Mental health care

Briefly outline the specialist field of enquiry and your learning
� Clearly describe one piece of innovative practice from within that field that you have
learned about and its evidence base
� Discuss why the particular innovation might be helpful to a defined group of mental
health users
� Explore how the innovation might be incorporated into and developed within a
particular area of practice.

The Tidal model as a Specialist field of enquiry on the provision of Mental Health Care


There’s a saying that states that there “is more than one way to skin a cat.” This is well
demonstrated in the realm of provision of mental health care because there are several unique
approaches to treating mental illnesses (Martin and Henderson, 2011). The tidal model is one of
the more recent ways of handling these conditions and the key factor that sets it apart from the
other fields of enquiry is the fact that it was developed through a collaborative process between
nurses and individuals who had previously used mental care facilities. Its key feature is the
empowerment of the patient in terms of taking action that will lead to a full recovery (Barker et
al, 2005).

Like other fields of enquiry, this approach is based on and dependent on information that the
healthcare provider is receiving from the mental patient. The tidal model is a pioneer approach
and is the first of its kind to be internationally acclaimed as a mid-range theory of nursing
(Barkway and Patricia, 2009). This model is also the first one to be employed as a basis for
initiatives in interdisciplinary mental health care programs. This model, unlike other existing

approaches is the only one that takes into account the recovery journey of a mental patient
including the time when the patient is at ‘rock bottom.’

The key innovative practice that is used in the Tidal Model is through the patient narrating his or
her story. This is known as “story telling’ or ‘telling my story’ and it borrows heavily from the
modus operandi at the Alcoholics Anonymous movement. What happens is that the patient is
given an opportunity to narrate his or her version of events regarding the possibly traumatic life
event that has led them to have a mental disorder. The mentality behind this practice is that what
the patient needs is to come face to face with his or her inner truths and thus reclaim control that
they have lost. This is in stark contrast with conventional psychiatric practice that applies
complex theoretical information that is highly objective to a patient’s condition yet each mental
illness is a subjective matter that changes from patient to patient (Sullivan and Garland, 2010).

The narrations that take place are not merely organized story telling sessions but actually a
process that enables the patient to discuss his or her issues and correlates them with the effects
that they have had on the life of the individual. This may be in the form of an undue burden or a
case of being deprived something valuable, say love or deserved status. The more the patient
narrates, the closer he or she will draw towards making a decision regarding what action needs to
be taken concerning the matter. The sooner the patient makes this realization, the quicker the
recovery becomes. A key element of these sessions is the reclamation process (Cotrell, 2003).

Reclamation is tantamount to recovery and this happens once a patient comes to terms with their
true identity and decides to take back the elements of this identity that have been lost. In making
a decision about what needs to be done, the patient is placed in a position to isolate what he or
she can do on their own and also the things that the patient cannot regain unaided. With respect

to the second category things, the patient then has to seek help from other people. At this stage, a
prerequisite for recovery is the patient’s acceptance of external guidance and help (Barker, 2003;
Holland and Reese, 2010).

Given the fact that the tidal model requires a mental patient to be in a lucid state of mind and also
that it targets mental conditions that have been caused by a life event, it is ideal for people who
suffer from Post-Traumatic Stress Disorder or PTSD in short. As the name suggests, Post
Traumatic Stress Disorder is a mental conditions that results from an event that the patient
experiences in the course of his or her life. Common causes of this mental illness include bad
experiences in war, terror attacks, the loss of a loved one in a violent manner and even physical
or psychological abuse such as rape or torture. These events replay themselves over and over
again in the mind of the patient thus traumatizing them each time. Narration of their ordeal can
be of tremendous help to the patient’s recovery process (Barker and Barker, 2008).

With a high number of war veterans suffering the effects of PTSD, it is essential that the army’s
medical department, specifically the one that deals with counselling to adapt the tidal model into
the already existing support programs that have been instituted to offer aid the recovery of army
officers who have developed mental disorders following nasty experiences at the battlefield
(Chambers et al, 2004). The beauty of this is that the model will ensure that the intervention of
nurses working with these patients is only doing what is absolutely necessary for the patient’s
recovery (Stevenson et al, 2002; Thompson and Dowding, 2002).


Barker P.; Barker, PJ 2008. “The Tidal Commitments: extending the value base of mental health
recovery”. Journal of Psychiatric and Mental Health Nursing 15 (2): 93–100
Barker, P 2003 Assessment in Psychiatric and Mental Health Nursing – In Search of the Whole
Person Nelson Thornes London
Barker, P.; Buchanan-Barker P. (2005). The Tidal Model: A Guide for Mental Health
Professionals. London: Brunner-Routledge. ISBN 1-58391-801-9.
Barkway, Patricia (2009). “Theories on Mental Health and Nursing”. In Elder, R.; Evans, K. &
Nizette, D. Psychiatric and Mental Health Nursing (2 ed.). Mosby. pp. 119–134

Chambers R, Boath E, Rogers D. 2004. Clinical Effectiveness and Clinical Governance Made
Easy Radcliffe Medical Press. Oxford
Cottrell S. 2003. Skills for Success. Palgrave McMillan. Basingstoke
Holland K and Rees C 2010 Nursing: Evidence Based Practice Skills. Oxford University Press
Martin V, Henderson E (eds) 2011 Managing in Health and Social Care Routledge, London
Sullivan. E.J. and Garland G. 2010 Practical Leadership and Management in Nursing New Jersey
Thompson C, Dowding D. (eds) 2002 Clinical Decision Making and Judgements in Nursing
Churchill Livingstone. London
Stevenson, C.; Barker, P. & Fletcher, E. 2002. “Judgement days: developing an evaluation for an
innovative nursing model”. Journal of Psychiatric and Mental Health Nursing 9 (3):