This document provides an overview of psychosocial rehabilitation. It defines rehabilitation as enabling individuals to return to their highest possible level of functioning. Psychosocial or psychiatric rehabilitation specifically aims to restore community functioning for those with mental health disorders. It discusses the history of deinstitutionalization and increased focus on community support. Key aspects of psychosocial rehabilitation covered include definitions, approaches, rehabilitation teams, steps, principles, facilities like day care centers, halfway homes, sheltered workshops, and the roles of nurses.
2. OBJECTIVES
At the end of the class student will be able to
• Define Rehabilitation
• Explain the principle of rehabilitation
• State the day care centre
• What is half way home
• Explain sheltered workshop
• Discuss correctional homes
3. INTRODUCTION
Rehabilitation is the process of enabling the
individuals to return to his highest possible level of
functioning. It is an important component of the
community mental health program, and is taken at the
level of tertiary prevention.
4. Psychiatric rehabilitation, also known
as psychosocial rehabilitation, and sometimes
simplified to psych rehab by providers, is the process
of restoration of community functioning and well-
being of an individual diagnosed in mental health or
mental or emotional disorder and who may be
considered to have a psychiatric disability.
5. HISTORY
From the 1960s and 1970s, the process of de-
institutionalization meant that many more individuals
with mental health problems were able to live in their
communities rather than being confined to mental
institutions. Medication and psychotherapy were the two
major treatment approaches, with little attention given to
supporting and facilitating daily functioning and social
interaction.
6. With the founding of Psychosocial Rehabilitation
Canada in 2004, the professional organization
International Association of Psychosocial
Rehabilitation Services (IAPSRS) changed its name
to United States Psychiatric Rehabilitation
Association (USPRA) and the trend is toward the use
of "psychiatric rehabilitation. In 2013, USPRA
removed the national designation from its name,
becoming the Psychiatric Rehabilitation Association
(PRA).
7. DEFINTION
According to Maxwell Jones, 1992
“ Rehabilitation is an attempts to
provide the best possible community
role which will enable the patient to
achieve the maximum range of
activity , interest and of which he is
capable”.
8. • Psychosocial rehabilitation promotes personal recovery,
successful community integration and satisfactory
quality of life for persons who have a mental illness or
mental health concern. Psychosocial rehabilitation
services and supports are collaborative, person directed,
and individualized, and an essential element of the
human services spectrum. They focus on helping
individuals develop skills and access resources needed
to increase their capacity to be successful and satisfied
in the living, working, learning and social environments
of their choice and include a wide continuum of services
and supports. (PSR/RPS Canada, 2013)
9. The vision of psychiatric rehabilitation is to enable
individuals with mental disabilities to recover and to
live as normally as possible in the community.
10. The mission is to engage patients and their families
or caregivers in a collaborative treatment process
that teaches skills and provides supports for
fostering illness management, psychosocial
functioning, and personal satisfaction.
13. REHABILITATION TEAM
The members of rehabilitation team are :
Psychiatrist
Clinical psychologist
Medico social worker
Psychiatric nurse
Counselor
Occupational therapist
Recreational therapist
Other mental health care professionals.
14. STEPS IN PSYCHOSOCIALREHABILITATION
The steps of rehabilitation include :
• Reduction of impairment
• Remediation of disabilities through skill training
• Remediating disabilities through support
• Remediation of handicaps
15.
16. PRINCIPLES
To provide an alternative to inpatient care. Hospitalization is not always
favorable for psychiatric patients; indeed, in many cases it leads to
damaging effects, particularly institutionalization with its excessive
dependency and the separation of patients from their natural location in the
community.
17. PRINCIPLES
Day care programs may also act as a transitional phase for
patients who, while able to leave inpatient care, are not felt
ready to give up completely a degree of supervision and
support.
In some cases day care must also provide a setting for
those whose disability and illnesses are such that they must
expect to receive a degree of support from society, perhaps on
a long term basis.
