Tidal model of mental health

The Royal Ottawa Mental Health Centre was the first North American site to implement the Tidal Model of Mental Health Recovery and Reclamation. This empowering approach to practice focuses on learning persons' stories as the key to practising person-centred nursing. The authors, who constituted the Tidal implementation team at ROMHC, describe the journey to excellence in psychiatric and mental health nursing practice following the introduction of the model.

The emerging concept of recovery in mental health is often only loosely defined, but appears to be influenced more by specific human values and beliefs, than scientific research and 'evidence'. As a contribution to the further development of the philosophical basis of the concept of recovery, this paper reviews the discrete assumptions of the Tidal Model, describes the development of the Model's value base -- the 10 Commitments -- and illustrates the 20 Tidal Competencies, which aim to generate practice-based evidence for the process of recovery...

It has been suggested that patient-centred care be adopted as the primary method of mental health service delivery. This approach has been widely described in the literature and various frameworks for its delivery have been developed; however, many lack evaluation at present. The primary aim of this study was to gain an understanding of psychiatric nursing practice with people who self-harm using a qualitative descriptive approach. One of its objectives was to explore psychiatric nurses' approach and philosophical underpinnings to care...

The concept of recovery is an important part of contemporary mental health services. During the past 5 years, Tidal Model projects, focused on developing the recovery attitude within nursing practice, have been established in several different countries. The Tidal model emphasizes 10 philosophical assumptions the "Ten Commitments," that are central to recovery-focused practice.

OBJECTIVE: Weaning predictors are often incorporated in protocols to predict weaning outcome for patients on mechanical ventilation. The predictors are used as a decision point in protocols to determine whether a patient may advance to a spontaneous breathing trial. The impact of including predictors in a weaning protocol has not been previously studied. We designed a study to determine the effect of including a weaning predictor (frequency-tidal volume ratio, or f/Vt) in a weaning protocol...

The Tidal Model of Mental Health Recovery has contributed to the transformation of nursing practice at the Royal Ottawa Hospital (ROH), a psychiatric and mental health facility in Ontario, Canada. Ten commitments affirm the core values of the Tidal Model. These commitments guide person-centred, collaborative, strength-based practice and they facilitate Tidal teaching. In this paper we illustrate fidelity to the values, principles and processes of the model and the commitments while implementing the model. We share how some of the commitments are realized in our Tidal teaching and provide examples of successes and challenges...

Launching the Tidal Model: evaluating the evidence This paper reports on two evaluations of the Tidal Model, in the context of two separate acute admission wards, one in Birmingham (2004) and the other in Newcastle (2001), and makes recommendations concerning the criteria and type of reasoning appropriate to evaluating the evidence the two projects have generated. In the Birmingham study, results showed that in the year following the introduction of the Tidal Model, the total number of serious untoward incidents such as physical assault, violence and harassment, decreased by 57%...

The Tidal Model has been implemented in Rangipapa, a regional secure mental health forensic unit in New Zealand. A phenomenological study was undertaken to obtain reflective description of the nursing care experience from the perspective's of four Registered Nurses and four Special Patients. Five major themes were identified that appeared to capture the experiences of the participants. The themes show changes to the unit's unique culture and values following implementation of the model. These changes engendered a sense of hope, where nurses felt they were making a difference and patients were able to communicate in their own words their feelings of hope and optimism...

TOPIC: Overview of the theoretical and practical basis of a new model of psychiatric and mental health nursing practice. PURPOSE: To illustrate the history of the development of the model and some of the processes that aim to re-empower the patient and develop genuinely collaborative approaches to care. SOURCES: Literature review, author's research, and related clinical experience. CONCLUSIONS: The Tidal Model provides a practice framework for the exploration of the patient's need for nursing and the provision of individually tailored care...

Psychiatric research and practice involves the colonization of the personal experience of problems of human living. From a Western perspective, this process shares many similarities with the subjugation of women, people of colour and people embracing non-Christian faiths and cultures. The Tidal Model is a mental health recovery and reclamation model, developed to provide the framework for discrete alternatives to the colonizing approach of mainstream psychiatric practice. The Model asserts the intrinsic value of personal experience and the centrality of narrative in the development of contextually bound, personally appropriate, mental health care...

AIM: To implement a new model of psychiatric nursing that uses person-centred care to empower people with acute mental health problems. METHOD: A pilot study involved the introduction of the model into two wards in the acute mental health services in Newcastle City Health Trust. This was followed by introduction of the model into all nine adult acute wards in the service. One ward was evaluated for six months before and six months after introducing the model and nurses' perceptions of the model have been assessed using questionnaires...

This paper reports on the process and outcomes of the evaluation of an innovative nursing model (the Tidal Model). In relation to process, the study has been used to refine the methodology in terms of defining important variables to take as outcome measures to be analysed both descriptively and inferentially. In relation to outcomes, the pre-post-test design has generated significant findings in relation to improved patient care.

In this discussion, James Noak critiques Fletcher and Stevenson's (2001) article 'Launching the Tidal Model in an adult mental health programme'. Responses from the authors and Phil Barker, author of the Tidal Model, follow.

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...