MHApps Take Control – Rehabilitation Training – Importance Of Independence And Occupation In Recovery
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The Irish Association of Rehabilitation Professionals has defined rehabilitation as: “A facilitative process involving individuals who are disadvantaged in terms of accessing life in the main stream. The rehabilitative process aims to enable individuals to access as independent a life as possible in social, cultural and economic terms which is congruent with their aspirations.”
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“A whole system approach to recovery from mental ill health which maximises an individual’s quality of life and social inclusion by encouraging their skills, promoting independence and autonomy in order to give them hope for the future and which leads to successful community living through appropriate support”. (Killaspy et al. 2005. Quoted in A Socially Inclusive Recovery Model of Mental Health Rehabilitation. National Learning Network)
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“Psychiatric Rehabilitation is the process of restoration of community functioning and wellbeing of an individual who has a psychiatric disability. Rehabilitation promotes recovery, full community integration and improved quality of life for people who have been diagnosed with any mental health condition that seriously impairs their ability to lead meaningful lives.
Psychiatric rehabilitation services are collaborative, person directed and individualised and should be an essential element of the healthcare and human services spectrum.
The service should focus on helping individuals develop skills and access resources required to increase their capacity to be successful and satisfied in the living, working, learning and social environments of their choice. Ideally an effective rehabilitation service should combine pharmacological treatment, independent living and social skills training, psychological support to individuals and their families, housing, vocational rehabilitation, social support and network enhancement, and access to leisure facilities. There should also be a focus on challenging stigma and prejudice to enable social inclusion.
The rehabilitation team should be representative of a wide range of mental health professionals acting within a team structure with the identified rehabilitation needs of the individual acting as the driving force for the programme. Ideally the rehabilitation team should consist of psychiatrists, social workers as well as a combination of allied health and social care professionals.
Rehabilitation work carried out by a team in collaboration with the individual should seek to effect changes in the individual’s environment and in a person’s ability to deal with the environment, so as to facilitate improvement in symptoms or personal distress.”
The role of the rehabilitation services is to provide:
· Education
· Training
· Resources
· Supports
All these things foster the recovery process.
Rehabilitation services should be designed to meet the needs of the individual in a holistic manner. This means that the biological (body), psychological (mind) and social (community) needs of service users are all taken into equal account.
A holistic approach is about taking account of the whole person.
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You are not just the diagnosis you may be given. All of us are unique and need different things at different times
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Rehabilitation should provide a meaningful range of occupations and lifestyle choices, so that the person can have as good a quality of life as possible. Rehabilitation builds on a person’s strengths so that the person can live their life in the mainstream of society, not separate from it.
Rehabilitation services should be consultative and user friendly in their approach. The person receiving the service should have a say in the type and style of service they use.
A number of things are important if we are to maintain our life in the community and manage our mental health.
They include:
· Adequate income and maintenance
· Reasonable accommodation, which should be community based and supported, at an appropriate level for the individual
· A range of meaningful training and occupational services
· Social integration services to ensure that issues such as social isolation, stigma and low self-esteem are addressed
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“There I was lying in bed feeling really bad, not wanting or not able to get up and face the day, thoughts racing in my head, voices screaming and shouting, if only I could make out what they are saying, all I know is they were somehow insulting me. A knock came to the door, it was my Mother, she said, “John, are you awake, I have a visitor for you”. Who the hell was that I thought? I could think of absolutely nobody who would visit me. I stopped talking to people a while back when I figured out they must be trying to control my thoughts.
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I struggled to bring myself back to focusing on my mother and what she was saying. The doctor wants a word John. The doctor spoke to me as if I was a ten year old, “your mother has been telling me you are having problems”. He then asked me if he could examine me, and for some reason I trusted him and allowed him to take my pulse, temperature and listen to my heart. When he was doing this he asked how I was sleeping, I said I wasn’t. When he asked about my mood I said I was very low and felt scared. He asked me what I was scared of and I told him about how the neighbours were trying to control my thoughts and make me do things I didn’t want to, I wouldn’t tell him what, because I was so frightened. With what I was being asked to do, I couldn’t bring myself to tell him.
When he asked me if I would be willing to go to see a specialist, a psychiatrist, I decided I can’t keep living in this fear, so agreed to go with my mother to the local hospital.”
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“I was 22 the first time I went to hospital. I was sure everybody was out to get me. For about four years I was hearing voices and having weird thoughts. At first I was frightened, trying to figure out where they came from and if they were spirits, ghosts or aliens. I got kind of used to them. I was maybe debating with myself, might they be some spirit guides sent by God to help me make the right choices. It was only when they began to get ugly and telling me to hurt myself that I was afraid, which soon led to pure horror about what was happening to me. Half the time I thought, I’m fine this is ok, nothing wrong here. But sometimes I knew people were looking at me and I knew I was somewhere else than with them.”
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One of the most traumatic experiences a person can have is being admitted into a psychiatric hospital. Relatives are also equally traumatised.