Existential concerns of individuals living with chronic mental illness in Guam.

摘要

Individuals living with chronic mental illness experience a host of challenges associated with the symptoms of their illness. In an effort to help restore healthy functioning, mental health treatment for individuals with chronic mental illness thus focuses primarily on symptom reduction and management. Recent research exploring the lived experience of individuals with chronic mental illness suggests that apart from their symptoms, these individuals also encounter existential issues related to the self, relationships with others, temporality, making meaning out of the illness experience, and managing life with the illness. At the same time, however, this research has tended to focus on distinct aspects of chronic mental illness rather than the overall experience of day-to-day living with the illness, resulting in a fragmented view of the phenomenon. Moreover, these studies have been conducted primarily in Europe, as well as North America, Australia, and South Africa, but not in Asia or the islands of the Pacific. The goal of this study was twofold: to gain a comprehensive understanding of the lived experience of chronic mental illness in the Pacific Island of Guam, as well as to examine whether the themes found in the extant literature are applicable to individuals from Pacific Islander and Asian cultures living in Guam. Interpretative Phenomenological Analysis was used to guide the research, emphasizing the phenomenological approach to understanding the lived experience of individuals and how they make meaning of their experience. Ten individuals living with chronic mental illness in Guam were interviewed. The interviews were designed to elicit descriptions of the participants' experience of chronic mental illness and its impact on their daily lives. Results suggest that the participants encountered existential concerns regarding defining and knowing the self, navigating relationships with others, trying to understand the illness, managing the illness, desiring control, and living a meaningful life with the illness, and that the role of the family impacted these concerns. Implications for clinical practice in Guam include both the integration of existential-oriented psychotherapy, as well as interventions that involve the individual's family to optimize the family's impact on the individual's existential well-being. The electronic version of this dissertation is at OhioLink ETD Center, www.ohiolink.edu/etd.