La Trobe Rural Health School, La Trobe University, Bendigo, VIC 3552 Australia.
Psychiatric Services Professional Development Unit, Bendigo Health, Bendigo, VIC 3552 Australia.
Int J Ment Health Syst. 2015 Mar 10;9:11. doi: 10.1186/s13033-015-0005-y. eCollection 2015.
Recovery-oriented care is a guiding principle for mental health services in Australia, and internationally. Recovery-oriented psychiatric rehabilitation supports people experiencing mental illness to pursue a meaningful life. In Australia, people with unremitting mental illness and psychosocial disability are often detained for months or years in secure extended care facilities. Psychiatric services have struggled to provide rehabilitation options for residents of these facilities. Researchers have argued that art participation can support recovery in inpatient populations. This study addressed the research question: Is there a role for the creative arts in the delivery of recovery-oriented psychiatric rehabilitation for people with enduring mental illness and significant psychosocial disability detained in a secure extended care unit?
The study had two major aims: to explore the experiences of consumers detained in a rural Australian secure extended care unit of an art therapy project, and to examine the views of nurse managers and an art therapist on recovery-oriented rehabilitation programs with regard to the art therapy project. A qualitative descriptive design guided the study, and a thematic network approach guided data analysis. Ethics approval was granted from the local ethics committee (AU/1/9E5D07). Data were collected from three stakeholders groups. Five consumers participated in a focus group; six managers and the art therapist from the project participated in individual interviews.
The findings indicate that consumer participants benefitted from art participation and wanted more access to rehabilitation-focussed programs. Consumer participants identified that art making provided a forum for sharing, self-expression, and relationships that built confidence, absent in the regular rehabilitation program. Nurse manager and the art therapist participants agreed that art participation was a recovery-oriented rehabilitation tool, however, systemic barriers thwarted its provision.
The transformation of mental health services towards a recovery orientation requires commitment from service leaders to provide evidence-based programs. Psychiatric rehabilitation programs based on local need should be included in public mental health services. This study supports the use of art-based rehabilitation programs for people detained in rural secure extended care facilities. Introducing these programs into clinical practice settings can improve the consumer experience and support organisational culture change towards a recovery orientation.
以康复为导向的护理是澳大利亚和国际精神卫生服务的指导原则。以康复为导向的精神科康复支持患有精神疾病的人追求有意义的生活。在澳大利亚，患有持续精神疾病和社会心理残疾的人经常在安全的长期护理设施中被拘留数月或数年。精神科服务一直在努力为这些设施的居民提供康复选择。研究人员认为，艺术参与可以支持住院人群的康复。本研究提出了一个研究问题：对于在安全的长期护理病房中被拘留的患有持久精神疾病和严重社会心理残疾的人，创意艺术在提供以康复为导向的精神科康复方面是否有作用？
该研究有两个主要目的：探讨澳大利亚农村地区一个安全的长期护理病房的消费者对一个艺术治疗项目的体验，以及检查护士经理和艺术治疗师对康复导向的康复计划的看法，包括对艺术治疗项目的看法。该研究采用定性描述设计，并采用主题网络方法进行数据分析。当地伦理委员会（AU/1/9E5D07）批准了伦理。数据收集来自三个利益相关者群体。五名消费者参加了焦点小组；六名经理和该项目的艺术治疗师参加了个人访谈。
研究结果表明，消费者参与者从艺术参与中受益，并希望更多地获得以康复为重点的项目。消费者参与者认为，艺术创作提供了一个分享、自我表达和建立信心的论坛，而这些在常规康复计划中是缺失的。护士经理和艺术治疗师参与者一致认为，艺术参与是一种康复导向的康复工具，但系统障碍阻碍了其提供。
精神卫生服务向康复方向转变需要服务领导者承诺提供基于证据的项目。基于当地需求的精神科康复项目应纳入公共精神卫生服务。本研究支持在农村安全长期护理设施中使用基于艺术的康复项目。将这些项目引入临床实践环境可以改善消费者体验，并支持组织文化向康复方向转变。
