PPN 303 Class 12: Hope, Resilience & Recovery: Peer Supports & Workforce Resilience to Support Mental Health

What is Recovery in Mental Health & Substance Use (mental health commission of canada, 2021)?

Recovery in mental health and substance use is about people living satisfying, hopeful lives and contributing to society even if they experience ongoing symptoms of a mental health problem or illness. It looks different for everyone, so people should be empowered to decide what recovery means for them and what they need to achieve it

Core Principles of Recovery Paradigm/Framework

• Non-Linear journey/process that is unique to each person

• Hope

• Dignity

• Respect

• Collaboration

• Recovery does not equate with “cure,” but refers to “living a satisfying,
  hopeful and contributing life, even when there are ongoing limitations
  caused by mental health problems and illnesses.”

Civil Rights movement (Evolution of the Recovery Paradigm)

Core ideas of empowerment, self-determination, self-help and advocacy

1980s-90s (Evolution of the Recovery Paradigm)

• People with Lived/Living Experience

• Describing their own journeys and experience

• Advocated for a system that provided hope, treated people with dignity and respect and
  supported everyone in finding their path to mental health & well-being

2000s (Evolution of the Recovery Paradigm)

• Mental Health Commission of Canada

• Recovery-oriented Mental Health Practices

The Meaning of Recovery (Deegan, P 1988)

• Disabled persons are NOT passive recipients of rehabilitation services...they experience themselves as recovering a new sense of self and of purpose within and beyond the limits of the disability.

• Recovery refers to the lived, or real-life experience of persons as they accept and overcome the challenge of the disability

The role of hope defined by Deegan P 1988

• The experience of being admitted to hospital, going for help in ER, and accessing formal care is often disempowering and create despair

The role of hope defined by Kirkpatrick, et al 1995

• We encounter our clients when they are most vulnerable to losing hope

Hope is…..(Miller, J.F)

• anticipation of continued good state, an improved state, or release from a perceived entrapment...Hope is an anticipation of a future which is good and based upon mutuality (relationships with others); a sense of competence; coping ability; psychological well- being; and meaning in life, as well as a sense of the possible

Why is Hope so important? (MHCC,2015)

• Too often, people who experience the onset of a mental illness are led to believe that they should not expect to be able to function at work, in school, within society or be capable of caring for themselves independently

• Research shows that having hope plays an integral role in the process of recovery

• Having hope is equally important for family members and others supporting people in their journey

• Hope provides motivation and sustains the strength required to confront challenges

Fostering Hope

• does not mean ignoring the real distress people experience or the challenges they may face

• In first-person stories of recovery, people frequently remark on how it was the sustained support of just one individual, able to see their potential and mirror it back, that helped to kick start their recovery process

Hope Instilling Strategies (Kirkpatrick et al 1995)

• Language Matters

• Building Relationships

• Facilitating Success

• Connecting to successful role models

• Managing the illness 

• Education 

• Peers 

Hope Key takeaways for nurses

By embedding, modelling and communicating a culture of hope in everything they do, mental health providers can make a significant contribution to a person’s recovery journey

The role of peers (Hope)

• also fostered by peers with lived experience who can share their own path of recovery, the actions they have taken, the resources they have drawn upon and the tools they have used to build a new meaningful life for themselves

The Voice of People and Families with Living & Lived Experience of Mental Health & Substance Use

• Peer Support Workers

• Decision-making power in the way services are designed, delivered and evaluated

• Nothing about us without us

• True partnering and collaboration with people and families who have/are living with mental health and substance use challenges

To keep in mind (Mental health) (Deegan, P 1988)

• Recovery is not a linear process

• Series of small beginnings with setbacks

• Programs should be environments that nurture recovery and are flexible

Recovery-Oriented Practice 

• Recovery-oriented practice involves a range of services and supports to meet a person’s goals and needs, while recognizing that:

  • Each person is unique and has the right to determine their own path toward mental health and well-being

  • Societies include many intersecting factors (biological, psychological, social, economic, cultural, and spiritual) that have an impact on mental health and well-being

MHCC six dimensions of recovery-Oriented practice

• Creating a culture and language of Hope 

• Recovery is Personal

• Recovery Occurs in the context of One’s Life

• Responding to the Diverse Needs of everyone Living in Canada 

• Working with First Nations, Inuit and Metis 

• Recovery is about Transforming Services and Systems 

Mental Health Continuum (keyes, 2002)

• Flourishing/Thriving with illness

• Flourishing/Thriving without Illness 

• Languishing/surviving with illness

• Languishing/Surviving without illness

World Health Organization (WHO definition of health

• “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.”

Public Health Agency of Canada (PHAC)

“Mental health is the capacity of each and all of us to feel, think, and act in ways that enhance our ability to enjoy life and deal with the challenges we face. It is a positive sense of emotional and spiritual well-being that respects the importance of culture, equity, social justice, interconnections and personal dignity

The First Nations Mental Wellness Continuum

Mental wellness is a balance of the mental, physical, spiritual, and emotional. This balance is enriched as individuals have: PURPOSE in their daily lives whether it is through education, employment, care-giving activities, or cultural ways of being and doing; HOPE for their future and those of their families that is grounded in a sense of identity, unique Indigenous values, and having a belief in spirit; a sense of BELONGING and connectedness within their families, to community, and to culture; and finally a sense of MEANING and an understanding of how their lives and those of their families and communities are part of creation and a rich histor

Healthy Workplaces exist when…

• Workers throughout the organization continually collaborate to address health and safety concerns.

