Assessment; Mental Illness and Mental Health Recovery Assignment
Assessment; Mental illness and mental health recovery
Word limit/length; 2500 words
This assignment invites you to consider the underlying assumptions of the dominant model of mental illness and compare these with the principles of the recovery paradigm. It encourages you to think critically how these contrasting perspectives influence the assessment and treatment of mental health problems. In contemporary mental health care, clinical or case formulation continues to be exceptionally important and the capacity to make sense of a person’s problems, rather than simply labelling or naming them, is an essential capability of all mental health professionals.
It is your opportunity to consider competing discourses which shape the need for other ways of being with people and assisting them than the dominant biomedical approach to mental health. You will do so by considering how a mental illness may be diagnosed and treated from a biomedical model. You are invited to consider the implications of formulating the from a psychotherapeutic framework. You will then consider the roles, virtues and competencies required to help the person from a position of biomedical discourse and the alternative framework.
This assessment task is aligned with the following learning outcomes:
- Analyse and critique the dominant discourses and models of mental health and illness and how these and other formative influences have shaped mental health policy, legislation, professional standards, influenced mental health practice and the experience of care
- Critically review the concept of the therapeutic alliance or relationship, its essential elements, how it can be developed and maintained, and argue its importance in contributing to collaboratively negotiated outcomes with service users.
- Construct a clinical / case formulation drawing on psychotherapeutic theory, extant research and clinical reasoning which effectively addresses the holistic needs of the individual and families
Assessment details; –
Is mental health recovery compatible with biomedical understandings of mental illness? Implications for the mental health workforce.
In essay format, your assignment should address the following:
- Identify a single mental disorder as defined by the Diagnostic and Statistic Manual of Mental Disorders (5 th Edition, Text Review) (DSM-5-TR) (American Psychiatric Association, 2022)1 and briefly describe the dominant biomedical discourse around the disorder and how this discourse informs expectations about assessment, aetiology, treatment and clinical recovery of that disorder. Assessment; Mental Illness and Mental Health Recovery Assignment
- Identify a person you have worked with, or a case study from the literature, with the same DSM-5- TR diagnosis as identified in Part 1. Drawing on alternative discourses around personal recovery and/or psychotherapeutic literature2 , describe an alternative way of formulating the problem. Briefly describe the implications for the process of care and treatment from this perspective.
- Discuss the compatibility of the biomedical discourse with the alternative discourses around the problem.
- Compare and contrast the skills, competencies and attitudes needed by mental health workers to effectively respond to a person with this diagnosis from these discourses.
Sub-headings should be used throughout your essay for each section.
. CMH Assignment B Rubric
Understanding of the biomedical discourse in mental health
Demonstrates an exceptionally high-level understanding of the dominant biomedical discourse in mental health. Critically and clearly considers the role of this discourse in the assessment, treatment and recovery from a particular diagnosis. Excellent integration of high-quality, evidencebased literature.
Understanding of alternative discourses in mental health
An exceptionally clear and critical discussion is provided demonstrating an understanding of the impact of an alternative psychotherapeutic discourse for a particular diagnosis. Excellent integration of high-quality, psychotherapeutic literature.
Comparison of the biomedical and alternative discourses in mental health
An exceptionally highquality, critical comparison is provided between the biomedical discourse in mental health and the competing psychotherapeutic discourse.
Skills and compatibilities discussed.
A succinct and articulate discussion is provided which describes the mental health worker’s skills, attitudes and competencies required to engage therapeutically with the person. Assessment; Mental Illness and Mental Health Recovery Assignment
Presentation and structure
Clear, concise and logically structured with a succinct, clear introduction and cogent conclusion. Demonstrates professional use of writing mechanics to engage the intended audience.
Excellent academic writing style. It is very well organised and contains no spelling, grammar or referencing errors.
Excellent choice and integration of evidence. Adheres almost flawlessly to APA citing style.
Case Study (A)
Post Traumatic Stress Disorder (PTSD).
I grew up as a particularly happy child, describing myself as coming from the perfect family. In reality, I spent a majority of my time ignoring the issues in my parents’ relationship. My parents went through a rough break-up when I was 11, made worse by my dad’s sudden death in a car accident. This was the beginning of a downward spiral that spanned throughout my teenage years. Between bullying at school and things not being good at home, I was sinking further into depression with each day that passed. I went from being an academic-achiever to someone who would skip school to self-harm. I was completely isolated and stopped attending school all together before the end of Year 7.
