Essay Sample on Empowerment: A Pathway to Recovery From Mental Health Illness

Introduction

Empowerment is a corrective for lack of control over the sense of helplessness and dependency, autonomy, self-confidence, and availability of meaningful choices. Traditionally, complete or partial remission of symptoms from mental health illness has been indicators of recovery, as opposed to actively engaging in life congruently with partial improvements in symptoms. The Recovery Model encompasses external and internal conditions. The main features of the internal domain include hope, healing, empowerment, and connection. The external field promotes equitable services, a collaboration between health care professionals and consumers and recovery-oriented services.

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Recovery is a conceptual construct that is a gradual, occurs in various stages, and has different meanings. Identifying each milestone for both external and internal conditions. Domains allow for the development of strategies for the application of the notion of recovery, in an individualized manner. However, each feature of each domain is intra-related, and the two domains are inter-related. In this way, the recovery model is reciprocal in its practical application by health institutions, healthcare professionals and consumers of the health- system (Jacobson and Greenley). In this paper, I will critically discuss and analyze empowerment as an element.

Social Determinants of Health - Low-Socio Economic Status (SES)

The social determinants of health are responsible for health inequities. These determinants are in the domains of economics, built environments, food, education, health systems. They all affect health and arise in the unequal distribution of power, money, and resources. These inequities encompass the environments that people are born into, live in, work in and age. Social determinants are the underlying cause of disease states in the cardiovascular, metabolic, nervous system, and hypothalamic-pituitary systems. Thus, most people's mortality is associated with a disease state, yet the underlying social determinant of health directly causes the state.

There is a connection between mental health and social factors. Jama et al. showed in a Danish population study of 1 million people that there is a dose-response relationship between parental income and the development of schizophrenia. The amount of time a child spends in a low-income household was positively associated with the development of schizophrenia, and when the parental income increased, the incidence decreased. Socio-economic status constitutes occupation, education, and income, which filter down to the psychological factors that influence and affect our behaviors. These translate into health outcomes, which in turn directly affect the morbidity and mortality of individuals with mental illness. Education attainment, gender, sexual- orientation, occupation, and psychological factors are social determinants.

High income is negatively associated with the onset of diabetes, depression, and cardiovascular disease. However, low-socioeconomic status leads to greater benefits. The Canadian Mental Health Association identifies three domains for encompassing social determinants of health. They include freedom from discrimination violence, social inclusion, and access to economic resources. The latter ties in with low socio-economic status and it are the primary determinant discussed in this paper.

The Connection Between SES and Schizophrenia and Empowerment

Despite the availability of in-patient services and investment in mental health services, patients with schizophrenia suffer disproportionate levels of social isolation and socio-economic deprivation. The social selection explanation views the lower socio-economic status of individuals with schizophrenia as a direct result of the illness. Personality traits associated with the illness, such as distorted thought processes and content, have a downward social trajectory. This paper discusses the recovery model through the lens of empowerment by identifying a nursing intervention on evidence-based practice that encompasses social skills attainment and mini role-playing sessions. This intervention will develop autonomy, courage and responsibility for my patient, Anthony. My assessment involves interactions with a patient suffering from schizophrenia in an in-patient ward. I observe the patient's social support and use my nursing intervention to develop a goal-oriented plan in collaboration with Anthony to use empowerment as the recovery model.

Overview of the Recovery Model

My nursing intervention aims to enhance factors that promote recovery, using empowerment with the application of its fundamental features of autonomy, courage and responsibility. Anthony's needs require developing a trustworthy relationship. Anthony is diagnosed with Schizophrenia- disorganized. He is currently in denial of this history and only acknowledges his past drug use. Anthony lived in Toronto Community Housing and is now a client at the in-patient Forensics unit of a mental health hospital. His history arises from heavy drug use and an encounter with the law that lead him to have an Incidence of Occurrence, resulting in a criminal charge. Subsequently, Anthony was transferred from custody to community, due to a disturbed mental state. While in custody, Anthony flooded his cell by breaking the sink. He became angry, belligerent and liable towards staff and started to shout and scream randomly. Anthony needed persuasion to attend to personal hygiene, became very rigid in his behavior, and was un-bale to perform tasks of sequence. Anthony's narrative on the Incidence of Occurrence is, "My hand accidentally went toward her groin." Anthony was deemed unfit for trial and was brought to the medium-security unit then transferred to the current minimum-security unit in the rehabilitation ward. Upon his initial arrival to the mental health unit, Anthony is confused, disoriented, restless, and agitated. He is noted saying, "I don't know how you can help me, can you get me some Percocet to calm me down." Fast forward to the current time, Anthony is in the minimum-security unit. Upon his transfer from medium to minimum Antony is noted, saying, "I feel alright about moving forward." My interactions with Anthony have led me to understand that he is motivated and wants to focus on attending groups and later seek employment, "I want to work in general labor, you know." He still has limited insight about his diagnosis of Schizophrenia as he says, "I do not have, it, it was just the drugs."

