Academic journal article Advances in Mental Health

Operationalising Recovery-Oriented Services: The Challenges for Carers

Academic journal article Advances in Mental Health

Operationalising Recovery-Oriented Services: The Challenges for Carers

Article excerpt

The need to implement Recovery-oriented ser- vices is now widely promoted in mental health policies and plans across the Western world, includ- ing Australia (e.g., Commonwealth of Australia, 2009; Department of Health, 2001; Mental Health Commission of Canada, 2009). While conven- tional biomedical models focus on diagnosis and reductions in symptoms, Recovery approaches to healthcare focus on supporting the personal journey of the consumer; consumer empowerment; improv- ing the consumer's level of wellbeing, and building the consumer's capacity to self-determine (Corrigan et al., 2012; Deegan, 2007; Happell, 2008). The achievement of effective Recovery-oriented ser- vices, however, continues to challenge health service organisations across the globe (e.g., Hungerford & Fox, 2013; Newman & Kulmann, 2011; Smith- Merry, Freeman, & Sturdy, 2011).

This paper adds to the growing body of work related to the factors challenging the implemen- tation of effective Recovery-oriented services, by exploring the experiences of carers. It is important to include carers in the process of evaluating Recovery- oriented services for two reasons. Firstly, carers have a significant place in national mental health policies and plans in Australia (Commonwealth of Australia, 2009). Secondly, carers play a central role in supporting the Recovery-journey of consumers (McAuliffe et al., 2009; Mental Health Council of Australia [MHCA], 2012).

BACKGROUND

In response to national government directives in Australia, there have been significant changes in the way mental health services are structured and operated in all states and territories (e.g., Australian Capital Territory [ACT] Health, 2009; Australian Health Ministers, 2009; Mental Health and Drugs Division, Department of Human Services (Victoria), 2009; Queensland Health, 2006). Such changes include greater levels of involvement of consumers and carers in the planning and deliv- ery of health services; and the implementation of approaches to providing healthcare that embrace the principles of hope and optimism, collaboration and partnership with key stakeholders (Kuijpers, Joosten, & de Natris, 2012; Meehan, King, Beavis, & Robinson, 2008). Another important change is the involvement of consumers and carers in the evaluation of service delivery.

Implementation of Recovery-oriented services into the case study context commenced in 2003 (Hungerford & Fox, 2013; Hungerford & Kench, 2013). The case study context is an urbanised jurisdiction populated by some 350,000 people, situated in south-eastern Australia. The public mental health services located in this jurisdiction includes four inpatient facilities: Acute involun- tary, acute voluntary, rehabilitation and older people; and a range of community mental health services for people across the life-span.

The process of implementing Recovery- oriented services began with a long period of consultation that involved a range of stakehold- ers, including health professionals, consumer and carer representatives, together with representatives from associated community managed organisa- tions (ACT Health, 2004, 2006; Fanning, Rosen, & Hoskin, 2006). Recommendations derived from this period of consultation included the need to make changes to the way mental health services were provided, in accordance with strategic direc- tion set by the national government (Australian Health Ministers, 2009); and to provide workforce training to support health professionals to make the transition to delivering Recovery-oriented services. To roll out these recommendations, an action plan was developed to facilitate the ongoing involvement of consumers and carers in the imple- mentation of Recovery-oriented services; and to ensure a comprehensive approach to bringing about the changes required (ACT Health, 2007).

By 2009, the mental health service organisa- tion was claiming that Recovery-oriented services had been achieved (ACT Health, 2009, 2010). …

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