I started at a new school in Year 8, improved my grades and for the first time since my parents’ break-up, I felt like I had a safe space. In fact, school became that very safe place for me throughout my teenage years. Being at school gave me enough to focus on that I could temporarily forget my own troubles. The issue was that when I wasn’t at school, I was overcome by a persistent darkness that would regularly manifest as self-harm. Soon, the depression became a part of my personality. I’d accepted that the days of bright, cheery Caiti were long-gone. In fact, if you had asked me to describe myself in three words, I likely would have said short, academic and depressed.
Ever since I was in primary school, I had dreamed of attending the University of Melbourne. It was a light at the end of a long, negative tunnel. Finding out I’d been accepted into Melbourne University at the end of year 12 should have been the happiest day of my life, so why was it so underwhelming?
That was one of the hardest things for me to accept. For so long I’d imagined that leaving home and being at the university of my dreams would bring my life together like a perfect fairy-tale, but things didn’t magically get better like I’d expected. In fact, the depression continued to worsen, and I was struck with horrific nightmares every night. I was losing motivation. I knew I didn’t want to continue to feel this way, but nothing I’d tried had worked.
I started off by seeing psychologists, who diagnosed me with Post Traumatic Stress Disorder (PTSD). The diagnosis was almost a relief, because for the first time in my life I understood why I felt the way I did. I found comfort in talking to psychologists, but at the same time, my negative thoughts weren’t really lifting. It felt as though I’d take one step forward, then three back. I ended up seeing three different psychologists, before finding Dr Jan.
For me, the therapies that worked best ended up being a combination of hypnotherapy and cognitive behavioural therapy. The hypnotherapy allowed me to reframe the associations I had with traumatic memories, whilst the cognitive behavioural therapy allowed me to re-train my way of thinking. I’ve always described myself as being an open and honest person, who is willing to tell my life story to anyone who cares to listen. Despite this, my sessions with Dr Jan made me realise that I hadn’t actually opened up about my true feelings with a psychologist before. In fact, I would completely disassociate myself from my past when discussing it with anyone. Overcoming this was one of the most important parts of my recovery. When I finally did break down in front of Dr Jan, telling her about the perpetual guilt I felt over dad’s passing, things took a turn for the better. She was helping me to manage my feelings and for the first time I was seeing an end to the negativity.
As time went on, I realised that one of the major obstacles to my recovery was the pressure I put on myself to fix every issue at once. I was ending up overwhelmed and losing progress as a result.
As a school teacher, I know that I would never expect a student to learn everything at once and it was time I started to focus on fewer things at a time. I began picking a new difficulty to focus on improving each fortnight with Dr Jan. These difficulties started with managing my guilt over Dad’s passing right through to dealing with issues about my home-life. As I slowed down my sessions, I began work on issues that weren’t as major to me as others, but that still prevented me from living the life I’d always wanted.
A huge turning point was managing my extreme fear of being dishonest. For years, I hadn’t been able to keep surprises, as I felt as though I was being dishonest in doing that. Dr Jan gave me strategies that resulted in me surprising my boyfriend with a weekend away for his birthday – something I didn’t think I’d ever be able to do.
I am at a point now in my life that I didn’t ever think was possible for me. Recovery wasn’t a straight-forward path like I thought. There were times when things were on track and times when I went completely backwards. That’s the part that people don’t always tell you – you will have moments in your recovery where things aren’t progressing like you expect. In the years that my recovery took, there were countless times that I lost motivation, gave up, decided happiness was too far out of reach – and yet, the hands-down best thing I did was to re-assess and keep trying. Assessment; Mental Illness and Mental Health Recovery Assignment
It’s been long and it’s been hard, but for where I am now, persevering has been so incredibly worth it. In fact, if you asked me to describe myself in three words now, I would tell you that I am still short, still academic, but I’m now also optimistic. I’ve seen how resilient I can be, and I’m finally happy with who I am.
Case Study B
Complex Post-Traumatic Stress Disorder
I have Complex Post-Traumatic Stress Disorder as a result of prolonged and repeated traumatic events. It has developed in response to a family member sexually, physically, psychologically, emotionally and financially abusing me.
