Mental illnesses are the most devastating and disabling of the diseases, affecting the mankind, giving its afflicted and their families a life of suffering, trauma and travail. They totally destroy the persons, personally sap their capacity to lead a normal family and social life and drive them to a life of isolation from the family and society.
Often the entire personality of the person with mental health problem becomes shattered due to dys-functioning of the mental faculty. What is needed is not just medical intervention but a multiple therapeutic approach to being them back even to a semblance of normal functionality. The need is, along with psychiatric treatment a scientifically planned and organised counselling and rehabilitation program aimed at recovery and reintegration.
While the illness affects the individual, the families who are the chief caregivers suffer equally because of lack of skills to handle critical situations, inadequate knowledge of the nature of illness dismally poor facilities to treat the illness.
Persons with psychiatric/mental health problems have limitations with their capacity to perform certain tasks and function due to illness. Psycho social rehabilitation helps them overcome this limitation as tabulated below.
CHALLENGES/LIMITATIONS DUE TO MENTAL ILLNESS/PROBLEM
CHALLENGES/LIMITATIONS DUE TO MENTAL ILLNESS/PROBLEM
- Impairment: Loss of normal function or abnormality of mental or physical function.
Eg: Hallucinations, Delusions, Depression, Anxiety
- Dysfunction: Restriction for or lack of environment for overcoming dysfunction.
Eg: Inability to work, Taking care of self, Problems for simple activities like bath, brushing
- Disability: Restriction or lack of ability to perform a role.
Eg: unemployment, under/discontinued education, Homelessness
- Disadvantage: Lack of opportunity for an individual that prevents him fulfilling the role of normal person.
Eg: Discrimination , Stigma
- Medication under supervised and structured environment
- • Structured activities in therapeutic environment
• Behavioural therapies to encourage acceptable behaviour and activity
• Social skill training.
• Supported employment
• Supported education
• Supported living
• Skill training
• Resource identification and mobilisation
• Family psycho education
• Measure to build self esteem and confidence
• Recovery oriented programs
• Community inter-phased residential care
Rehabilitation Centers in Bangalore
In India for many people with mental health and addiction health issues they require rehabilitation health care. To achieve this they require short term rehabilitation centers or long term therapy depending on the condition of the patient. The objective of these rehabilitation centers in India is to provide solace to the mind and body from a holistic viewpoint. The major activities surrounding these Psycho-Social Rehabilitation centers and De-addiction centers are described below. The patient is assessed by a team of clinical psychologist and a call is taken on whether the patient requires outpatient or inpatient therapy.
At Cadabams the patients that require initial critical care are admitted to the Cadabams Neuro-Psychiatry Multi Specialty Hospital for observation and psychological first aid and associated therapy. Subsequently they are transferred to the rehabilitation hospital depending on the nature of their complaint. That is, Psychiatric or Addiction rehabilitation centers.
- Pharmalogical Intervention. Gone are the days when psychiatric or addiction medication required limited range of chemical formulations. Today the ease of availability of the required medication has made the psychiatrist’s job easier. This has resulted in sharp recovery of patient’s overtime. Given the abundance of in house psychiatric nurse who are guided by in-house Doctors in a well equipped nursing hospital relapses, panic attacks , etc are well taken care off. Many a patient who shows signs of functional improvement is subjected to vocational therapy to compliment pharmalogical interventions.
- Psychological intervention. With a battery of well qualified and experienced consultant psychiatrists and clinical psychologist at Cadabams both in psychiatry and addiction centers, the counselors have their role cut out. In this engagement process the treating team along with a set of daily activities aimed at both short term rehabilitation process and long term rehabilitation care coupled with counseling, personal hygiene, personal counseling, vocational up gradation have the most difficult of cases in shape in no time.
- Sociological Intervention. This process is dependent on the needs of the patient. From special children to fully functional residents the focus is to develop social skills among the residents to reintegrate with society to the best of their ability and inherent skills. For this is group activities like AA/NA meetings, psycho-education, family visits outside movies etc, to begin the first steps of social integration and vocational therapy.
- Vocational Rehabilitation. From a provision store, to phone call booth for in-house nursing interns, a back end handicraft workshop linked to a retail outlet, to a functional BPO managed by residents for in house work, are some of the crowning glories of our rehabilitation centers.
But the important question that arises is that can rehabilitation center be seen as Rehabilitation Hospitals? It is in vogue to call a center as a hospital. But the fact is that they are best seen as complimentary. The infrastructure, the structure, the facilities, the location and so on make a hospital unique. Similarly, the focal points of a center are all the above mentioned distinguishing features. This in comparison far from bridging the gap will go a long way in widening the gap.
The menace of addiction needs a special attention. For one psychiatry and addiction patients need different type of environment, Therapeutic interventions, medication and above all a different type of identity, space and treatment. The drug and alcoholic issue is getting into greater awareness with the need of separate rehabilitation centers as is in Cadabams and institutions overseas from which we require some guiding posts in our evolution process focusing on recovery and inclusive development.
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