trauma (s) that lead to distressImpact of the trauma (s) that lead to distressNegative impact of medications and other treatmentsNegative impact of medications and other treatmentsDevaluing and disempowering service Devaluing and disempowering service Lost opportunity for education, employment, Lost opportunity for education, employment, friendshipsfriendshipsFractured relationships and friendships Fractured relationships and friendships Stigma/‘spoiled identity’ and internalised stigmaStigma/‘spoiled identity’ and internalised stigmaDiscrimination and social exclusion by society/staffDiscrimination and social exclusion by society/staffConstructed identity - diagnosis and label(s) (master Constructed identity - diagnosis and label(s) (master status) status)


Recovery: Positive messagesRecovery: Positive messages

People can recover and People can recover and lead fulfilling and lead fulfilling and meaningful livesmeaningful lives

Recovery a process not Recovery a process not an eventan event

Journey of DiscoveryJourney of Discovery

Recovery about re-Recovery about re-establishing/re-authoring establishing/re-authoring a positive identitya positive identity

Having friends, Having friends, relationships, rolesrelationships, roles


Recovery for family membersRecovery for family members

Recover from grief, pain, guilt, Recover from grief, pain, guilt, Fractured relationshipsFractured relationshipsCourtesy stigmaCourtesy stigmaExclusion by servicesExclusion by servicesNarrative of pessimismNarrative of pessimismRediscover belief that Rediscover belief that – Family member will and can Family member will and can

recoverrecover

Positive messagesPositive messages

Involvement is critical Involvement is critical

Want to be involvedWant to be involved

Want educationWant education

Family can also hinder Family can also hinder

recovery processrecovery process


Societal recoverySocietal recoveryMental health responsibility of allMental health responsibility of all

Binary divisions: Them and Us; Mad Binary divisions: Them and Us; Mad and Sane; Ill and Welland Sane; Ill and Well

Social inclusion and building Social inclusion and building connectednessconnectedness

Individual/family/street/communityIndividual/family/street/community

Schools/employer/housing/sports Schools/employer/housing/sports

Recognition of civic and human rightsRecognition of civic and human rights


Mentaldistress

Social/Economic Determinants Social/Economic Determinants

AgeGender Ethnicity

Current Current narrative narrative

1818Agnes Higgins Trinity College DublinAgnes Higgins Trinity College Dublin

3 C’sCureCareContainment

Recovery: Positive messagesRecovery: Positive messages

Recognition that we are all wounded and Recognition that we are all wounded and resilient (Move from them and us culture)resilient (Move from them and us culture)

Redefine who is the expert (peer support)Redefine who is the expert (peer support)

Return power, control and choiceReturn power, control and choice

Rethink how we frame and respond to Rethink how we frame and respond to people’s experience of mental distress people’s experience of mental distress

Partnership approach that involves risk Partnership approach that involves risk takingtaking

Service user led serviceService user led serviceA Higgins TCDA Higgins TCD

Recovery positive messagesRecovery positive messages

Hope inspiring relationshipsHope inspiring relationships

Values of dignity, respect, listening Values of dignity, respect, listening

Information (WRAP)Information (WRAP)

Difference between people residing in the Difference between people residing in the

community and living in the communitycommunity and living in the community

Services and practitioners should be Services and practitioners should be

working to make themselves redundantworking to make themselves redundant

Agnes Higgins Trinity College DublinAgnes Higgins Trinity College Dublin 2020

EOLASEOLAS

Power of InformationPower of Information

““I never got one satisfactory answer from I never got one satisfactory answer from anybody that I talked to. It was like, they were so anybody that I talked to. It was like, they were so vague with me all the time but when I attended vague with me all the time but when I attended EOLAS, it was like, like I said it was the answer EOLAS, it was like, like I said it was the answer to my prayers. Well the reason I agreed to this to my prayers. Well the reason I agreed to this (interview) was the fact that I wanted to shout (interview) was the fact that I wanted to shout this from the rooftops. For what it’s done for me this from the rooftops. For what it’s done for me and my son has been ten-fold. We now have a and my son has been ten-fold. We now have a relationship where I can understand his relationship where I can understand his suffering”suffering” (NEK F&F 2) (NEK F&F 2)


Power of InformationPower of Information

“…“…what they taught us was to look at and be aware that what they taught us was to look at and be aware that you’re going there to the path of a bad episode. Just to you’re going there to the path of a bad episode. Just to be more aware in your body as to what’s going on. For be more aware in your body as to what’s going on. For me and I think for most people it would be little things me and I think for most people it would be little things that you would start with like say you wanted to stay in that you would start with like say you wanted to stay in bed a little bit longer. Say not putting your makeup on, bed a little bit longer. Say not putting your makeup on, not washing your hair, not having showers, before the not washing your hair, not having showers, before the EOLAS programme I wouldn’t of even thought about EOLAS programme I wouldn’t of even thought about them things where now I know that there a sign to me.” them things where now I know that there a sign to me.” (SU11)(SU11)


Enhanced empathyEnhanced empathyI think it probably made me more aware of the I think it probably made me more aware of the difficulties that the carers or the services users difficulties that the carers or the services users were having. It also kind of reminded me of how were having. It also kind of reminded me of how competent they were as well…We kind of competent they were as well…We kind of sometimes lose perspective or lose sight of the sometimes lose perspective or lose sight of the carer or the service user, of what they’re actually carer or the service user, of what they’re actually going through and their experiences so I think going through and their experiences so I think that the group has actually opened up that door that the group has actually opened up that door for me again.” for me again.” (CFTI05 – Family Member Group)(CFTI05 – Family Member Group)


Impact of peers: you are not aloneImpact of peers: you are not alone

“…“…comfort in meeting other people in a similar situation I comfort in meeting other people in a similar situation I think that was the biggest single thing. The realisation that think that was the biggest single thing. The realisation that we’re not alone; that there are many people going through we’re not alone; that there are many people going through similar situations…”similar situations…” (F&F05) (F&F05)

““It was great to be able to share and learn from other It was great to be able to share and learn from other people…everybody’s experience when you have the illness is people…everybody’s experience when you have the illness is different, and I think it’s important to share that and learn from different, and I think it’s important to share that and learn from that you know…what was interesting, is our experience of our that you know…what was interesting, is our experience of our diagnosis was almost identical, but the way in which we diagnosis was almost identical, but the way in which we ended up in hospital was very different...you are basically ended up in hospital was very different...you are basically learning from each other you know…” (SU04)learning from each other you know…” (SU04)


Future: Recovery for allFuture: Recovery for all


Wheels of changeWheels of change


Risk being and acting differentRisk being and acting different


Recovery: a positive message for the Recovery: a positive message for the futurefuture

Prof Agnes HigginsProf Agnes Higgins

School of Nursing and Midwifery Trinity College DublinSchool of Nursing and Midwifery Trinity College Dublin

Mental Health Ireland Annual Conference 14 - Prof Agnes Higgins - Recovery a positive message for...

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