My first memory of being sexually assaulted was when I was five years old. I frequently had nightmares, fear of being alone with him – I would not let go of my mother’s hand at night. I would scream for my mum which would result in the perpetrator hurting me more.
As I entered my teenage years, I began to stand up to him which led to more punishments. He had broken me. I was sick of his abusive ways. I became angry with myself. No one seemed to care or to want to help me. I wanted to die every day because of what was happening to me. I began self-harming to help with the pain. I had to see the pain on the outside.
I often felt misunderstood and left out. I was trying to figure out my confusing life alone. I still had contact with the perpetrator until I was 22 and this affected every aspect of my life. I was trying to get through university and relying on my family financially. I didn’t want anyone to know about the sexual abuse.
At the age of 19 I was first referred to the Youth Mental Health team by my doctor due to increased disordered eating behaviours and difficulty sleeping.
My self-harm behaviours increased and at this time my GP was more concerned about my safety, and I was admitted into the in-patient psychiatric unI saw myself as a freak for being in a hospital setting and not being able to ask for help earlier. I felt like a prisoner. It felt like no one wanted to help me. I was constantly passed on from psychologist to psychologist because no one could understand me. In many ways I tried reaching out for help but no one could hear my silent screams. it for the first time.
During my hospital stays the nurses were fantastic. I was offered female nurses due to my history and was offered a lot of space. In the beginning of my journey I was frequently in the hospital, particularly over the Christmas and New Year period. I also had great supports from the Family Violence Unit and the Sexual Offenders Child Investigation Police Teams throughout the court processes. They have helped me learn how to protect myself and not rely on my family who have turned their backs on me
My family are still waiting for me to say that I lied and ask for their forgiveness.
Due to my experiences I often felt hurt and alone, leading to reckless behaviours. I met a man online and he raped me. I said no to him. I tried to push him off me. I stood up to this man by giving my evidence in court, leading to a tough court trial. I am not going to lie and say it was easy, because it wasn’t. It has been the hardest thing I have ever had to do. Even though it didn’t lead to a conviction I know I tried my best.
My treating clinician has helped me through everything. I no longer feel alone. The Youth Mental Health Service helped me through suicidal thoughts and behaviours in a safe way so I no longer need to be hospitalised. I have also been referred to various other services to assist with financial hardship and housing crises. My clinician identified ways to help me that no one had ever before.
Since turning 25 I am no longer a client of the Youth Mental Health Service, however I still require some assistance. I regularly take medication, attend art therapy, equine therapy and counselling. Therapy helps me to manage my emotions, flashbacks and nightmares.
I am also very fortunate to have a side-kick to get me through each day. His name is Charlie and he is my assistance dog. Charlie is a two-year-old Golden Retriever x Poodle and is still learning everyday about how best to assist me.
An assistance dog is trained to assist an individual with a disability. They can be trained by an organisation or by their handler with the help of a qualified trainer. Legally an assistance dog is classified as a supporting aid and therefore is protected in the same way a wheelchair or a walking stick is.
Since having an assistance dog with me I have gained independence. I can comfortably leave my house and not be overwhelmingly terrified of the world. Charlie is able to pick up on my emotions very quickly and if my breathing becomes out of control he will nudge my hand.
He can often be found standing on my feet, or leaning up against me to keep me grounded. Particularly at the supermarket he is a barrier between me and other people.
Despite all of my challenges, I am a member of this community. I work, study and participate in a sporting club. I have a life – I have chosen a family consisting of friends and my dogs. I choose every day to participate in this world and to look to the future, to be a member of this society. Although some may see me as crazy for struggling with my mental health, I am strong. I am not weak and I will not be pushed around.
I have chosen to not let these experiences define who I am. I now choose to be an advocate for those who struggle with their mental health in our community.
Case Study C
diagnosed with depression.
