Personal Medicine is an activity that a person does to obtain wellness, rather than something a person takes (e.g., medication) for wellness. [1]
In the psychiatric setting, Personal Medicine, or other self-initiated, non-pharmaceutical self-care activities, is used to decrease symptoms, avoid undesirable outcomes such as hospitalization, and improve mood, thoughts, behaviors, and the overall sense of well-being. [1] The phrase "Personal Medicine" has also been used by the popular press to refer to personalized medicine. [2] [3]
The self-care use of "Personal Medicine" was first introduced in early 2003 as a result of qualitative research conducted by Patricia E. Deegan through the University of Kansas School of Social Welfare. [1] After interviewing individuals who were taking psychiatric medication as a part of their recovery process, Deegan found that:
When describing their use of psychiatric pharmaceuticals or "pill medicine", research participants also described a variety of personal wellness strategies and activities that I have called "Personal Medicine". Personal Medicines were non-pharmaceutical activities and strategies that served to decrease symptoms and increase personal wellness. [1]
Interferences or conflicts between a person's Personal Medicine and their prescribed medications may result in non-adherence and/or a diminished quality of life. [1] Personal Medicine can be integrated with shared decision making within the psychopharmacology consultation to improve adherence. [4] Research by Deegan and Robert E. Drake observed that:
When medications support or enable people to more effectively pursue activities such as employment, parenting, and returning to school, they are perceived by clients as a valued tool in the recovery process. However, if medications interfere with Personal Medicine, such that clients cannot engage in valued social roles and activities, the medications are viewed as blocking the recovery process and are often rejected. Insistence on compliance in such situations is experienced as counter-therapeutic and unhelpful. On the other hand, shared decision making allows the practitioner to work as an expert collaborator, actively helping the client to identify personal medicines and to optimize regimens and dosages of specific medications to support and complement the recovery of valued social roles. [4]
In 2006, Deegan expanded the concept of Personal Medicine into a software program called CommonGround for use in mental health clinics. [5] Users of CommonGround are encouraged to develop their own unique Personal Medicines and are reminded of these personal medicines with subsequent use. [6] The software also includes three-minute video vignettes of people talking about their recovery from mental illness and how they achieved it, i.e., gaining wellness via personal medicine. [6]
The American Psychiatric Association (APA) is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the largest psychiatric organization in the world. It has more than 38,000 members who are involved in psychiatric practice, research, and academia representing a diverse population of patients in more than 100 countries. The association publishes various journals and pamphlets, as well as the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM codifies psychiatric conditions and is used mostly in the United States as a guide for diagnosing mental disorders.
Psychiatric nursing or mental health nursing is the appointed position of a nurse that specialises in mental health, and cares for people of all ages experiencing mental illnesses or distress. These include: neurodevelopmental disorders, schizophrenia, schizoaffective disorder, mood disorders, addiction, anxiety disorders, personality disorders, eating disorders, suicidal thoughts, psychosis, paranoia, and self-harm.
Peer support occurs when people provide knowledge, experience, emotional, social or practical help to each other. It commonly refers to an initiative consisting of trained supporters, and can take a number of forms such as peer mentoring, reflective listening, or counseling. Peer support is also used to refer to initiatives where colleagues, members of self-help organizations and others meet, in person or online, as equals to give each other connection and support on a reciprocal basis.
In medicine, patient compliance describes the degree to which a patient correctly follows medical advice. Most commonly, it refers to medication or drug compliance, but it can also apply to other situations such as medical device use, self care, self-directed exercises, or therapy sessions. Both patient and health-care provider affect compliance, and a positive physician-patient relationship is the most important factor in improving compliance. Access to care plays a role in patient adherence, whereby greater wait times to access care contributing to greater absenteeism. The cost of prescription medication also plays a major role.
Self-care has been defined as the process of establishing behaviors to ensure holistic well-being of oneself, to promote health, and actively manage illness when it occurs. Individuals engage in some form of self-care daily with food choices, exercise, sleep, and hygiene. Self-care is not only a solo activity, as the community—a group that supports the person performing self-care—overall plays a role in access to, implementation of, and success of self-care activities.
The biopsychiatry controversy is a dispute over which viewpoint should predominate and form a basis of psychiatric theory and practice. The debate is a criticism of a claimed strict biological view of psychiatric thinking. Its critics include disparate groups such as the antipsychiatry movement and some academics.
The psychiatric survivors movement is a diverse association of individuals who either currently access mental health services, or who have experienced interventions by psychiatry that were unhelpful, harmful, abusive, or illegal.
Psychiatric rehabilitation, also known as psychosocial rehabilitation, and sometimes simplified to psych rehab by providers, is the process of restoration of community functioning and well-being of an individual diagnosed in mental health or emotional disorder and who may be considered to have a psychiatric disability.
