Person-centred approaches for people with long-term mental health problems

This chapter will explore the core values that underpin a person-centred approach to working with people who have long-term mental health problems. The emphasis will be on adapting models and approaches to person-centred mental health care, to different stages in a person’s recovery from, or life with a long-term mental illness. In order to adapt how we work with people during transition from an acute phase of illness in to recovery; during recovery; whilst maintaining wellness and during relapse; it will be proposed that it is our responsibility as practitioners to be flexible; to fulfil different roles in the relationship; and to respond to the person’s needs rather than expect the person with mental illness to fit in with prescribed professional roles and teams. This will require the reader to accept two things. First, that healthcare services exist within complex systems and that it may be a challenge to adapt some of these principles to the context in which they work; and second, that the therapeutic relationship is fundamental to all of our work with people with long-term mental health problems. We must first invest in the relationship with our clients so that any of the models or organisational frameworks might be employed effectively.

In order to have the chapter centred on the experience of people with long-term mental health problems, it is illustrated by a letter from Jonathan, a service-user with schizoaffective disorder. It is a reasonable critique of service-user involvement that one or two voices do not represent the experience of all and that it is not possible to generalise from the narratives of, in this case, Jonathan, and to translate his experience to others. However, there is power in his narrative and as you will see below, Jonathan acknowledges “I can only tell you what I need and this may be different from the next person, but at least it is a start.” His narrative will be used to link theory to practice and to explore different approaches to person-centred care.