For my Clinical 1 class, we were required to volunteer 50 hours and I lucky was already connected to MOCA house a program connected to NAMI. This paper was all about researching the population, looking into the need, implications, and how art therapy interventions fit for this population.
Mental illness can cover a wide range of mental health disorders. Some specific diagnosis can include anxiety disorders, addictive disorders, personality disorders, depressive disorders, psychotic disorders, neurodevelopmental disorders, as well as many more.
Specific Characteristics The population of clinical mental health covers a variety of diagnoses and levels of functioning. Moca House is a program of the National Alliance on Mental Illness (NAMI), which provides help and education for adults who suffer from depression, anxiety, schizophrenia, addictive behavior, autism, and many more. Most clients are outpatients with high to low levels of functioning. The clinical mental health population has risks associated with troublesome outcomes which include lower financial status, unemployment, substance abuse, suicidality, lower social functioning, and lower education (Asselmann, Wittchen, Lieb, & Beesdo, 2018). Moca house specifically focuses on recovery and illness management similar to Dalum et al., (2018) study which implemented Illness Management and Recovery (IMR) rehabilitation program. IMR has been found to help individuals with severe mental illness and to improve self-management, increase functioning, limit the severity of symptoms, and to achieve remission (Dalum et al., 2018). Mental health services focus on recovery to provide support to clients as well as helping them find places within their communities giving clients opportunities and chances to take part in activities (Allan, Barford, Horwood, Stevens, & Tanti, 2015). Individuals who participated in an Illness Management and Recovery program (IMR) found an improvement in psychiatric symptoms that affect many within the clinical mental health field. Some of these improvements included coping with symptoms, psychosocial functioning, a decrease in suicidal ideation, an overall decrease in hospital need (Dalum et al., 2018). Another characteristic of the Moca population is the rural location and diversities it brings. Urban cities have more accessibility, availability, and acceptability of mental health services while Moca house is one of the few offering important resources to this community (Smalley, Rainer, & Warren, 2012). Needs One main need for the mentally ill population is education for the general public but also those diagnosed. Clients who are diagnosed are at risk when hearing stigmatization and may internalize them creating threats to their self-esteem and self-efficacy (Corrigan et al., 2010). Public stigma is an issue and it is “the prejudice and discrimination that occur when the general population endorses the stigma” (Corrigan et al., p. 517, 2010). The National Alliance on Mental Illness (NAMI) is an organization for people with diagnosed mental illness as well as the families to educate and care. Many times, for those with mental illness, self-care and empowerment are limited but, NAMI services and programs help improve upon both (Bister et al., 2012). These facilities are necessary and provide a multitude of support for those diagnosed as well as their caregivers and families. Educating the public also leads to change by implementing facts many in the general public have misunderstood (Corrigan et al., 2010). Caregivers and family play an important role for the mental illness population and providing education for them leads to better chances for the client. NAMI helps increase caregiver confidence, helps advocate for mental health, and works to reduce caregiver strain (Bister et al., 2012). While NAMI focuses on clients and their needs, creating great tools for the population, it also provides strategies for parents and caregivers to better communicate and build on emotional regulation (Bister et al., 2012). Some specific issues NAMI educates on is a normal reaction to mental illness, skill- building, the biology of mental health, planning for a crisis, and advocacy which, all work toward the improvement of family problem-solving and communication, self-care, decreasing parental stress, and empowerment (Bister et al., 2012). Overall education and contacts are needed to inform the general public about what mental illness really is and inform loved ones on how they can help.
Implication There are a lot of challenges while working with a population of clinical mental health. The diversity and variety of those who are treated with mental illness mean counselors and therapists' way of treatment is also diverse and most are not specialized within a specific pathology or theory. One implication is the lack of empirical evidence found for this diverse group and the lack of specialization across this field. Many times, the lack of evidence is a result of small sample sizes, case studies, and studies having poor scientific quality (Mirabella, 2015). Specifically, art therapy may be beneficial for this population, but the lack of empirical data makes it hard to definitely claim art-based therapy success; This could also be skewed by each individual depending on differences across patients and their ability to enjoy the therapy (Mirabella, 2015). Due to this population’s variety, the difficulty of claiming a therapy helpful or is beneficial can be an issue across the field. This is why many are not specialized but have a broad understanding and are willing to be flexible and resourceful (Allan et al., 2015). Another implication in the clinical mental health population is the stigma that surrounds mental health, which affects the general public but also people diagnosed with mental illness. Studies have found that stigmas of mental illness interfere with the lives and goals of clients diagnosed with serious mental illness (Corrigan et al., 2010). A challenge for therapists and counselors in this population is to battle the interferences and help advocate for their clients. Studies have found while protests are rarely beneficial and sometimes worsen stigmatizing, education and contact are two processes that lead to positive changes and better outcomes (Corrigan et al., 2010). Another internal limitation for the clinical mental health population is the social isolation and loneliness of clients and combating those symptoms. Social isolation and distress are two issues limiting people diagnosed with mental illness and group sessions can oftentimes help provide more inclusion and decrease the symptoms of distress (Allan et al., 2015).