My mental health problem started when my father left. It was a hard transition for me and my three sisters. We had to go to lawyers and family consultants to see who we would be living with, so we never quite knew where we were going to end up. It was super stressful, because my family had already been broken up once when my dad actually left. I didn’t want it to happen again by having to live in two different places. I felt powerless, in that where my sisters and I lived, was up to the government. This made me angry because It felt like I wasn’t being listened to. Assessment; Mental Illness and Mental Health Recovery Assignment
As things got worse my mum made me seek help by going to sessions for kids whose parents had separated. However, these sessions did not feel very meaningful and felt like I just had to be there. I also went to other services; however I hated it there because it felt too clinical. I felt like just a number not a person looking for help. Soon after, I ended up going to headspace. The first times I went, nothing changed but that was before I found a connection with one of the workers. I now realise it was important for me to establish a trusting relationship with a worker who I could express myself to safely and emotionally, and from here, I could be supported.
As I went in to the senior years of high school my depression got worse. I ended up pushing good friends away and burning bridges. I had so many family circumstances to navigate with mum and dad and felt very protective of my sisters. I felt a lot of responsibility on my shoulders. School was expecting at least three hours of study from me each night. Because of these expectations, I felt there was no room for my identity.
Every day was just about getting through each day, one at a time. I kept going until one day I realised I was out of energy, I couldn’t be bothered, I had no motivation for anything. This left me with what seemed like an easier option at the time, ending my life. I realised I had to seek help. Mum and I were arguing a lot. I wouldn’t/couldn’t get out of bed. The things that I previously loved such as drama, media and seeing my friends didn’t even motivate me anymore. I could put on a big smile and perform in the school production but inside I was hurting – everything was heavy. Because of my ‘brave’ front, nobody checked in, nobody asked how I was, but why would they have? On the outside I appeared totally fine.
I ended up going to the GP and getting diagnosed with depression and getting medication. I wasn’t too impressed with it at the start because of the effects of toxic masculinity, ‘manning up’ and being too proud to accept help. But I gave it a chance after some thought and it ended up really helping.
I don’t want to focus on the negatives, I want to focus on the positives and the recovery. The progress is never linear and even now, where I am much better, I still have my bad days. On these days I feel so alone my heart aches. Recovery to me was finding something, anything to hold onto and live for, if you’re not going to live for yourself. For me that was my mum. When things were at there worst mum was there. When things were heavy, mum lightened the load.
The hugs, the meals, the check ins, mum was there – even the cold-pressed apple juice that mum always made sure was in the fridge when I’d had a particularly bad day. The juice was there, mum was there.
I’ve gotten back into what I enjoy, reading, catching up with friends, and I’ve even gone to Europe. Things that I didn’t/couldn’t do, before I got help. On days that my illness acts up and I don’t want to do anything besides disappear from the world, I know I just have to get up and push through. Nothing big, just little things such as getting up to have breakfast, or to sit with someone so I don’t feel so alone. I force myself to do these things to fight back even a little, to improve that little bit every day.
If I rewind back to the start, two things have happened; I’ve started a journey of recovery that may never end, but with this I have grown into a person that recognises the importance of being kind to myself and having positive people around me. I now have islands that I can climb upon when the ocean is rough.
This journey may never end but I have made a commitment to myself to be honest with who I am, however that may look, and to share my experiences and learned knowledge with others around me.
Case Study D
I sit here wondering where I start… I sit here anxious about saying the right things…. I sit here after approximately five weeks of trying to write this.
Hi, my name is Bon and I have panic disorder.
I have not always had the grand title of having ‘panic disorder’ although I wonder if it has always been a part of me. I grew up in a household like many, I always felt warmth, loved and was always fed. I was young when I experienced reoccurring dreams of being run down by a very distinctive white semi trailer. I could not sleep and remember my mum comforting me, telling me to think about things I liked, which was dirt bikes and dancing at the time. My mum was 21 when she had me, I was her third child, so she was an expert at soothing her children although was probably not aware of anxiety. Looking back, I think I was having anxiety attacks on a regular basis.
It was not until the age of 14 years that my symptoms became apparent. Although I have vague memories of this episode my mum still remembers it like it was yesterday.
I was home when I had a psychotic episode, there were no drugs or alcohol involved. Mum tells me I was talking to my fingers as I believed they had faces on them and I also believed there was a giant monkey in my room. Mum and dad soon had me at our local hospital where I spent the next week having had a nervous breakdown.
It was the many hours of counselling that enabled me to find the root of my unexplained anxiety. I was sexually abused by my babysitter’s father at six or seven years of age. It was something I supressed for all those years only for it to rear its ugly head in one of the worst years of my life. This was the first time my parents heard about what had happened to me.
