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Empowerment of clients at the Center for Mental Health Ostrava

The role of the mental health center staff is to empower the client. He often comes to us in a situation where he feels hopeless, is passive and does not want anything. With comprehensive care, we gradually get to the point where he is able to solve things completely independently. Ultimately, full recovery requires people with mental illness to gain some meaningful role in their lives that has nothing to do with their illness. Being a victim is not a role worthy of a recovered person, and frankly, neither is the role of a survivor. Newly acquired attitudes such as hope, confidence and greater responsibility for oneself must be applied in the ”normal” roles of employee, son, mother, neighbor and the like.

It is important for people to join the wider community and socialize with those outside the spheres associated with mental illness. Meaningful roles will end isolation and help people with mental illness recover and ’get their lives back’. From our experience, the following topics should be worked on in the journey to human empowerment:

RESPONSIBILITY FOR OURSELVES We begin to believe that we can change many things in our lives. We look ahead to what we want as well as what we don’t want. To reach our goal of recovery, we begin to do things ourselves. But we also accept help from others. As people with mental illness gradually recover, they realize that they must take responsibility for their lives. This means they need to start taking ”healthy risks”, trying new things and learning from their mistakes and failures. It also means that they have to let go of the feelings of guilt, anger and disappointment that are somehow associated with their illness. This stage is very difficult for people with mental illness and their service providers. There is a need to break old patterns of dependency, supporting clients to take ’charge’ instead of remaining in the easy and safe role of ’cared for’.

EMPOWERMENT We are set up to accept help. But we hope that someone will solve the problems associated with the disease for us. In order for people to make progress, they need to believe in their own abilities and to be aware of their own power. Their hope needs to be focused on what they can do for themselves, rather than relying on new drugs or treatment methods that someone else will introduce or provide. To feel empowered, they need access to information and the ability to make their own decisions. They may need support at first so that they can begin to focus on their strengths instead of their losses. Sometimes they will need someone else to believe in them before they are confident enough to believe in themselves. ”Readiness” often comes only in hindsight, that is, after something has been accomplished. Therefore, waiting until a person with a mental illness is ready to take a step forward can often lead to stagnation and ”de-illness”. People often have to experience success first before they believe they can be successful.

HOPE We do not feel able to face problems. We have trouble accepting help. We may experience a sense of hopelessness and a feeling of being ”stuck” in the disease. Anyone experiencing despair needs to feel hope, some sense that things can and will get better. Without hope there is nothing to look forward to and nothing positive can be done. Hope is a great motivator, but to be truly motivating, hope must be more than an ideal. It must take the form of a concrete, reasonable vision of what it could be like if it were better. It is not so much that people with mental illness should achieve the exact vision they create, but that they have a clear idea of what is possible, as a result of which they can more easily accept complex changes and make steps forward. It is possible that a person with experience of mental illness may return to the ”lower rungs” several times. Even such a journey, if it is well processed and grasped, can be a significant experience. Recovery is a normal adaptive process following tragedy, just as grief is a normal adaptive process following loss. Indeed, many people in recovery describe going through the stages of grief (denial, anger, bargaining, depression, and acceptance) as part of the recovery process. However, both of these processes often complement each other. People with experience of mental illness themselves see the following areas as key: KEY AREAS FOR RECOVERY WORK WITH HOPE ”IT WAS IMPORTANT TO ME THAT SOMEONE BELIEVED IN ME WHEN I DIDN’T BELIEVE IN MYSELF YET.” Being open to all possibilities for one’s future life path is important , that is not foreclosing certain possibilities because one is going through or has gone through an experience with mental illness.

DEVELOPMENT OF STRENGTHS Attention is paid to the development of a person’s potential and talent. To what one can, more than what one cannot.

COMPREHENSIVE APPROACH Human support is focused on all areas of life (housing, finances, work, free time, social, partner – family life, personal and professional growth, etc.).

10 principles of a team oriented towards multidisciplinary cooperation and recovery

1. We promote restoration of health, functioning and identity. This can be referred to as the three main domains of recovery. They are interconnected, but can still be separated. There is no hierarchy. Recovery-oriented treatment includes these three areas and works with the person on the areas in which they themselves want to succeed.

2. Offering hope is key. One does not begin the journey of recovery without hope.

3. We ask ourselves in everything we do: are we helping or hindering? Any interventions and interventions we have can potentially be counterproductive as they may not match the level of treatment and support that a person needs.

4. Do we focus on what is strong, not what is bad? It is important to explore an individual’s strengths, talents, ambitions and abilities.

5. Do we decide WITH and not ABOUT the service user? The professional and the person/client/patient make decisions together. We respect the opinion of the person/client/patient. This process begins in working with a diagnosis, which can be described as a shared understanding of what is actually going on.

6. Do we recognize that the expertise of the person using the services is as important as ours? A dialogue with a person is a meeting between two experts. The expert’s expertise consists of knowledge, experience and the ability to conduct dialogue. A person’s/client’s/patient’s expertise is the experiences, goals, and awareness of what has helped them in the past, and who or what are their resources, competencies, and talents.

7. Do we cooperate with social ”investors/donors” and other participants? Much of recovery takes place outside of mental health services: at work, at school, with family, in the community. That is why the cooperation of mental health services with social ”investors” and participants is important.

8. Do we recognize the rights of the person/user/patient to take ”healthy” risks? Denying and limiting the right and ability to “take healthy risks” often undermines the possibility of recovery.

9. Do we work with family and network as resources and partners? In most cases, it is better to walk the path of recovery together with others, family, partners, friends, etc. 10. Do we share and incorporate knowledge? Recovery-oriented treatment requires the engagement of objective, subjective, and normative knowledge.