Mental Health Issues in the Sunnyboy, Essay Example

Introduction

In Sunnyboy, the  story of Jeremy Oxley is revealed from different perspectives. The audience can see how the schizophrenic artist experienced his illness, and how his family felt helpless about trying to support him. The mental health issues were clearer for the family members than Jeremy, who simply said that he lost connection with reality. His father and brother, however, describe the experience as “losing him” without hope for treatment. The below paper will look at the different experiences from a medical and therapeutic point of view, and the treatment options available for recovery or living a quality of life. It is also important to examine  the role of his partner in making him come to terms with his condition and living with the mental health issues.

Mental Health Issues

In the documentary, it is evident that the patient, Jeremy does not want to admit that he has a problem. He does not admit his mental health issues, as he lives with them, and  – as he describes – he becomes disconnected from the reality. This is hard on his loved ones, in particular his father and brother. He  blames them for putting him into a mental hospital when he became sick and his behavior became erratic. His wife, also a nurse, Mary Oxley Griffiths knows much more about the condition and understands how she can help her husband.  While the “clouds”  – as Jeremy describes them – do not fully go away, he can slowly start reflecting on his behavior and his past actions. He, however, still does not admit that his schizophrenia is responsible for his bad choices. His brother is protective of Jeremy, and does not fully understand him. At the same time, Jeremy blames his brother for trying to intervene in his life, which – according to him – is normal. The difference between the outsiders’ and Jeremy’s perception of his condition is that Jeremy does not believe he has a problem, he simply says he is different, while refusing being labeled as “schizophrenic”. His wife tries to explain him that his behavior is caused by the condition, but he does not believe it, either.

The Australian Health Minister’s Advisory Council (2010), according to The National framework for recovery-oriented mental health services describes the process of  personal mental health  recovery “as being able to create and live a meaningful and contributing life in a community of choice with or without the presence of mental health issues”.

According to the Practitioner Guide to Recovery Principles (Australian Health Minister’s Council, 2010), there are six principles or different “reflective questions” that support recovery. From the documentary, it is evident that Mary knows and applies the below principles.

The uniqueness of the individual is important to take into consideration. Mary, for example, knows that Jeremy needs to understand his illness, condition, and its consequences. On the other hand, she also knows that playing music and making up random lyrics helps him understand his condition better, just like painting self-portraits. Further, Mary encouraged Jeremy to choose from real choices. While he tried various medication, he now found the drug that keeps him level, and reduces the symptoms of his schizophrenia.

The principle of attitudes and rights came in the picture within the documentary when Jeremy’s mother talked about the treatment. While she was worried about her son, just like her husband and other son, she was unable to make mental health services involved, without the consent of Jeremy. This created a difficult situation, as the patient did not realize that he had a problem, and – as he said – self-medicated with alcohol. Mary is the first person who is trying to help Jeremy who treats him with dignity and respect: the fourth principle of recovery. She does acknowledge that he is unique, and an individual, and does not label Jeremy as a “schizophrenic”.

Mary also involves Jeremy in decisions about his future, treatment, while trying to encourage him to make the right choices. This does not always happen, and she struggles to keep the diabetic patient off chocolate, for example. A good example of the sixth recovery principle, evaluation is provided in the last few minutes of the documentary, after the band’s reunion. Mary tells the audience that she is planning to monitor the progress of Jeremy’s recovery, and make sure that she works with him on positive outcomes.

It is also important to examine the main barriers of Jeremy’s recovery process. The NSW Consumer Advisory Group – Mental Health Inc (2009) talks about self-stigmatization, and medication side effects. It is clear from the documentary that Jeremy has a low self-respect, and he does blame himself for not being “clear”. On the other hand, he also states that he is ill, not well, and cannot help his wife out, who is looking after him and the house, as well as her three children. It is likely that Jeremy suffered from medication side effects severely, before he finally found the right drug and dosage, and he talks about his time spent at the mental hospital as one of the worst experiences of his life. The document (NSW Consumer Advisory Group – Mental Health Inc, 2009, p. 4) also states that “identified barriers to recovery for consumers as a collective group include when a person becomes hopeless and passive in their care”. This barrier is clearly present in Jeremy’s case.

The Schizophrenia Commission (2012) talks about individual care and the role of nurses. The first recommendation of the article is to improve acute care, as many patients with schizophrenia end up being treated at a hospital after a serious incident or mental health episode. The report states that research shows many of the acute care units where schizophrenia patients are treated are chaotic, unorganized, and stressful. This makes patients’ experience more negative, and reduces the chance of recovery. Further, the report also indicates that “physical health problems are not addressed and there is a lack of therapy or exercise and little for people to do” (The Schizophrenia Commission, 2012, p. 25).