Throughout my teen and young adult years I struggled from time to time with depression and anxiety, and although I appeared to be confident and happy all the time, the black dog had me. I was ‘happy’ as much as I thought happiness looked like. I have been on the ride of ups and downs and it was not until I was in my late 30s when I received training and attended counselling, that I realised I had a medical condition
In my 30s I was working in a highly stressful workplace, running on adrenaline 24/7. I did not recognise the distress my body was under and was not feeling depressed, although was greatly aware of my anxiety levels which I controlled with quick-fix medications. It was not until I left that workplace and joined a slower paced environment that everything came to a head again. Assessment; Mental Illness and Mental Health Recovery Assignment
One day I travelled by train to Coroy for a routine meeting and on return to Balla was faced with a scary scenario. I was sitting on the train and happy chatting with people around me. There was nothing to be alarmed about and I didn’t realise, but I was about to have a full-blown panic attack. I started feeling my body ‘go’ – how I describe my body when having a panic attack.
I started to feel excited from the adrenaline, which is a short-lived experience. My skin started prickling all over, I felt a hot flush, became short of breath, and disassociated with my surroundings. I quickly took half a tablet to get a quick fix, although it was not to be. I tried to stay calm and breathe, using all the techniques I knew, though I was not able to get this feeling to subside. As soon as the train pulled in to the next station, I jumped off to get as much fresh air into my lungs as possible. I was in Bacchus Marsh, many stops from home and I was terrified! I called a friend who lives in Bacchus Marsh to collect me from the station so I could feel safe. I spent the next hour calming down before heading back to the station to catch the next train. My friend dropped me off and I attempted to catch the next train but I could not do it. The staff were wonderful and after gaining permission, drove me back to Ballarat. I was fine in the car as I felt I would be able to get out at any time. After that day, I did not attempt to catch a train for an exceptionally long time
From that day on I thought I would be broken forever. It took me weeks to leave my home and having panic attacks when people would visit. I could not drive my car, I could not go to my doctor, I could not be in a shopping centre. I gently pushed myself a little at a time. There were many tears and embarrassing moments, although each day has been worth building my self awareness of my condition.
People are often confused as to what happens and how I feel when I have a panic attack, my husband being one of these people. I asked him what he feels like when he has an asthma attack, he went on to describe how I feel when having a panic attack. There is no one size fits all. I have undergone many therapies which, for the most part, work for me. I take regular medication, seek counselling when required, do regular meditation, have had hypnosis and acupuncture. I ensure I challenge myself to step out into the world of the unknown. I have been able to fly internationally several times since this time, not always with ease, although I keep on trying.
I have my own successful cultural consulting business where I am challenged daily by talking in front of hundreds of people or having to make quick decision
When I tell people I have panic disorder, they look at me in disbelief. I feel like I am doing what I love and almost living my best life, my health and fitness are my next challenges. Although I have not felt depressed for several years, I know this could again occur in the future.
I do not know when I will have my next panic attack, although I know my family and I have many strategies to assist me to get through. I know this may sound like it is easy for me to say, but I promise there are good people out there to assist and strategies to help you to live your best life.
Case Study E
I was 13 when I was first able to place a name to the feeling, to the illness.
Like most young men I struggled internally with my own self-image, struggled with the ideas and pressures of what it meant to be a man. An abusive home life combined with the daily torment of high school bullies led me down a path ultimately ending in my being diagnosed with Anorexia Nervosa.
Anorexia is an eating disorder and despite the stigma is a disease that affects people of all genders and all races. It is a disease that not only impacts people physically, but mentally as well
I don’t remember exactly when I stopped eating, all I remember is wanting to get bigger, to get that six pack and to be as big as I could to stop the bullying.
In February 2013, I was admitted to the Royal Children’s Hospital in Melbourne, extremely underweight, malnourished, mentally and physically exhausted, still unsure what exactly was going on. I spent the first few days undergoing tests, until I was met by a young doctor who first explained the diagnosis and disease. Assessment; Mental Illness and Mental Health Recovery Assignment
Stigma surrounds us all, regardless of our diagnosis, for me the hardest pill to swallow was the toxic masculinity – the fact I had just been diagnosed with a disease that until that moment I thought was only able to affect women. How could that be? How, after trying so hard to amount to being the man society demanded of me, could I be anorexic?
