Discussion on Mental Illness and Health


Sandy Jeffs has used poetry, and storytelling to share her lived experience of mental health and illness.
•    She is a prize-winning poet and author who has lived with schizophrenia for 35 years. This film was created by George Clipp for Tell Me A Story, a digital storytelling project of Something In Common and the Australian Human Rights Commission

•    ABC OPEN:Bearing Witness from Speak Your Mind,  written by and about Sandy Jeffs.
•    Street poetry reading (spoken words) from Sandy Jeffs
•    In "Medicated", Jeffs converts the names of her 21 successive or simultaneous medications into verbs.
o    'Medicated'- poem in written words
o    . 'Medicated' was published in 2015 in a collection of poems by Sandy Jeffs:   Jeffs, S (2015). The Mad Poets Tea Party. North Melbourne, Vic.:Spinifex
•    Sandy Jeffs poetry reading (spoken words) for The Crazy Chicks Showcase at the Epsy-
o    Jeffs, S. (2002). A Thesaurus of Madness.  In Jeffs, S,  Poems from the madhouse (2nd ed.).(pp 77-78) North Melbourne, Vic.: Spinifex. Poem in written words (pp 77-78).
The lived experience of people like Sandy Jeffs is the focus of, and reflected in, policy documents like the National framework for recovery-oriented mental health services: guide for practitioners and providers (http://www.health.gov.au/internet/main/publishing.nsf/content/mental-pubs-n-recovgde )
Explain how the lived experience of Sandy Jeffs, as told through stories and poetry, enable mental health professionals to align their practice with the recovery principles as outlined in the National Recovery framework for recovery orientated mental health services.
In your discussion you need to address the following:
•    The concept of the lived experience of mental health and illness;
•    The concept of recovery in the experience of mental health and illness;
•    An outline of the main ideas from the National framework for recovery-oriented mental health services: guide for practitioners and providers;
•    Provide examples from the work of Sandy Jeffs to illustrate your argument about how mental health professionals can implement recovery orientated practice.
•    You must, at a minimum, refer to the two poems by Sandy Jeffs, and the audio-visual link, located with this question on the LEO site. 
•    Links have been placed on LEO to the Department Health site A National framework for recovery-oriented mental health services: guide for practitioners and providers.  You must access this document but you may access other academic sources to support your discussion.


Mental Illness and Health- Concept of Livid Experience and Recovery


Mental illness is among the top ten disabling diseases worldwide accounting for 13% of the total disease burden. Mental disorders such as schizophrenia and psychotic type disorders and depression are on the rise (Glandinoto, 2015). In Australia, it is estimated that significant number of people (one in five) will experience some form of mental illness in a 12 month period (AIHW 2018).There is a correlation between mental illness, the symptoms and risks of other disease such a cardiovascular disease, diabetes, cancer, and HVV/ AIDS.  This is due to the fact that a person suffering from mental illness generally experiences the following- poor management of the illness, financial disadvantage, stigma, substance abuse, etc (Glandinoto, 2015). This essay attempts to explore the newer unchartered territories of livid experience and recovery in patient suffering with mental illness. The resource material for this essay was procured by using online database such a PUBMED, Google Scholar, various Government aided websites and You Tube.

Livid Experience, Mental Illness Patients and Nurses

Livid Experience is defined as the subjective perception of one’s experience of health or illness (Lived experience, n.d.).  The livid experience is harmonious with the principle of nursing i.e. a holistic approach is used to form basis of nurse-patient relationship.  Livid experience cannot be quantified, besides it is not constant as it may change over time and social environment, hence rigorous qualitative methods must be used for its inquiry (Glandinoto, 2015). The livid experience is based on Parse’s Theory –Human Becoming, which is a new and radical way of visualizing health.  This theoryemphasizes the uniqueness of an individual and how they can create their own unique destiny.  Each patient is unique, with his or her own strengths; the livid experience would tap into that aspect to make a holistic, patient centric experience. In other words, all the concerned viz, the patient, the nurse, the surroundings and the health goals are interconnected revolving around the treatment that is unique to the patient.

