- Whole Person, Whole Life and Wellbeing
- Cultural Diversity and Values
- Respect and Dignity
- Individualisation, Identity and Personal Responsibility
Community Mental Health Services
- Person Centredness
- Evidence based practice and values
- Family involvement
- Efficient use of resources
Individual Service User IMHCN Values and Principles
Individual Service Users
The concept of citizenship incorporates the belief in equal rights for every individual regardless of their circumstances to access civil, political, social and economic opportunities. It is particularly important for people with mental health problems to enjoy the same rights and social justice as all citizens and to be protected from laws; social exclusion; institutional service and treatment practices that segregate or discriminate in any form or kind.
The concept of the recovery approach for service users is founded in human values and their application by the service user, professionals and the service itself. Its objective is to achieve health and wellbeing regardless of the degree of disability or distress of the individual.
It requires a paradigm shift in thinking from pathology and illness to self determination, life stories, human strengths, hopes and dreams, peer support and control by the user with support from professionals as partners, mentors and advocates.
It should be rooted in cultural, social, religious and ethnic diversity that gives meaning to the persons identity, belief and circumstance.
To promote the recovery approach staff should reevaluate their role in the treatment process to one of negotiation, partnership and trial and error.
Service organisations need to allow and support staff in practicing in this way by adopting a culture of creativity, innovation, openness, encouragement for diversity and recognition for good practice.
3. Whole Person, Whole Life and Wellbeing
A person with a mental health problem has the same basic human needs as all of us. Recognising the whole person is the way to develop and lead a life that is full of purpose, interest, recognition, contribution, value and reward. People with a mental health problem are seeking s whole life comprising of these needs and aspirations. Enabling people to have a whole life opportunity and assisting them in their recovery and wellbeing requires full access to health, educational opportunities, vocational training schemes, work, volunteering, social networks, sport and leisure, art and culture.
The IMHCN Whole Life approach promotes this by applying a Whole Systems methodology in the design, planning and implementation of a comprehensive integrated mental health system. The Whole system has to have an agreed common purpose and objectives negotiated and owned by all community stakeholders. In this way the components of the System are interdependent with each other and have themselves a well defined contribution to the Whole System. The Whole is the most important objective and not each component on their own.
4. Cultural Diversity and Values
In many countries in the world people from diverse ethnic backgrounds have struggled with being treated as different to the rest of the community. This has a significant impact on peoples wellbing and mental health. In Western countries people from black and minority communities are over respresentative in services and it is acknowledged by policy makers and providers as an issue of concern.
Specifically, more people from diverse ethnic backgrounds are diagnosed as having a mental health disorder for emotional and mental distress, furthermore they are being diagnosed with serious mental illnesses more than the rest of the population. In some countries, particularly the UK, people from these backgrounds are being compulsory treated and to stay longer in hospital than the rest of the population.
Instead of people from diverse ethnic backgrounds being stigmatised and treated differently they should be valued for the diversity and richness they bring to society. All people having an impact on an individual’s wellbeing should be aware of their own perceptions, assumptions and prejudices particularly when making judgements and assessments of an individual’s mental health status.
There is much to be learned in the world from cultures, ways of life and the ways people are included of people in every aspect of a community life. For example there are many countires in the developing world with greater recovery rates from serious mental health conditions in comparison with European and Western countries. The evidence from international longitudinal studies need to be taken into account by service users, family members, policy makers and providers.
5. Respect and Dignity
Every person has the right to be treated with respect and dignity and it is essential that this is common practice by professionals, organisations and the public. Being treated with respect and dignity enhances people’s feeling that they are worthwhile and are valued, useful and important as fellow human beings. This will lead to the person gaining confidence in their self worth, self respect, ability and contribution to society.
6. Individualisation, Identity and Personal Responsibility
People want to be regarded as individuals and not to be identified or labelled by their diagnosis or pathology. People want to be in control of their recovery journeys and assisted by services in a equitable and empowering way. All to often people have been slotted into an illness paradigm that disempowers and maintains people within mental health services. Professionals and services need to recognise and harness the capabilities and assets of people with mental health problems. People with mental health problems need to take personal responsibility for their own recovery journey. In this way an individual can take the power to ensure that their unique goals, strengths and needs are harnessed, are fully recognised and acted upon
Community Mental Health Services
1. Person Centredness
Knowing the person is fundamental to establishing and maintaining a trusting relationship and only by working alongside a person in this way can practices and treatments be fully effective.
Services should be organised and provided in a way that enables easy access through a single point of entry with a pathway that is well understood by users, carers and other providers. Whenever possible services should be provided close to where people live.
It is well understood that a comprehensive, well integrated service system that meets the needs of people in a way that is holistic and provides continuity of care is much more likely to provide better recovery opportunities and outcomes for service users. Each component of the service should be seen and interwoven as part of the Whole System.
To ensure the best outcomes for people, services should be; evidence based, subject to good governance, meet quality standards and performance indicators that promote and measure their effectiveness.
Mental Health Services and resources should be organised and provided at an equitable level and standard to every geographical area in a given region or country. This will ensure that the whole population is being served.
6. Evidence based practice and values
It is acknowledged that there are many treatments and therapies that are effective for many mental illnesses. These should be commonplace and where necessary introduced into the daily practice of professionals to maximise the best outcomes for service users. Service users should be given choice and be able to determine and access the most appropriate treatment and therapy to meet their need.
7. Family involvement
Families and friends should be valued and involved as partners in the recovery process of the service user, alongside professionals and the service as a whole. The involvement, education and understanding of mental health and the needs of their family member by families and other supporters is an essential part of a participative, effective, positive therapeutic alliance and experience.
8. Efficient use of resources
Mental health human and financial resources are not always sufficient to provide the best service possible in most countries. This is particularly the case in low to middle income countries. It is fundamental that the resources that are available are used in the most efficient and effective manner. Resources should not be wasted on administrative and bureaucratic structures and large psychiatric hospitals. Instead they should be focussed on developing frontline services that directly support service users. The priority should be to develop and support effective community based services.
The evidence base demonstrates that the most important factor in developing an effective therapeutic alliance is founded the trust forged between the people working in services and the people using the services. These relationships must be mutual, reciprocal and founded on good rapport and shared responsibility.
Advocacy in all its forms seeks to ensure that people, particularly those who are most vulnerable in society, are able to have their voices heard. People with mental health issues often have difficulty in having their voices heard on issues that are important to them. In defending and safeguard their rights and have their views and ensuring their wishes are genuinely considered when decisions are being made about their lives is the repsonsibility of us all.
Professionals, family and friends have a role in advocating for the person. It is essential that people with mental health issues must have access to a range of advocacy services that professionals are aware of and support the person to access they include;
- Citizen Advocacy
- Independent (Issue-based) Advocacy
- Group Advocacy
- Peer Advocacy
- Legal advocacy
Advocacy services should be independent of service providers and not be controlled by the organisations that are providing the mental health services. This is because advocacy has to be truly independent to be effective. The goal of advocacy in all its forms should be to enable and support the person to develop the confidence and skills to be able to speak and advocate for themselves.