Psychiatric Rehabilitation

Definition of Psychiatric rehabilitation:

Rehabilitation in psychiatry is that process which attempts to benefit a mentally ill person back, as near as possible, to his original state. It is the process designed to help the handicapped individuals to make maximum use of their residual capacities and to enable them to lead a beneficial and meaningful life in the community.

Goal of psychiatric rehabilitation:

The goal of psychiatric rehabilitation is to help individuals with persistent and serious mental illness to develop the emotional, social and intellectual skills needed to live, learn and work in the community with the least amount of professional support.

Objectives of psychiatric rehabilitation:

1.To encourage and empower clients with mental illness and caregivers to lead an independent, productive and dignified life with help of society, industry, community leaders, governmental and nongovernmental agencies.

2. To investigate in a holistic manner, the pharmacological, psychological, social, legal and economic aspects of mental health rehabilitation and to evolve suitable techniques for application in day-to-day problems.

3. To develop public education programmes on mental health in association with clients with mental illness, their caregivers, mental health professionals, non-governmental agencies and media.

4. Facilitate exchange programs with international and national agencies engaged in mental health rehabilitation research for training of technical personnel.

5. To attempt to improve the quality of life and decrease disability of clients with mental illnesses and their family members.

Principles of psychiatric rehabilitation:

1. Enabling a normal life.

2. Advocating structural changes for improved accessibility to pharmacological services and availability of psycho-social services.

3. Person-centered treatment.

4. Actively involving support systems.

5. Coordination of efficient services.

6. Strength-based approach.

7. Rehabilitation isn't time specific but goal specific in succeeding.

Indications for psychiatric rehabilitation:

1. Chronic schizophrenia.

2. Chronic organic mental disorders.

3. Mental retardation.

4. Alcohol and drug dependence.

Psychiatric rehabilitation services:

1. Community residential services

2. Workplace accommodations

3. Supported employment or education

4. Social firms

5. Assertive community treatment (or outreach) teams assisting with social service agencies

6. Medication management (e.g., self-medication training and support)

7. Housing

8. Programs

9. Employment

10. Family issues

11. Coping skills and activities of daily living and

12. Socialising.

General responsibilities of the rehabilitation nurse:

1. 1. Possesses the specialized knowledge and clinical skills necessary to provide care for people with physical disability and chronic illness.

2. Coordinates educational activities and uses appropriate resources to develop and implement an individualized teaching and discharge plan with clients and their families.

3. Performs hands-on nursing care by utilizing the nursing process to achieve quality outcomes for clients.

4. Provides direction and supervision of ancillary nursing personnel, demonstrates professional judgment, uses problem solving techniques and time-management principles, and delegates appropriately.

5. Coordinates nursing care activities in collaboration with other members of the interdisciplinary rehabilitation team to facilitate achievement of overall goals.

6. Coordinates a holistic approach to meeting patient's medical, vocational, educational, and environmental needs.

7. Demonstrates effective oral and written communication skills to develop a rapport with clients, their families, and health team members and to ensure the fulfilment of requirements for legal documentation and reimbursement.

8. Acts as a resource and a role model for nursing staff and students and participates in activities such as nursing committees and professional organizations that promote the improvement of nursing care and the advancement of professional rehabilitation nursing.

9. Facilitates community education regarding acceptance of people with disabilities.

10. Actively engages in legislative Initiatives affecting the practice of rehabilitation nursing or the people in their care.

11. Applies nursing research to clinical practice and participates in nursing research studies.

Roles and functions of the rehabilitation nurse:

1. As a teacher:

a) Shares information about the disease processes underlying disabilities and teaches nursing techniques to help clients and their families develop the self-care skills necessary to move toward wellness on the illness-wellness continuum.

b) Prepares clients and their families for future self-management and decision-making responsibilities by fostering clients' independence and goal achievement.

c) Provides in-service education for healthcare team members and members of the community regarding the prevention of disabilities.

2. As a caregiver:

a) Assesses the physical, psychological, sociocultural, and spiritual dimensions of clients and their families, as well as their educational and discharge needs in order to formulate nursing diagnoses.

b) Plans nursing care while acknowledging that rehabilitation nursing is practiced within a dynamic, therapeutic, and supportive relationship that is constantly changing, as nurses and clients influence one another.

c) Implements a plan of care by providing nursing care and education directly or through ancillary personnel, as needed, to maintain and restore function and prevent complications and further loss.

d) Evaluates the nursing care that is being provided and modifies the plan, as needed, to achieve measurable goals and objectives.

3. As a collaborator:

a) Develops goals, in collaboration with clients, their families, and the rehabilitation team, that is oriented to wellness behavior and is reality based and that encourage socialization with others, and promote maximal independence for patients with disabilities or chronic disabling conditions.

b) Participates in the interdisciplinary team process at team conferences and other team meetings and offers input into team decision making.

c) Intervenes with team members and other healthcare professionals to ensure that the optimal opportunity for recovery is made available to the client, the most significant member of the rehabilitation team.

d) Collaborates with team members to achieve cost-effective care by utilizing appropriate clinical measures to meet emergent physical, psychosocial, and spiritual situations.

4. As a client advocate:

a) Actively listens, reflects, and guides clients and their families through the stages of the grieving process to mourn the loss of abilities and roles while also "instilling hope".

b) Advocates for policies and services that promote the quality of life for individuals with disabilities and participates in activities that will positively influence the community's awareness of disabilities.

c) Contributes to a safe and therapeutic environment and supports activities that promote the clients' return of function and prevent complications or chronic illness.