Art Interventions A variety of interventions are implemented for the clinical mental health population which has been described as a diverse population with a high need of variety due to each client’s unique differences. Art therapy is sometimes implemented as an intervention within treatment for this population. Art therapy provides a more holistic approach so, with this diverse population, it seems to work well (Mirabella, 2015). Many symptoms come with mental illness and anxiety is often a symptom of those attending clinical mental health and ranks high in diseases diagnosed (Abbing et al., 2018). The use of fine arts helps those with anxiety to rather focus on the creative experience, allowing individuals to express emotions, feelings, memories, and practice new copings skills (Abbing et al., 2018). Recovery Art therapy interventions set goals to improve well-being reduces symptoms and distress, and increase social inclusion (Allan et al., 2015). The hope is that through these sessions, clients will develop artistic confidence and growth in independent identity, and in group sessions, art therapy will offer an opportunity for socialization (Allan et al., 2015). Some studies have found that art therapy has helped clients cope with symptoms and improve quality of life (Abbing et al., 2018). Drass (2015) conducted many art therapy interventions with those diagnosed with borderline personality disorders. One specific art intervention, that could be beneficial for clinical mental health is a project called ‘Strength Medallions’ which allows the clients to focus on hope and empowerment. The objective is to use cardboard and a lanyard and create symbols of strength which opens up the discussion of opposing forces in the client’s life. Many times, these strength medallions can be used to help the client self-sooth and practice mindfulness. This intervention is based on individuals with borderline personality disorders which, maybe a part of the clinical mental health population, but can prompt a sense of control and start conversations about choices within the client’s life.
Conclusion Mental illness covers a wide range of mental health disorders from high to low functioning and because of this, the population it is made up of a lot of diversity and variety. Moca House is one rural program that works with many different individuals, providing help and education through NAMI. Recovery and illness management are two objectives for Moca House which further supports and integrates people with mental illness within their communities. One big need for this population is education on mental health and on stigmatizations. There are many challenges working in mental health including combating public and self-stigma. Being flexible and resourceful are also needs for this population. Although most intervention research has not definitely been beneficial for this population, art therapy is often implemented and has proven to be a holistic way to provide treatment. More research and studies should be conducted to help gain a better understanding of this diverse population.
References
Abbing, A., Ponstein, A., van Hooren, S., de Sonneville, L., Swaab, H., & Baars, E. (2018). The effectiveness of art therapy for anxiety in adults: A systematic review of randomized and non-randomized controlled trials. PLoS ONE, 13(12), 1–19. doi: 10.1371.0208716
Allan, J., Barford, H., Horwood, F., Stevens, J., & Tanti, G. (2015). ATIC: Developing a recovery-based art therapy practice. International Journal of Art Therapy, 20(1), 14–27. doi: 10.1080/17454832.2014.968597
Asselmann, E., Wittchen, H. ‐U., Lieb, R., & Beesdo, B. K. (2018). Sociodemographic, clinical, and functional long‐term outcomes in adolescents and young adults with mental disorders. Acta Psychiatric Scandinavia, 137(1), 6–17. doi: 10.1111.12792
Bister, T., Cavaleri, M. A., Olin, S. S., Shen, S., Burns, B. J., & Hoagwood, K. E. (2012). An evaluation of the NAMI basics program. Journal of Child and Family Studies, 21(3), 439–442. doi: 10.100710826-011-9496-6
Corrigan, P. W., Rafacz, J. D., Hautamaki, J., Walton, J., Rüsch, N., Rao, D., … Reeder, G. (2010). Changing stigmatizing perceptions and recollections about mental illness: The effects of NAMI’s In Our Own Voice. Community Mental Health Journal, 46(5), 517–522. doi: 10.100710597-009-9287-3
Dalum, H. S., Waldemar, A. K., Korsbek, L., Hjorthøj, C., Mikkelsen, J. H., Thomsen, K., … Eplov, L. F. (2018). Illness management and recovery: Clinical outcomes of a randomized clinical trial in community mental health centers. PLoS ONE, 13, 1–15. doi: 10.1371.0194027
Drass, J. M. (2015). Art therapy for individuals with borderline personality: Using a dialectical behavior therapy framework. Art Therapy: Journal of the American Art Therapy Association, 32(4), 168–176. Retrieved from http://uc.opal-libraries.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=eric&AN=EJ1081693&site=ehost-live
Mirabella, G. (2015). Is art therapy a reliable tool for rehabilitating people suffering from brain/mental diseases? The Journal of Alternative and Complementary Medicine, 21(4), 196–199. doi:10.1089.2014.0374
Smalley, K. B., Rainer, J., & Warren, J. (2012). Rural Mental Health: Issues, Policies, and Best Practices. New York: Springer Publishing Company. Retrieved from http://uc.opal-libraries.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=e000xna&AN=464789&site=ehost-live
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