Psychosocial rehabilitation

For clear understanding about psychosocial rehabilitation

1. PSYCHOSOCIAL REHABILITATION PRESENTED BY : Miss. Mahima Eliazer M.Sc Nursing 1 st Year TMCON

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.

11. PSYCHIATRIC REHABILITATION APPROACHES Psycho education Working with Families Group Therapy Social skill training

12. 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.

13. STEPS IN PSYCHOSOCIAL REHABILITATION The steps of rehabilitation include : Reduction of impairment Remediation of disabilities through skill training Remediating disabilities through support Remediation of handicaps

14. 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.

15. 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.

16. 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.

17. 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.

18. 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.

19. 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.

20. 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

21. 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.

22. ACTIVITIES IN 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.

23. 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.

24. The focus of community rehabilitation is on empowering the patient towards independent living in the community, and strengthening family relationships.

25. PROGRAMS OF COMMUNITY INTEGRATION Preventive Health Lifelong Learning Opportunities Social / Recreational Activities

26. BARRIERS TO SUCCESSFUL COMMUNITY REINTEGRATION Double stigma   Lack of family and social support Co morbidity Adjustment problems Boundary issue

27. SHELTERED WORKSHOPS 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. 

28. 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.

29. ROLE OF NURSE IN PSYCHOSOCIAL REHABILITATION ASSESSMENT COMMUNITY FAMILY INDIVIDUAL

30. INTERVENTION INDIVIDUALS INTERVENTION   Skill training Supportive intervention Community supportive programs Vocational rehabilitation activities FAMILY INTERVENTION Family therapy Group therapy Family Counseling Supportive psycho educational programs Crisis intervention programs Outreach programs COMMUNITY INTERVENTION   Halfway homes Residental prevention programs

31. INSTITUTIONS IN INDIA WHICH 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

32. 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

33. ?????? A N Y Q U E R I E S ??????

34. BIBLIOGRAPHY Manisha Gupta. A textbook of therapeutic modalities in psychiatric nursing , Page No. 237-243 https://www.scribd.com/doc/58002245/Facilities-for-Psycho-Social-Rehabilitation   https://www.google.co.in/url?sa=t&rct=j&q=&esrc=s&source=web&cd=3&cad=rja&uact=8&ved=0ahUKEwin_o-VsozYAhXKQY8KHfbtCe0QFg MAI&url =https%3A%2F%2Fwww.psyrehab.ca%2Fpages%2Fwhat-is-psr&usg=AOvVaw3CTzHA5saXnM-nhj0IeB5O https://en.wikipedia.org/wiki/Psychiatric_rehabilitation