• Inclusive work Culture

• Healthy workplaces are those that have policies, practices, and programmes in place to provide workers with the conditions necessary to protect and promote their health and well-being

Healthy and Safe workplace

• Workers understand their roles and believe they can contribute to decisions about how their work is carried out.

• The National Standard of Canada for Psychological Health and Safety in the Workplace outlines a systematic framework for employers to use in creating and sustaining healthy, safe workplaces

13 Factors of Psychological Health & Safety in the Workplace

• Organizational Culture

• Psychological and Social Support

• Clear Leadership & Expectations

• Civility & Respect

• Psychological Demands

• Growth & Development

• Recognition & Reward

• Involvement & Influence

• Workload Management

• Engagement

• Balance

• Psychological Protection

• Protection of Physical Safety

Mental Health Problems in the workplace

• Work-life Balance

• Role Overload

• Burnout 

• Work-life conflict 

• Stress in the workplace

• Compassion Fatigue

Depression (Work-related symptoms of common mental disorders)

• Trouble concentrating 

• Trouble remembering 

• Trouble making decisions

• Impairment of performance at work

• Sleep problems 

• Loss of interest in work 

• Withdrawal: family, friends, and coworkers 

• Feeling pessimistic and hopeless 

• Feeling Slowed down 

• Fatigue 

Anxiety Disorders (Work-related symptoms of common mental disorders)

• Feeling apprehensive and tense 

• Difficulty managing daily tasks 

• Difficulty concentrating 

Burnout (Work-related symptoms of common mental disorders)

• Becoming cynical, sarcastic, and critical at work 

• difficulty coming to work and getting started 

• More irritable and less patient with coworkers, clients, and customers

• Lack of energy to consistently productive at work 

• Tendency to self-medicate with alcohol or drugs 

Vicarious/Secondary Trauma (Flannery, 1999)

• High prevalence in helping professions especially healthcare, social services, military, psychiatry, first responders

• Vicarious traumatization (VT) was coined by Pearlman & Saakvitne (1995) to describe the profound shift in world view that occurs in helping professionals when they work with individuals who have experienced trauma: helpers notice that their fundamental beliefs about the world are altered and possibly damage

Critical incident stress (Flannery, 1999)

• Specific, often unexpected, time-limited events that may involve loss or threat of to personal goals or well-being, and may represent a potential turning point in the person’s life” (Everly, Flannery, & Mitchell, 2000, p.4

• Critical events are outside the usual realm of human experience and are markedly distressing. Such events can evoke adverse psychological and physiological experience/reaction

• As a result normal coping mechanism are strained and may affect how professionals function at work, with their families, and sociall

Workplace Violence 

• Includes any type of intimidation, harassment, or abuse directed against a person in his or her place of employment

  • Bullying

Bullying Defined

• Occurs repeatedly with intent to do emotional and/or physical harm.

  • A power difference exists between the victim and the aggressor

Emergencies and Disasters

• Traumatic events that constitute an emergency or disaster can affect those involved both physically and emotionally

• The workplace may be a good and familiar place for employees to be following a traumatic event

At-Risk Employees 

• Vulnerable groups that are predisposed to stress and other work-related threats

• Workplace strategies can be put in place to assist and support specific workers or groups of workers

• Employers in Canada are expected to provide reasonable accommodation to special needs of current or potential employees

Workplace mental health problems

• Awareness of the potential for mental health issues among employees is an essential component of a psychologically healthy and safe workplace

• Workplace strategies can be put in place to assist and support specific workers or groups of workers

• Addressing mental health is economically worthwhile

Accomodation

• Changes in communication

• Modifications to the physical environment

• Job modifications

• Schedule modification

Work and Persons living with a mental illness

• important role in recovery from mental illness and is a means to integrate persons with mental disorders back into their community.

• Supported employment (SE)

  • An approach to assisting people with disabilities in finding appropriate work and supporting them once employed through the services of trained professionals

Nurses and Workplace psychological health and safety

• The education, recruitment, and retention of workers in the health sector are a pressing global concern

  • Can compromise nurses’ self-esteem, sense of self, and sense of worth

Nurses and workplace mental health 

• Fatigue has been identified as a major negative influence on safe practice.

• Burnout

  • Exhaustion due to chronic job stress

• Compassion fatigue

  • Reduced public empathy toward
    social problems or crises

• Recommendations for workplace
  health, safety, and well-being of the
  nurse

Violence in Healthcare workplace

• Health care practitioners are at particularly high risk of workplace violence.

• Nurses are most at risk.

• Appropriate staffing levels and shift lengths can reduce stress and avert aggression.

• Reducing violence:

  • Ensure everyday practice is grounded in courtesy, decency, and civility.

Resilience

• The ability to overcome or rise above adversity, learn from the experience, and apply strategies and cope with life events even when the situation dictates otherwise

• Not limited to an individual but can apply to a group, or to society’s ability to move beyond negative circumstances

Resilience defined by Zolkoski & Bullock, 2012)

Refers to achieving positive outcomes despite challenging or threatening circumstances, coping successfully within traumatic experiences, and avoiding negative paths associated with risks