Recovery Model of Mental Illness

Conventional medicine has always been a paternalistic culture.  The doctor listens to the patient’s concerns, acts on them by means of further investigation e.g. a laboratory test followed by diagnosis of the disease, leading to prescription of appropriate medication. The patient has very little to do or say in such a model, even alternative opinion or suggestion from patient’s are not taken kindly by the medical advisor. Conversely, the field of psychiatry has its primary focus on symptoms which in turn led to detailed assessments, rating scales and standardized interviews to document thecondition.  Overtime monitoring the symptoms closely and administration of optimized psychotropic medication lead to the reducing symptoms of psychosis, giving hope to the patients that they can have a chance at leading a normal life. During the late 20th century, a substantial change occurred both in medicine as well as society. The recovery model evolved during this time.  The recovery model was very different from the earlier paternalistic model.  The recovery model focuses on people with mental disorders taking control of their lives; it is an approach that does not focus on complete symptomatic recovery, instead it gives importance to flexibility and control over problems and life(Jacob, 2015).

Domains of Recovery

The basic framework of the recovery model comprises of 17 capabilities that are bundled into five fields of practice called ‘practice domains’.  These domains are overlapping and used parallelly.

•    Domain 1: Promoting a culture and language of hope and optimism-
A service culture and language that makes the patient feel valued, important, safe and welcome; one that promotes hope and optimism is central to recovery oriented practice and service delivery.
•    Domain 2: Person 1st and holistic
Placing the person suffering from mental illness first, given precedence and priority over anything else- being the centre of practice and service delivery. This focuses on viewing a person’s life holistically.
•    Domain 3: Supporting personal recovery
Recovery, which is defined and led by a person’s suffering and occupies the chief position rather than being just an additional task.
•    Domain 4: Organizational commitment and workforce development
A workforce having skilled people who are well equipped, supported with appropriate resources in addition to service, work environment and organizational cultureare the key to the recovery model.
•    Domain 5: Action on social inclusion and the social determinants of health, mental health and wellbeing
A person experiencing mental health issues ought to have basic human rights, right to challenge stigma, discrimination, poor and unequal living circumstance.  These can have significant effect on recovery(Australian Health Ministers’ Advisory Council, 2013).

Sandy Jeffs- A Model for Livid Experience, and Recovery.

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Sandy Jeffs is a prize-winning poet and author who was diagnosed with schizophrenia when she was only 23 years old in 1976.  She has lived with schizophrenia for over 35 years. When she was 40 years old, her first book of poems was published.  In Sandy’s words- “17 years of psychotic hell with nothing happening, no purpose in life, and no reason to get out of bed, no hope and then suddenly having my poetry published was the beginning of something on a more positive note.”  Writing became pivotal to Sandy’s existence, having a purpose made her feel better and recover. She became an advocate and community educator, sharing her experience of living with mental illness (SomethingInCommonAus, 2013).  

Sandy is a role model for the livid experience and the recovery model.  Describing the time when she was diagnosed with schizophrenia asbeing completely shattered - like a death sentence. To make matters worse, the doctors told her that she would go deeper into madness to the point of no return. She started documenting her illness and her madness via poetry. By 2016, Sandy had published seven books on poetry. In 2010, she published her memoir “Flying with Paper Wings: Reflections on Living with Madness which gave a detailed account of her struggle with schizophrenia and how she managed to conquer it (Pearson., 2010).

Sandy’s Poems- Here I sit and Medicated.
Here I sit was the first poem penned down by Sandy on November 17, 1976.  It gives a detailed account of what she was going through internally at that point of time. One can easily sense her disillusion from the repeated use of the word “burden” and her loss of clarity which was submerged and her being in an eternal state of confusion and torturous maize of distress finally ending it with a gut-wrenching “renders me helpless” encompassing her state of mind Jeffs, S (2012). In contrast, Medicated is a funny humorous account of all the medication she has to take to be able to function well.  She very cleverly uses the 21 medicines as verbs and has a quirky play on words. She starts the poem asking the reader to “roll up and join her on the medication trolley- one she has been on for years”. Delightful lines such as ‘I’ve been Largactiled with bitter syrup’, ‘I was so Stelazined I was like a cat on a hot tin roof’ bring a smile(Jeffs, S, 2013).  One can easily see the transition in Sandy though her poems. Her single minded focus on getting better and positive attitude comes across shining.  She has broken the glass ceiling, wearing the stigma associated with mental illness on her sleeve. She champions the cause of the mentally-ill, fighting for equal rights, sense of dignity and belonging.