18. The promotion of more independent social
activity in patients who may have lost this
facility due to illness.
To allow the psychiatric care team to maintain
contact with patients' families, and in many
cases to allow them to work with the family.
19. In maintaining patients' contact with their normal social
background, they can be encouraged not to avoid
problems whose origins lie in the family constellation or
work situation.
The typical work day timing of day care programs,
resembling as it does the normal work week for the
average person, makes attendance at day care of value in
retraining psychiatric patients to normal work week
routine.
20. EXCLUDED PATIENTS FOR DAY CARE
• Suicidal patients
• Patients on heavy medication are rarely suitable for
day care.
• Patients who are so confused and disoriented that they
cannot travel easily
• The patient who lives alone in a socially isolated way
and returns to this unhelpful setting at weekends or in
the evening is often unsuitable for day care.
• Day care is rarely a satisfactory situation for the
'acting out' patient whose behavior is hard to accept
socially.
21. It is the transition facility for mental patients who
no longer need the full services hospital but are not
yet completely ready for an independent living. It
is a transitional supervised residence assigned to
help the patient after discharge from in patient
setting. It is temporary residence where various
kinds of social skill training are given to this
patient: make readjustment to the social life and
employment in the community.
22. AIMS
• To maintain a climate of health and develop and
strengthen the normal capacities and normal
responsibilities and prepares them in the normal
living in the community.
• To alleviate the social isolation experienced by the
mentally ill in communities
• To improve the self concept
• Encourage to develop self image
• To improve self worth
23. DURATION
Minimum of one year to consolidate the gain
achieved over a period of time. This gives the
sufficient time for them to adjust to the family and to
home environment.
24. ACTIVITIESIN HALFWAY HOUSE
Group counseling
Recreational activities
Home visiting
Job placement
Follow-up counseling
Educational and vocational
program
Additional activities such as
religious activities etc
Social skill training
Training in independent
skills.
25. COMMUNITY REHABILITATION
It is a community-based program that promotes
recovery, community integration, and improved
quality of life for members who have been
diagnosed with a behavioral health condition that
significantly impairs their ability to lead meaningful
lives.
26. The focus of community rehabilitation is on
empowering the patient towards independent living
in the community, and strengthening family
relationships.
27. PROGRAMS OF COMMUNITY INTEGRATION
• Preventive Health
• Lifelong Learning Opportunities
• Social / Recreational Activities
28. BARRIERS TO SUCCESSFUL COMMUNITY
REINTEGRATION
• Double stigma
• Lack of family and social support
• Co morbidity
• Adjustment problems
• Boundary issue
29. SHELTEREDWORKSHOPS
Sheltered workshop is work oriented rehabilitation facility
with a controlled working environment to fulfill
individual's vocational needs. In this workshop long term
mentally ill patients can utilize their experience and
abilities by relearning. It helps in progress towards a
normal living and economic independence.
30. CORRECTIONAL HOME
Correctional homes define as
an institution where juvenile
offenders can be held temporarily .
Correctional homes are for young children who have
been found guilty of an offence that would be
categorized as a crime if committed by an adult.
31. ROLE OF NURSEIN PSYCHOSOCIALREHABILITATION
ASSESSMENT
COMMUNITYFAMILYINDIVIDUAL
34. INSTITUTIONSIN INDIAWHICH PROVIDES PSYCHO-SOCIAL
REHABILITATION
GOVERNMENT SECTOR
1)Centre for Rehabilitation
• Central Institute of Psychiatry, Ranchi
2) Centre for Comprehensive care and rehabilitation
• NIMHANS, Bangalore
• IMHANS, Kerala
• Institute of Mental Health, Chennai
35. NON GOVENMENTAL ORGANISATION
• Vishwas Day Care Centre with Vocational Training
• VIMHANS (Vidyasagar Institute of Mental Health and
Neuro-Sciences New Delhi6)
• Shraddha Rehabilitation Foundation- Mumbai