Approximately one in every five Australians will experience a mental illness each year (ABS, 2007). Mental illnesses are not homogenous. There are no clearly established clinical pathways and, as such, care and treatment is necessarily highly individualised

Brighton, Renee M

Liersch, Susan

Moxham, Lorna

Patterson, Christopher F

Perlman, Dana J

Taylor, Ellie K

English

Research Online

University of Wollongong Research Online Faculty of Science, Medicine and Health - Papers: part A Faculty of Science, Medicine and Health 1-1-2016 Self-determination in the context of mental health recovery Ellie K. Taylor University of Wollongong, elliejo@uow.edu.au Lorna Moxham University of Wollongong, lmoxham@uow.edu.au Dana J. Perlman University of Wollongong, dperlman@uow.edu.au Christopher F. Patterson University of Wollongong, cpatters@uow.edu.au Renee M. Brighton University of Wollongong, reneeb@uow.edu.au See next page for additional authors Follow this and additional works at: https://ro.uow.edu.au/smhpapers  Part of the Medicine and Health Sciences Commons, and the Social and Behavioral Sciences Commons Recommended Citation Taylor, Ellie K.; Moxham, Lorna; Perlman, Dana J.; Patterson, Christopher F.; Brighton, Renee M.; and Liersch, Susan, "Self-determination in the context of mental health recovery" (2016). Faculty of Science, Medicine and Health - Papers: part A. 3864. https://ro.uow.edu.au/smhpapers/3864 Research Online is the open access institutional repository for the University of Wollongong. For further information contact the UOW Library: research-pubs@uow.edu.au Self-determination in the context of mental health recovery Abstract Approximately one in every five Australians will experience a mental illness each year (ABS, 2007). Mental illnesses are not homogenous. There are no clearly established clinical pathways and, as such, care and treatment is necessarily highly individualised. Disciplines Medicine and Health Sciences | Social and Behavioral Sciences Publication Details Taylor, E., Moxham, L., Perlman, D., Patterson, C., Brighton, R. & Liersch, S. (2016). Self-determination in the context of mental health recovery. Australian Nursing and Midwifery Journal, 23 (10), 41-41. Authors Ellie K. Taylor, Lorna Moxham, Dana J. Perlman, Christopher F. Patterson, Renee M. Brighton, and Susan Liersch This journal article is available at Research Online: https://ro.uow.edu.au/smhpapers/3864 Title:	Self‐determination	in	the	context	of	mental	health	recovery	Authors:	Ellie	Taylor1,	Lorna	Moxham2,	Dana	Perlman3,	Christopher	Patterson4,	Renee	Brighton4,	Susan	Sumskis4		1	PhD	Candidate	(Health	Science),	University	of	Wollongong,	Northfields	Ave,	Wollongong	NSW	2522;	PH:	(02)	4239	2137;	elliejo@uow.edu.au;	Qualifications:	BPsych(Hons);	MSc(Research).	2	Professor	of	Mental	Health	Nursing,	School	of	Nursing,	University	of	Wollongong	3	Senior	Lecturer,	School	of	Education,	University	of	Wollongong	4	Lecturer,	School	of	Nursing,	University	of	Wollongong		Article:	Approximately	one	in	every	five	Australians	will	experience	a	mental	illness	each	year	 (ABS	 2007).	 Mental	 illnesses	 are	 not	 homogenous.	 There	 are	 no	 clearly	established	 clinical	 pathways	 and,	 as	 such,	 care	 and	 treatment	 is	 necessarily	highly	individualised.	It	is	within	this	nebulous	treatment	approach	that	personal	recovery	 is	 the	 goal	 for	many	who	 live	with	 debilitating	mental	 health	 issues.	Personal	recovery	is	not	synonymous	with	cure,	but	can	be	defined	as	“gaining	a	social	identity	through	engagement	in	an	active	life”	(Moxham	et	al	2015,	p.	62).		In	 recent	 years,	 self‐determination	 has	 arisen	 as	 an	 area	 of	 importance	within	mental	 health	 care	 (Craike	 and	 Coleman	 2005).	 Carpenter	 (2002)	 asserts	 that	there	 are	 strong	 links	 between	 increased	 self‐determination	 and	 personal	recovery.	 Self‐determination	 can	 be	 considered	 as	 the	 propensity	 of	 an	individual	to	act	in	a	“self‐directed,	self‐regulated,	autonomous”	way	(Field	et	al	1998,	 p.	 2).	 Such	 an	 approach	 is	 respectful	 of	 values	 and	 appreciates	 lived	experience	 –	 a	 fundamental	 tenant	 of	 personal	 recovery.	 People	 with	 a	 lived	experience	 of	 mental	 illness,	 however,	 report	 significantly	 low	 levels	 of	 self‐determination	(Okon	and	Webb	2014).	According	to	Hagger	and	Chatzisarantis	(2009),	 self‐determined	motivation	 is	 strongly	 associated	 with	 engagement	 in	positive	health	behaviours	such	as	increased	medication	and	service	adherence,	and	other	activities	that	promote	wellbeing	(Chang	2011).				