The battle of acceptance, of understanding that you’re illness doesn’t define you but instead is part of you, although never easy, is the first step to recovery. I was lucky enough to be placed in a ward with four other similarly aged teens, one of which was another young man. I spent four weeks on the ward, four weeks where I was lucky enough to grow and learn from my peers, to begin to break down the thought processes that fed my struggles. For me I found escape in music, with my headphones in I wasn’t some sick, mentally unstable kid, but I was on fire, burning with desire, a want to be more, to be better. More importantly, I found hope in friendship, I grew very close with the others on my ward as we were all battling so hard to beat this disease that it became a much less daunting task when facing it together.
As much as I learned from my time at the Royal Children’s, it took me a long time to realise, even with my acceptance, I was still afraid. For years I refused to let anyone know about my eating disorder, scared of what they would think or how they would react. I sat as the news continued to promote this life long battle as one purely faced by women. That there is the problem, the fault in our society. Yes Anorexia is my result, my outcome, however it is an outcome reached after setting an unrealistic bar and then taking my legs out from under me. The pressure we are under as young men and women to conform and reach markers set generations before us. To stand six feet tall, with huge arms and a six pack or to fit into the smallest size on the shelf are toxic targets, they are our biggest battles. Toxic gender stereotypes and social stigmas are the seeds planted in us as children and when they flourish they do so in the form of our biggest battles – depression, anxiety disorders, or for me, Anorexia Nervosa.
If we are to grow and thrive we need to stop viewing each other as if we were poured from the same moulds. Love is our most inexhaustible source of magic and in a world that at times feels so intent on causing pain, we have the choice to stand united in our differences, love one another without judgement and to bust out these toxic traits, to fight alongside each other regardless of what stereotypes an outdated society expect from us. We are only ever as strong as we are united, as weak as we are divided. Celebrate your differences, don’t stand for bullying, be uniquely who you are each and every day and don’t ever let anyone tell you otherwise.
Assignment B Example Template
General reminders: •
There is no need to include a cover page, we have these details already.
- Please use double (2.0) spacing to allow for in-text comments to be made and feedback to be easily visible to you
- Sub-headings will be helpful to you here. Examples of how to use sub-headings can be found here https://apastyle.apa.org/style-grammar-guidelines/paper-format/headings
- While dot-points are used in this template example, they should not be used in your assessment • Example template starts over page for clarity of reading
Heading of paper
- Introduction – at least one paragraph
- No heading required. Informs the reader of what ‘lies ahead’. What can be expect to be covered, learned
Part 1 Heading
- Choose a short, descriptive heading for your first section
- Identify your chosen diagnosis
- Briefly describe the dominant biomedical discourse around the disorder and how this discourse informs expectations about assessment, aetiology, treatment and clinical recovery of that disorder
- This section will use a few paragraphs. Assessment; Mental Illness and Mental Health Recovery Assignment
Part 2 Heading
- Choose a short, descriptive heading for this section
- Identify a person you have worked with, or a case study from the literature, with the same DSM-5-TR diagnosis as identified in Part 1.
- Drawing on alternative discourses around personal recovery and/or psychotherapeutic literature, describe an alternative way of formulating the problem
- Depending on your formulation framework you may choose to use further subheadings, such as
A short paragraph here.
A short paragraph here… and so on
- Briefly describe the implications for the process of care and treatment from this perspective.
- You will require a few paragraphs in this section
Part 3 Heading
- Choose a short, descriptive heading for this section
- Discuss the compatibility of the biomedical discourse with the alternative discourses around the problem.
- Depending on how much information you choose for this section, you may only require a couple of paragraphs here
Part 4 Heading
- Choose a short, descriptive heading for this section
- Compare and contrast the skills, competencies and attitudes needed by mental health workers to effectively respond to a person with this diagnosis from these discourses
- Depending on how much information you choose for this section, you may only require a couple of paragraphs here
- Include a paragraph to ‘sum up’ your work. It should remind the reader of what has been covered and what the aim of the paper was
- Remember to include a page break before your reference list
- Ensure your references are formatted per APA 7th format. Assessment; Mental Illness and Mental Health Recovery Assignment