The Tidal Model: developing an empowering, person‐centred approach to recovery within psychiatric and mental health nursing

Abstract

Nursing theories and nursing models have a low profile within psychiatric and mental health nursing in the United Kingdom. This paper describes the philosophical and theoretical background of the Tidal Model, which emerged from a 5-year study of the 'need for psychiatric nursing'. The Tidal Model extends and develops some of the traditional assumptions concerning the centrality of interpersonal relations within nursing practice. The model also integrates discrete processes for re-empowering the person who is disempowered by mental distress or psychiatric services or both. The paper reports briefly on the ongoing evaluation of the model in practice.

The mental health of nurses in the UK

“…The debate is fuelled by a sense of unease on the part of nurses that their role needs clarification in a health care context where technical skills seem to be more eagerly sought than caring skills. Barker (2001) suggests that health care is becoming emotionally distant and that nursing's long-standing attachment to the concept of caring through interpersonal relationships has been superseded by the need to provide evidence of their utility within a post-positivist research paradigm. Because nursing/caring is frequently marginalised in health care strategy and planning, mental health nurses in particular have tried to validate their work by assuming the title of 'nurse therapist', thus acknowledging that nursing is often not perceived to be a therapeutic activity.…”

"I Want to Go Home, but I Need to Stay": The Transition to become Ready for Discharge from Acute Psychiatric Wards, as Narrated by Persons Who Experienced Acute Psychotic Illness

“…The mental health care in the different care settings intends to follow and adjust to persons' changing care needs during phases of acute psychotic illness [28]. The nurses plan the discharge in cooperation with the persons in care, their family members and local mental health professionals intending to ensure the discharge as smooth, safe and secure as possible.…”

“…This may address their needs of safety, security and to be cared for in the specialised mental health inpatient care provided by nurses present day and night(cf. [28,47]). Other authors have also reported that persons with severe mental illness express feeling unsafe and insecure before discharge about if the community mental health care can meet their care needs [9,[20][21][22].…”

“…[11,28]). We reflected on the following question: how do persons' experience and describe the process of becoming ready for discharge from acute psychiatric wards?…”

Interdisciplinary Capstone Course: Synthesising Theory and Practice through an Innovative Mental Health Clinical Placement

“…Further, studies have shown that mental health care delivered by multidisciplinary teams improves mental health outcomes [17] [19]; promotes individualized care [9]; and, supports a person's positive experience of recovery [3].…”