Academic journal article Ethical Human Psychology and Psychiatry

A Case Study Approach to Mental Health Recovery: Understanding the Importance of Trauma-Informed Care

Academic journal article Ethical Human Psychology and Psychiatry

A Case Study Approach to Mental Health Recovery: Understanding the Importance of Trauma-Informed Care

Article excerpt

This article documents one woman's experience of mental health recovery using a case study approach. Specifically, qualitative data collected through a semistructured interview were triangulated with the medical record to understand more about how this woman experienced a transition from a period of her life marked by severe psychological and emotional impairment to an extended period of time during which she was thriving and did not experience symptoms consistent with her former diagnosis of severe mental illness. This case study offers important implications regarding the importance of trauma-informed care in the field of mental health.

Keywords: mental health recovery; case study; psychiatric rehabilitation; clinical depression

The process of mental health recovery is complex. Moving from a diagnosis of serious mental illness (SMI) toward a state of recovery can take years and involves a complicated set of experiences as people navigate both the mental health system along with their own emotional and psychological distress. This article presents a case study documenting one woman's journey from adolescence and early adulthood marked with ongoing and serious psychological impairment to an extended period of time during, which she did not experience symptoms indicative of SMI. This case study offers important implications regarding what is helpful and not helpful in fostering the process of recovery. This case study also illustrates that mental health recovery is possible, challenging the notion that SMI has to be lifelong and debilitating.

LITERATURE REVIEW

Mental health recovery is a topic of great interest to both researchers and practitioners. Mental disorders, including affective and personality disorders, are often considered to be chronic, lifelong medical conditions that require ongoing psychiatric intervention, usually medication. Paradoxically, long-term recovery among those diagnosed with mental disorder is relatively common; for instance, in a 10-year longitudinal study, 88% of those diagnosed with borderline personality disorder achieved remission (Zanari, Frakenburg, Hennen, Reich, & Silk, 2006). Intriguingly, some studies show that being off psychiatric medication is associated with better outcomes (e.g., Harding, 1987; Harrow & Jobe, 2007; Whitaker, 2010).

Mental health recovery is difficult to define and there are several different narratives defining what recovery means (Hess, Gantt, Lacasse, & Vierling-Claassen, 2014; Hess, Lacasse, Harmon, Williams, & Vierling-Claassen, 2014). For instance, a mental health consumer may embrace their diagnostic label, along with biological explanations of its etiology and treatment with psychiatric medications. These consumers may receive disability payments, live in an assisted housing facility, and work in a sheltered workshop setting. They may receive recovery-oriented services and self-identify as "in recovery" or "recovered" from mental disorder despite their continued reliance on services. At the other end of the continuum lie former mental health clients who reject their diagnostic labels and do not accept a medical view of their problems. These former mental health consumers are functioning well without the need for psychiatric intervention. Although many variations exist and stark distinctions are difficult to draw on the individual level, some such former clients may identify with the "psychiatric survivor" movement (see Adame, 2013; Adame & Knutson, 2007).

This article focuses on the latter version of recovery. This version of functional recovery includes the initial diagnosis of a severe mental disorder followed by an eventual resumption of a productive life in terms of relationships, employment or school, and general functioning. Because people who experience success often drop out of the mental health system, such individuals are rarely studied. Given the centrality of psychiatric medications in the current mental health system (Gomory, Wong, Cohen, & Lacasse, 2011) and the ongoing debate regarding their impact on outcomes (Whitaker, 2010), individuals who have attained functional recovery without continuing to take psychiatric medication are of particular interest. …

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