The recovery model, recovery approach or psychological recovery is an approach to mental disorder or substance dependence that emphasizes and supports a person's potential for recovery. Recovery is generally seen in this model as a personal journey rather than a set outcome, and one that may involve developing hope, a secure base and sense of self, supportive relationships, empowerment, social inclusion, coping skills, and meaning. Recovery sees symptoms as a continuum of the norm rather than an aberration and rejects sane-insane dichotomy.
Interpersonal psychotherapy (IPT) is a brief, attachment-focused psychotherapy that centers on resolving interpersonal problems and symptomatic recovery. It is an empirically supported treatment (EST) that follows a highly structured and time-limited approach and is intended to be completed within 12–16 weeks. IPT is based on the principle that relationships and life events impact mood and that the reverse is also true. It was developed by Gerald Klerman and Myrna Weissman for major depression in the 1970s and has since been adapted for other mental disorders. IPT is an empirically validated intervention for depressive disorders, and is more effective when used in combination with psychiatric medications. Along with cognitive behavioral therapy (CBT), IPT is recommended in treatment guidelines as a psychosocial treatment of choice for depression.
Self-help groups for mental health are voluntary associations of people who share a common desire to overcome mental illness or otherwise increase their level of cognitive or emotional wellbeing. Despite the different approaches, many of the psychosocial processes in the groups are the same. Self-help groups have had varying relationships with mental health professionals. Due to the nature of these groups, self-help groups can help defray the costs of mental health treatment and implementation into the existing mental health system could help provide treatment to a greater number of the mentally ill population.
Mentalization-based treatment (MBT) is an integrative form of psychotherapy, bringing together aspects of psychodynamic, cognitive-behavioral, systemic and ecological approaches. MBT was developed and manualised by Peter Fonagy and Anthony Bateman, designed for individuals with borderline personality disorder (BPD). Some of these individuals suffer from disorganized attachment and failed to develop a robust mentalization capacity. Fonagy and Bateman define mentalization as the process by which we implicitly and explicitly interpret the actions of oneself and others as meaningful on the basis of intentional mental states. The object of treatment is that patients with BPD increase their mentalization capacity, which should improve affect regulation, thereby reducing suicidality and self-harm, as well as strengthening interpersonal relationships.
The National Empowerment Center (NEC) is an advocacy and peer-support organization in the United States that promotes an empowerment-based recovery model of mental disorders. It is run by consumers/survivors/ex-patients "in recovery" and is located in Lawrence, Massachusetts in Essex County.
Patricia E. Deegan is an American disability-rights advocate, psychologist and researcher. She has been described as a "national spokesperson for the mental health consumer/survivor movement in the United States." Deegan is known as an advocate of the mental health recovery movement and is an international speaker and trainer in the field of mental health.
Case management is the coordination of community-based services by a professional or team to provide quality mental health care customized accordingly to individual patients' setbacks or persistent challenges and aid them to their recovery. Case management seeks to reduce hospitalizations and support individuals' recovery through an approach that considers each person's overall biopsychosocial needs without making disadvantageous economic costs. As a result, care coordination includes traditional mental health services but may also encompass primary healthcare, housing, transportation, employment, social relationships, and community participation. In the 1940s, this was known as social counseling. It is the link between the client and care delivery system.
The mainstay of management of borderline personality disorder is various forms of psychotherapy with medications being found to be of little use.
CommonGround is a Web app that helps mental health clients identify treatment preferences and effectively communicate them to clinicians. CommonGround Software supports shared-decision making in behavioral health. It brings the voice of the individual to the center of the care team. In this way, the team can focus on "what matters to you" rather than "what's the matter with you?"
Psychiatry is, and has historically been, viewed as controversial by those under its care, as well as sociologists and psychiatrists themselves. There are a variety of reasons cited for this controversy, including the subjectivity of diagnosis, the use of diagnosis and treatment for social and political control including detaining citizens and treating them without consent, the side effects of treatments such as electroconvulsive therapy, antipsychotics and historical procedures like the lobotomy and other forms of psychosurgery or insulin shock therapy, and the history of racism within the profession in the United States.
The taxonomy of the burden of treatment is a visualization created for health care professionals to better comprehend the obstacles that interfere with a patient's health care plan. It was created as a result of a worldwide, qualitative-based study that asked adults with chronic conditions to list the personal, environmental, and financial barriers that burden a patient. The purpose of this visualization is to help health care providers develop personalized management strategies that the patient can follow through a narrative paradigm. The goal is to target interventions, achieve an interpersonal doctor-patient relationship, and improve health outcomes.
Coordinated Specialty Care (CSC) is a recovery-oriented treatment program designed for people with first episode psychosis (FEP). CSC consists of collaborative treatment planning between the client and the client's care team, consisting of mental health clinicians, psychiatrists, and case managers. CSC includes individual and family therapy, medication management, psychoeducation and support, case management, and support surrounding education and employment goals. The program is considered an early psychosis intervention and is intended to be used shortly after symptoms onset.