The	 Australian	 Department	 of	 Health	 (2013),	 in	 their	National	Framework	 for	Recovery‐Oriented	Mental	Health	Services:	Guide	 for	Practitioners	and	Providers,	posits	 that	 mental	 health	 care	 should	 maximise	 opportunities	 for	 personal	autonomy	and	self‐determination.	This	involves	maximising	choice	on	the	part	of	the	 consumer,	 with	 less	 reliance	 on	 restrictive	methods	 of	 treatment,	 such	 as	restraint	 and	 seclusion.	 However,	 very	 little	 empirical	 research	 has	 been	conducted	 regarding	 the	 relationship	 between	 practices	 and	 outcomes	(including	 self‐determination)	 associated	 with	 personal	 recovery	 from	 mental	illness	(Le	Boutillier	et	al	2011).		This	 research	 project	 explores	 the	 influence	 of	 a	 recovery‐oriented,	 strengths‐based	therapeutic	recreation	initiative	and	how	it	 influences	self‐determination	among	 people	 with	 a	 mental	 illness.	 In	 doing	 so,	 a	 detailed	 examination	 will	occur	 to	 investigate	 the	 mechanisms	 (e.g.	 shared	 decision	 making,	 addressing	social	 context)	 by	which	 self‐determination	 influences	 personal	 recovery	 from	mental	illness.	Informed	by	the	lived	experience	of	people	with	a	mental	illness,	a	mixed	methods	 approach	 has	 been	 employed.	 Surveys	will	 be	 administered	 at	three	 time	points:	 	before	and	after	 the	 intervention,	and	again	at	 three‐month	follow‐up.	 At	 follow‐up,	 a	 qualitative	 approach	 will	 be	 used	 to	 collect	 data	through	 individual	 semi‐structured	 interviews	 and	 focus	 groups.	 These	interviews	 will	 further	 explore	 the	 quantitative	 findings	 by	 incorporating	 a	comprehensive	 person‐centred	 approach.	 To	 date,	 quantitative	 findings	 from	this	project	have	 supported	 the	efficacy	of	 therapeutic	 recreation	 in	 increasing	self‐determination	 among	 people	 with	 a	 mental	 illness.	 The	 mechanisms	 by	which	this	contributes	to	personal	recovery	are,	however,	not	visible	in	research	literature.	It	is	this	concept	that	will	be	explored	in	this	project.		Health	 care	 providers	 have	 a	 responsibility	 to	 respect	 and	 emphasise	 the	autonomy	and	self‐determination	of	all	people	for	whom	they	provide	care.	This	is	no	less	an	expectation	for	people	who	live	with	a	mental	illness.	Their	journey	towards	 personal	 recovery	 is	 one	 that	 should	 be	 heavily	 reliant	 on	 their	 own	expertise	 and	 based	 on	 their	 own	 choices.	 Results	 from	 this	 research	 are	expected	to	inform	future	mental	health	services	and	programs.		Word	count:	539	words		References:	Australia.	Bureau	of	Statistics	(ABS).	2007.	National	Survey	of	Mental	Health	and	Well‐being:	Summary	of	results.	Canberra,	ACT:	Australian	Bureau	of	Statistics.	Cat.no.4326.0.		Australia.	Department	of	Health.	2013.	A	national	framework	for	recovery‐oriented	mental	health	services:	Guide	for	practitioners	and	providers.	Canberra,	ACT:	Australian	Department	of	Health.		Carpenter,	J.	2002.	Mental	health	recovery	paradigm:	Implications	for	social	work.	Health	and	Social	Work.	27(2):	86‐94.	Chang,	L.	2011.	An	interaction	effect	of	leisure	self‐determination	and	leisure	competence	of	older	adults’	self‐rated	health.	Journal	of	Health	Psychology.	17(3):	324‐332.	Craike,	M.	and	Coleman,	D.	2005.	Buffering	effect	of	leisure	self‐determination	on	the	mental	health	of	older	adults.	Leisure/Loisir.	29(2):	310‐328.	Field,	S.,	Martin,	J.,	Miller,	R.,	Ward,	M.	and	Wehmeyer,	M.	1998.	A	practical	guide	for	teaching	self‐determination.	Reston,	VA:	Council	for	Exceptional	Children.	Hagger,	M.	and	Chatzisarantis,	N.	2009.	Integrating	the	theory	of	planned	behavior	and	self‐determination	theory	in	health	behavior:	A	meta‐analysis.	British	Journal	of	Health	Psychology.	14:	275‐302.	Le	Boutillier,	C.,	Leamy,	M.,	Bird,	V.	J.,	Davidson,	L.,	Williams,	J.	and	Slade,	M.	2011.	What	does	recovery	mean	in	practice?	A	qualitative	analysis	of	international	recovery‐oriented	practice	guidance.	Psychiatric	Services.	62(12):	1470‐1476.	Moxham,	L.,	Liersch‐Sumskis,	S.,	Taylor,	E.,	Patterson,	C.	and	Brighton,	R.	2015.	Preliminary	outcomes	of	a	pilot	therapeutic	recreation	camp	for	people	with	a	mental	illness:	Links	to	recovery.	Therapeutic	Recreation	Journal.	49(1):	61‐75.	Okon,	S.	and	Webb,	D.	2014.	Self‐determination:	A	curriculum	of	empowerment	for	health	and	wellness	in	a	psychosocial	rehabilitation	clubhouse.	Occupational	Therapy	in	Mental	Health.	30(2):	196‐212.	

Self-determination in the context of mental health recovery

https://ro.uow.edu.au/cgi/viewcontent.cgi?article=4887&amp;context=smhpapers

Self-determination in the context of mental health recovery

Abstract

Similar works

Full text

Available Versions

Research Online