Watson’s Carative Factor 9 As Related to Reducing Recidivism in Mental Health

Recidivists are defined as patients who are readmitted frequently into the mental health system, sometimes called the revolving door syndrome. Up to 50% of service users are readmitted within 12 months. The assumed needs for hospitalization are safety, security, stabilization as most inpatient crises are precipitated by danger to self, others or gravely disabled-an inability to care for self. “Social mal-adaptation” is a predictive risk factor in relapse-the inability to cope living in a community that is unwilling to tolerate mental illness in its presence. Other variables include the individual’s diagnosis, age, use of substances, motivation for compliance, medical history, and economic status. Jean Watson’s Carative Factor 9 is the Human Need for Affiliation and Belonging; without relationships humans lose contact with reality. The opposite of affiliation is isolation. The isolation leads to a sense of despair and hopelessness, depression and suicidal thoughts. Ideally, the person does seek treatment before acting out and comes to the security of our accepting, safe structure and therapeutic milieu. The dream is to establish meaningful connection with the outside community to create that sense of belonging and purpose in lasting relationships in order to effect a reduction in the rate of recidivism at RCH. Accomplishing this may mean adding a position beyond the role of discharge planner, possibly a care coordinator or life coach to track and assist the individual’s progress way beyond the actual day of discharge. We may be able to actively participate in getting the person involved in rehab programs, church programs, adult day programs, classes, volunteering or even a job to instill a sense of well-being and restore equanimity.