It is evident from Jeremy’s case that patients are generally less motivated to exercise, therefore, the hospital should put measures and programs in place to encourage their mental and physical recovery.

Regarding alternative and regular treatment plans, Lehman et al. (2010) states that health care workers need to develop and implement an individual treatment plan, which is relevant to the assessment of the patient’s mental health. Targets for all treatments need to be created after the diagnosis, and therapeutic alliances need to be formed. The document distinguishes between two phases of treatment: stabilization phase, and stable phase. It is important to note that schizophrenia still needs to be managed in a stable phase, and this is true for Jeremy Oxley’s case.

Remington,  Foussias, and Agid (2010) states that treatments’ optimal outcome consists of three different elements: quality of life, functional, and clinical. A nurse dealing with these patients needs to focus on all the above areas.

Heinssen, Goldstein & Azrin  (2014) highlight the importance of early intervention. While in the documentary Mental Health Services refused to intervene, the seriousness and risk level of the condition should always be assessed by health care professionals.

Nuechterlein et al. (2008) talk about the importance of connecting with the patient on an individual level, and a good example can be seen in the documentary. Being both the partner and the nurse of Jeremy, Mary managed to fully understand the struggles of the patient, their individual preferences, and related conditions. She negotiated between Jeremy and the family members.

Likewise, Wise-Rankovic (2014) talks about patient-centered care, and the importance of considering the whole patient. The author mentions that medication non-adherence can be reduced and prevented by using complementary alternative treatments, along with medication. Further, she mentions that caregivers have to address the negative cognitive impact of schizophrenia, by making sure that patients stay active, stimulated, and motivated.

As it has already been mentioned, schizophrenia needs to be managed long term. Harrow  & Jobe (2013) highlight the fact that studies do not confirm the effectiveness of drugs on patients  long term, and only a small proportion of schizophrenia sufferers become symptom-free. This indicates that a patient-centered, individual care plan needs to be created for long term. Likewise, Caldas (2011) also mentions that community-based interventions can improve patient outcomes, while offering a greater flexibility for carers and family members.

Boardman et al. (2010), however, also mention that integrated care can put  extra pressure on social services. Recovery, according to Turton et al.’s (2010) list of the Delphi exercise’  results depends on social inclusion, autonomy, self-management, interventions, and post discharge care, among others.

Conclusion

The above review of Jeremy Oxley’s personal experience with schizophrenia and the perception of his family about the impact of the illness has revealed that nurses and health care workers have a crucial role in delivering long-term, individualized, patient centered health intervention plans, monitoring the progress of the patient, and involving them in important decisions, while ensuring that they are informed of the alternatives and opportunities available for them. Mary, Jeremy’s wife demonstrated how one can create a relationship with the patient to tailor the treatment to their needs and maximize the benefits of the intervention.

References

Australian Health Minister’s Council (2010) Practitioner guide to recovery principles that support recovery-oriented mental health practice. Retrieved from http://www.health.gov.au/internet/main/publishing.nsf/content/705FBCD381853F0BCA257C1D000607A9/$File/recovpra.pdf

Boardman, J. (2010). Social inclusion and mental health. RCPsych Publications.

Caldas, J. M. (2011). Long-term mental health care for people with severe mental disorders. European Union Publication, 5.

Goldstein, Amy B., and Susan T. Azrin. (2014) “Evidence-Based Treatments for First Episode Psychosis: Components of Coordinated Specialty Care.”

Harrow, M., & Jobe, T. H. (2013). Does long-term treatment of schizophrenia with antipsychotic medications facilitate recovery?. Schizophrenia bulletin, 39(5), 962-965.

NSW Consumer Advisory Group – Mental Health Inc. (2009) Developing a recovery oriented service provider resource for community mental health organisations. Retrieved from           http://www.mhcc.org.au/media/2498/nsw-cag-mhcc-project-recovery-literature- review.pdf

Nuechterlein K.H., Subotnik K.L., Turner L.R., Ventura J., Becker D.R., & Drake R.E. (2008). Individual placement and support for individuals with recent-onset schizophrenia: integrating supported education and supported employment. Psychiatric Rehabilitation Journal, 31 (4), 340-349.

Remington, G., Foussias, G., & Agid, O. (2010). Progress in defining optimal treatment outcome in schizophrenia. CNS drugs, 24(1), 9-20.

Turton, P., Wright, C., White, S., Killaspy, H., & Psych, M. R. C. (2010). Promoting recovery in long-term institutional mental health care: an international Delphi study. Psychiatric    Services, 61(3), 293-299.

Wise-Rankovic, A. (2014) Improving treatment options in schizophrenia: considering the whole patient.  Journal for Clinical Studies. Volume 6 Issue 4