Through my interactions with Anthony, I made the following assessments: Anthony desires a meaningful and trustful social connection. The observation is evident in his narrative to questions: What can others do to help? "Spend some time with me," "Listen to me" What makes you feel safe? "Trusting people around me." What does mental health mean to you? "Support and someone to talk about the problem, someone to talk to me."

My intervention of social skills role-playing sessions with free-chat time will allow for the implementation of a therapeutic plan in propelling Anthony towards recovery using each key feature of empowerment, autonomy, courage, and responsibility. My choice of utilizing empowerment as a hallmark in Anthony's care stems from the sense that it argues that in caring for his schizophrenia, Anthony has to make choices each day by way of aggressive thoughts, emotions, and feelings of helplessness that make Anthony deprived of social interaction and connection. I am using empowerment as a tool for increasing Anthony's self-esteem to build pride and self-confidence that can shape Anthony's self-confidence promoting autonomy. Olaf et al., show that low SES populations living with schizophrenia subjectively identified weak will as the underlying cause as having schizophrenia. For my patients coming from a low SES and living with schizophrenia. Leamy et al. have shown that the discovery of identity and a sense of self is crucial in the road to recovery. Anthony has voiced his need to "Having people around me that I can trust." Increase social contact and allowing Anthony to internalize the understanding of through having a therapeutic relationship with myself that is safe, confidential, reliable and consistent. My intervention will have clear boundaries so that Anthony can learn how to live with the consequences of his responsibilities. In his narratives, Anthony has voiced, "If somebody tells me something and they don't do it."

Soundy et al. identified the provision of social support and value as milestones in empowering participants in the journey of recovery. Participants subjectively identified two areas related to the provision of social support and value. 1) the essential availability of individuals that would listen, accept, value, and understand them 2) a necessity to be able, to be honest, and open. The practical application of these two factors will, in turn, initiate a trustful relationship between Anthony and me and can aid in promoting autonomy in Anthony. Role-play sessions can allow for the initiation or re-emergence of Anthony's self-confidence that will assist him in empowering him to rebuild-himself. Anthony's narratives of "I sit by myself and think about my problem."

The social skill role-plays sessions will create a safe space for Anthony to learn and understand social cues. Chadwick et al. have shown that people with schizophrenia seek knowledge about their experience of illness. Yet in-order for him to be aware of his schizophrenia Anthony needs to release any internalized stigma he has about his past. There needs to be a mobilization of resources so that Anthony can reduce his feelings of helplessness. These can be achieved through social interaction and coping and engagement interventions, which the role-playing sessions do directly provide. Here Anthony can explore with me the practices of grounding strategies and technique, identify individual stressors and triggers. "These people done trust me." It seems internalized stigma reduces the impact of schizophrenia recognition on patients ' optimism and self-esteem. Notably, rejecting social and self-stigma among participants may have led to a sense of hope and confidence in the possibility of recovery and changed other negative self-evaluations. Consequently, it may lead to high engagement in the intervention and treatment and a tendency to use effective coping strategies (i.e., reassurance, persuading or seeking support from others) to deal with schizophrenia symptoms and stressors. Anthony is in denial about his illness and due to lack of trust in "people around him," he is experiencing social isolation, evident by him sleeping till noon and not fully being engaged in his group sessions. Anthony has refused to participate in the Safety and Comfort plan group, saying, "I already did it." The role-playing sessions can help Anthony in exploring current environmental strategies that affect his coping.

Unpacking these desires of Anthony that will present themselves in the role-playing sessions can assist Anthony in uncovering strategies for moving forward, in-turn gives him opportunities to seek out activities that enhance his self-esteem through increased social interaction and participation in his hospital group sessions. I will be providing positive verbal reinforcement for Antony's disclosure of stressors and triggers. The intervention will increase Anthony's courage because it necessitates him to step outside his comfort zone by engaging in role-playing sessions. Progressively, Anthony can see both the positive effects of goal setting in his life congruently with control over his self-esteem. In the social skills role-playing sessions, the expression of Anthony's feelings through social interaction builds an allian...