Development of a Recovery-Oriented Nursing Program for People with Mental Illness

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Recovery is a way of living a satisfying, hopeful, and contributing life even with the limitations caused by illness. A recovery-oriented approach, which emphasizes the importance of a partnership between consumer and clinician, has been recognized as a promising alternative service that can facilitate healing and well-being of people with serious mental illness. The aims of our project were to clarify the concept of recovery from the perspective of consumers as well as to develop and evaluate a recovery-oriented nursing program.In 2004, a qualitative study was conducted to clarify the concept of recovery as defined by people with serious mental illness. Forty seven persons (35 men and 12 women) with mental illness in the community provided written consent to be interviewed. Qualitative analysis of interviews revealed two categories of recovery : "rebirth as a new person while holding the wound within" and "transcendence of social norms and reclaim of own life values". Five factors rel … More ated to recovery were also identified : "learning how much is too much and challenging the impossible", "learning illness self-management", "combining social resources to meet the basic needs", "having support and trust from society", and "suffering from wishing for an ordinary life". The first two categories suggest recovery at a personal level, while the latter three categories suggest the nature of social systems that undermine confidence and competence of socially marginalized people. The findings indicated the need for a transformation of societal values toward mental illness.In 2005, a recovery-oriented nursing program was developed and its relevance in clinical practice was examined. The program consisted of total of four sessions to promote "finding hope for recovery", "advocating for oneself", "honoring selfishness" and "reconstructing a new sense of self". The program utilized small group discussions. Eight persons (six men and two women) with mental illness in the community provided written consent to participate in the program. Discussions in the program were tape-recorded and observations were recorded in field notes. Discussions in a small group helped participants learn new coping strategies from each other, discover strength in each other, and reintegrate their illness experiences into their lives. A central issue raised by the participants was not how to manage the illness and disabilities but how to live his/her life, suggesting recovery is a total process and spans beyond the mental health system. The findings indicated the need for a holistic approach in which person's life is utilized as an organizing construct of recovery rather than an approach in which persons are defined by pathology and deficits. Less