Question

1). One of the major problems faced by individuals with mental illness and their families is stigma. Stigma leads to community misunderstanding and discrimination. Identify stigmas attached to the mentally ill population.

2). Recovery is the single most important goal for individuals with mental disorders. Discuss recovery components and their role in the treatment of mental illness. Discuss trauma-informed care.

3). Individuals seeking mental health care must provide informed consent, a legal procedure to ensure that the client knows the benefits and costs of treatment. Discuss how gaining informed consent may be complicated in mental health treatment.

4). A client diagnosed with schizophrenia is being voluntarily committed to a local mental health unit. Differentiate between voluntary and involuntary treatment (commitment).

5). Defense mechanisms or coping styles are mechanisms that mediate the client’s reaction to emotional conflicts and to external stressors. Discuss several defense mechanisms used by individuals to deal with conflict or stress.

Answer 1

* Stigma is when someone sees one in a negative way because of their mental illness.

Discrimination is when someone treats one in a negative way because of their mental illness.

Stigma and discrimination both can make mental health problems worse and stop a person from getting the help they need.

People with mental illness face both the challenge of the disease along with the stereotype and other's judgmental thoughts.

Many people with serious mental illness are challenged doubly. On one hand, they struggle with the symptoms and disabilities that result from the disease. On the other, they are challenged by the stereotypes and prejudice that result from misconceptions about mental illness. As a result of both, people with mental illness are robbed of the opportunities that define a quality life: good jobs, safe housing, satisfactory health care, and affiliation with a diverse group of people.

The impact of stigma is twofold -

- Public stigma is the reaction that the general population has to people with mental illness.

- Self-stigma is the prejudice which people with mental illness turn against themselves.

Both public and self-stigma may be understood in terms of three components: stereotypes, prejudice, and discrimination.

## Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her potential.

Fundamental components of mental health recovery are -

• Self direction - Individuals determine their own path of recovery with autonomy, independence, and control of their resources.

• Empowerment - Consumers have the authority to participate in all decisions that will affect their lives, and they are educated and supported in this process.

• Strengths based - Recovery focuses on valuing and building on the multiple capacities, resiliencies, talents, coping abilities, and inherent worth of individuals. The process of recovery moves forward through interaction with others in supportive, trust-based relationships.

• Peer support - Mutual support plays an invaluable role in recovery. Consumers encourage and engage others in recovery and provide each other with a sense of belonging.

• Respect - Eliminating discrimination and stigma are crucial in achieving recovery. Self-acceptance and regaining belief in oneself are particularly vital.

• Responsibility - Consumers have a personal responsibility for their own self-care and journeys of recovery. Consumers identify coping strategies and healing processes to promote their own wellness.

• Hope - Hope is the catalyst of the recovery process and provides the essential and motivating message of a positive future. Peers, families, friends, providers, and others can help foster hope.

**Trauma-Informed Care (TIC) is an approach in the human service field that assumes that an individual is more likely than not to have a history of trauma. Trauma-Informed Care recognizes the presence of trauma symptoms and acknowledges the role trauma may play in an individual’s life- including service staff.

The intention of Trauma-Informed Care is not to treat symptoms or issues related to sexual, physical or emotional abuse or any other form of trauma but rather to provide support services in a way that is accessible and appropriate to those who may have experienced trauma. When service systems operating procedures do not use a trauma-informed approach, the possibility for triggering or exacerbating trauma symptoms and re-traumatizing individuals increases.

## The dual ethical goals of informed consent are the protection of the welfare and promotion of the autonomy of patients. As a legal doctrine, informed consent guarantees certain rights of patients in determining their treatment.

The problem is that it is hardly possible for a clinician to assess a mentally ill patient's capacity to give informed consent for a clinical examination until s/he has examined the mental state of the patient. Practically, this dilemma is eased in most civilised countries by provisions of law—for example, a mental health act, which may order or require a doctor to examine a patient even without a patient's consent. When informed consent for a mental and physical examination is required, though, the same conditions are necessary as for informed consent to treatment and participation in research. A mental disorder should not prevent a patient from understanding the nature and purpose of the examination, from choosing decisively whether to have it done or not to have it done, from communicating his/her consent, and from accepting that the examination is needed or warranted.
The clinical assessment of a particular patient's capacity to give informed consent in a case of mental disorder is better informed by the consideration of conditions necessary to give informed consent than by making inferences from the general features implied by a specific diagnosis. An assessment of a particular patient's capacity to give informed consent by the consideration of conditions necessary to give informed consent may remain difficult clinically, yet such an assessment may strengthen ethically a clinical decision about a mentally disordered patient's capacity to give informed consent.

## Voluntary commitments are limited to those individuals 14 years of age and older, with the exception of adolescents committed by a parent or guardian per physician recommendation from an emergency room,and involuntary commitments  are not limited to any age group.

* Voluntary treatment Is when a person seeks treatment for a condition, he or she has the choice to acquire the necessary procedure or medication. Sometimes, these procedures are surgeries. Occasionally, the voluntary treatment is cosmetic and entirely voluntary without the prescription or diagnosis coming from a doctor. Other times, the treatment is an important step in correcting a condition or illness. Many voluntary treatments are for injuries incurred either at work or in the private life of the victim. Usually, the process is necessary, but some may choose not to seek medical help unless someone convinces them to do so at a hospital,

where as,

Involuntary treatment is when the person acquires involuntary treatment, it can happen because of certain conditions such as comas, unconsciousness or mental illness. Certain inmates in prison will receive involuntary treatment with the consent coming from the prison or state. The hospital will usually provide healthcare processes for someone that cannot grant consent unless there is a standing order to refrain from doing so on threat of a lawsuit. However, those in a coma or that come into the facility unconscious will receive treatment without giving permission. If the person cannot understand, lacks judgment or must comply through force such as when a patient at a mental health facility, treatment is normally involuntary.

## Defence mechanisms -

Defense mechanisms are behaviors people use to separate themselves from unpleasant events, actions, or thoughts. These psychological strategies may help people put distance between themselves and threats or unwanted feelings, such as guilt or shame.

• Denial - Denial is one of the most common defense mechanisms. It occurs when one refuse to accept reality or facts. One block external events or circumstances from mind so that one don’t have to deal with the emotional impact. In other words, one avoid the painful feelings or events.

• Repression - Unsavoury thoughts, painful memories, or irrational beliefs can upset. Instead of facing them, one may unconsciously choose to hide them in hopes of forgetting about them entirely.

• Projection - Some thoughts or feelings one have about another person may make uncomfortable. If one project those feelings, misattributing them to the other person.

• Displacement - Direct strong emotions and frustrations toward a person or object that doesn’t feel threatening. This allows one to satisfy an impulse to react, but one don’t risk significant consequences.