Not Everything is Peaches and Cream!
Livid experience and recovery model seem perfect, however there are some stumbling blocks that make it difficult to achieve outcomes as desired. The care givers or nurses are not trained extensively to handle mentally-ill patients and thereby limiting the recovery that could be achieved. Some of the concerns the care givers were unable to handle were-
(i)    Managing challenging behaviour
(ii)    Various factors such as environmental and organizational 
(iii)    Lack of skill, experienceandknowledge
(iv)    Lack of hypervigilance and anxiety
(v)    Duty of care
(vi)    Negative attitudes (Glandinoto, 2015).


It is observed that lived experience and intrinsic qualities of people with mental health issues are at the core of recovery-oriented culture (Australian Health Ministers’ Advisory Council, 2013). The concept of recovery was put forth by and for people with mental health issues to document their experiences and journey, thereby lending a helping hand to other with similar condition.  Recovery is not the destination but the journey that enables them to lead a life of normalcy with minimum dependence on others. An exemplary model of livid experience and recovery model is Sandy Jeffs. A successful writer and poet who has personally fought the schizophrenia battle for over 35 years.  She found her passion, her calling in poetry and has used it as a medium to channel all her energy which led to her road to recovery.


The key role of recovery-oriented culture within mental health service is to help people find the right combination of treatment and support.  A very important role in this is played by the normalization of a mentally ill person’s life.  Giving them equal opportunity, wiping the stigma associated with mental illness and lending them a helpful hand are the main factors that would help them on their road to recovery. An outstanding individual like Sandy Jeffs, who suffered with mental illness first hand, has shown the world that schizophrenia is just another disorder that can be controlled,and cannot be a stumbling block or excuse from achieving success.


AIHW (2018) Mental health services in Australia. Retrieved from https://www.aihw.gov.au/reports/mental-health-services/mental-health-services-in-australia/report-contents/summary/prevalence-and-policies.
Australian Health Ministers’ Advisory Council. (2013). A National framework for recovery-oriented mental health services: guide for practitioners and providers. Retrieved from http://www.health.gov.au/internet/main/publishing.nsf/content/mental-pubs-n-recovgde 
Byrne, L., Happell, B., Welch, T. & Moxham L J. (2012) Things you can't learn from books’: teaching recovery from a lived experience perspective. International Journal of Mental Health Nursing. https://doi.org/10.1111/j.1447-0349.2012.00875.x
Glandinoto, J, A., & Edward, K, L., (2015) The phenomenon of co-morbid physical and mental illness in acute medical care: the lived experience of Australian health professionals. BMC Research Notes. 8:295. DOI 10.1186/s13104-015-1264-z
Lived experience. (n.d.) Medical Dictionary. (2009). Retrieved April 08 2018 from https://medical-dictionary.thefreedictionary.com/lived+experience
Ioanna Papathanasiou, I., Sklavou,M.,& Kourkouta, L. (2013). Holistic nursing care: theories and perspectives. American Journal of Nursing Science. ( 2)1,  1-5. doi: 10.11648/j.ajns.20130201.11
Jacob, K. S. (2015). Recovery model of mental illness: a complementary approach to psychiatric care. Indian Journal of Psychological Medicine, 37(2), 117–119. http://doi.org/10.4103/0253-7176.155605
Jeffs, S. (2012) Medicated and Mcmadness. Retrieved from http://centreformedicalhumanities.org/medicated-and-mcmadness/
 Jeffs, S. (2013) The mad women in this poem. Retrieved from http://centreformedicalhumanities.org/the-madwoman-in-this-poem/
Jeffs, S (2012) The beginnings of a professional lunatic. Retrived from https://www.killyourdarlings.com.au/2012/12/the-beginnings-of-a-professional-lunatic/
Pearson, A. (2010) Sandy Jeffs on her poetry, madness +rec  Retrieved from https://www.youtube.com/watch?v=BKgAeHQ-IFQ.
SaneAustralia (2017). What not to say to someone with schizophrenia? Retrived from https://www.youtube.com/watch?v=n5lCc_9gmP0
SomethingInCommonAus. (2013). Sandy Jeffs. Retrived from https://www.youtube.com/watch?v=pEszvWRsgZg
Stanghellini,G., Ballerini,M.,  Presenza, S., Mancini, M., Raballo, A., Blasi, S., Cutting, J. (2016) Psychopathology of lived time: abnormal time experience in persons with schizophrenia. Schizophrenia Bulletin, 42 (1), 45-55, https://doi.org/10.1093/schbul/sbv052


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