Open AccessAn update on Individual Placement and Support
Author(s) -
Bond Gary R.,
Drake Robert E.,
Becker Deborah R.
Publication year - 2020
Publication title -
world psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 15.51
H-Index - 93
eISSN - 2051-5545
pISSN - 1723-8617
DOI - 10.1002/wps.20784
Subject(s) - supported employment , mental health , mental illness , medicine , quality (philosophy) , public relations , psychology , work (physics) , nursing , medical education , psychiatry , mechanical engineering , philosophy , epistemology , engineering , political science
World Psychiatry 19:3 October 2020 practice wisdom and for experiential knowledge. A second implication is that clinical explanatory frameworks are not universal. Alternative explanatory frameworks exist, and it is simply not possible to know whether it is ultimately more beneficial to a person to frame his/her experience as, for example, a spiritual crisis, a trauma-related response, or an illness relapse. This is challenging, since some people experiencing mental health-related crisis actively want “psychiatric rescue”, i.e. an authoritative institutionalized response which temporarily takes decisions on behalf of the person in order to restore stability. However, the phenomenon of revolving door and the challenges of improving long-term outcomes in psychosis indicate the limits of any single explanatory framework. Therefore, any clinical explanation for experiences should be offered with tentativeness rather than authority, and clinicians might usefully sign-post service users towards alternative perspectives, such as Alternatives To Suicide, Hearing Voices Network, Mad Pride, positive psychotherapy for psychosis, post-traumatic growth, spiritual emergence, and trauma-informed approaches. More challengingly, a focus on the experience of social exclusion may generate momentum away from individual-level explanations of experience and towards activities to generate collective action to improve mental health and social care system compliance with human rights legislation. Modesty in clinical knowledge claims is empirically justified.