Definition and Overview
Also referred to as psychosocial rehabilitation, psychiatric rehabilitation refers to the mental health discipline that involves providing all the resources needed to help mentally ill patients reintegrate themselves back to society. This is different from de-institutionalization wherein patients with mental health problems are not allowed to leave the hospital or institution.
Psych rehab requires a multidisciplinary approach to be successful and it involves the following:
Recovery – One of the first steps of rehabilitation is to guarantee the recovery of patients. While some of them may not completely recover, the rehab will help them cope with their symptoms more effectively.
Empowerment – Once the patients go back to society, they will be subjected to the standards and expectations of others. For many of them, it will be difficult, more so if others learn of their background and predicament. However, when the patients are empowered and motivated, they are more likely to sustain themselves and even rise above these expectations.
Collaborative – There is more than one professional helping these patients to recover and move forward from their illness. In fact, most of those that offer rehabilitation programmes are organizations with teams that are composed of psychiatrists, social workers, and community-trained workers, to name a few.
Personalized – Rehabilitation programmes provided to patients are according to a set of standards, guidelines, and existing methods that can be modified according to the needs, skills, and overall personality and outlook of the patient. Rehab cannot succeed without the patient's active participation and interest. The rehab is expected to focus on building up or reinforcing the innate strengths of these patients.
In the end, the goal of psychiatric rehabilitation is to give the patients hope, motivation, respect for oneself, as well as social, economic, and other types of skills so they can reintegrate themselves back to the society more efficiently and effectively.
Who Should Undergo and Expected Results
A psych rehab is intended for long-term mentally ill patients. A poor mental health is expected to deprive a person with the necessary set of skills to be fully functional, contributory, and supportive of a community. In the same manner, one has to live with the stigma that comes with having the health problem, which may only further force the patient to retreat and disassociate himself or herself from the rest.
The different signs and symptoms of mental health can also increase the risk of discord, conflict, and ineffective communication in the group where the patients belong. According to Psychiatry.org, a person with a mental health problem is more likely to:
- Withdraw from society and lose interest in others
- Lose the ability to concentrate or understand himself and others
- Sense a disconnection between himself and the environment
- Develop an illogical way of thinking
- Promote unusual, imaginary, and exaggerated beliefs
- Feel a sense of distrust and suspicion toward others
The success of the rehab significantly varies from one person to another as many factors come into play. One of which is the patient’s receptiveness or openness to newer or modified skills, as well as the chance to get back to society.
Nevertheless, patients can expect all throughout their rehab that:
- They will be respected.
- They will develop a new sense of belief in their capability to grow and learn.
- They will experience personal growth through continuous support and learning.
- The services or resources they need to recover quickly and effectively will be accessible.
- They will work alongside a diverse team that can address different areas of their needs and challenges.
- The will learn to make their own decisions and in the process, become empowered individuals.
- They can build their own support group in the community, including their family members, with the help of their rehab team.
- They will experience growth in various areas of their lives.
How Does the Procedure Work?
There are many considerations with regard to psychiatric rehabilitation, such as the needs and goals of the patients, the services that can be offered by the team, and the kind of mental health problem these patients have, to name a few.
Overall, the process begins by determining the goals or desired outcomes of the patient (person-centered approach). The role of the psychiatric team is to ensure that the patients will be guided in creating their objectives for themselves based on their knowledge, expertise, and their assessment of the patients.
The team then proceeds to assisting patients in determining the steps they need to take to achieve their specific objectives. They will also present the resources that will be helpful and will be unique to the circumstance (individualized approach).
Typically, psych rehab programmes offer the following;
- Health and wellness support including nutrition or diet
- Symptom relief management through the used of correct medications
- Reduction of stress and distress through different techniques including meditation
- Introduction to the right support groups
- Building up of the patient’s own support group that can be composed of other patients in rehab, family, friends, and even colleagues at work
- Medical services such as consistent long-term counseling and accessible physician care (including urgent and emergency care)
- Legal assistance
- Education through enrollment in vocational schools or colleges
- Work placement
- Housing such as apartment living or group homes
The team also provides:
- Necessary living skills like personal care, home safety, travel safety, and life planning
- Programs and therapies that enhance the patient’s social and technical skills
- Financial assistance
- All other resources that might be needed by the patient such as those related to taking up hobbies, health insurance, and financial accounts (e.g., bank accounts)
Once the resources have been identified and the skills are already taught to the patients, the team’s responsibility then shifts to monitoring. The communication and interaction between the patient and the team should be long-term, consistent, and continuous. Both should be able to modify their approaches to ensure better outcomes.
Possible Complications and Risks
The risks come from the fact that it’s not a one-size-fits-all approach, as many factors have to be considered. There are various areas that need to be worked on and even if just one fail, the whole programme will also fail.
Further, patients will depend largely on the team during the first few phases of the rehab. However, a good number of psychiatrists are trained in hospitals, not in community setting, so they may not have the right set of skills to help the patients 100%.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013
American Psychiatric Association. Practice Guideline for the Treatment of Patients with Major Depressive Disorder. 3rd edition. October 2010. Available at: http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf Accessed: March 10, 2014