COMMUNITY MENTAL HEALTH SERVICES: A WAY FORWARD TO REHABILITATE CHRONIC MENTALLY ILL CLIENT
Abstract
Schizophrenia and other mental illnesses produce devastating effects on a clients’ personal andpsychosocial wellbeing. Besides the sufferer, it has irrevocable impacts on the lives of their loved ones.With advancement in the treatment modalities, researches have proven that hospital based care andpsychotropic drugs are not the sole solution in managing the client symptoms. Deinstitutionalization isthe paradigm shift from hospital based to community based care model that allows client/s to spend restof their lives in the community setting. A well-structured community care based programme thatfocuses on psychosocial interventions has significant contribution in treatment and rehabilitation ofclient/s. This article is aimed to provide the evidence of the effective use of community mental healthcare for management and prevention of relapse of a client with chronic schizophrenia. The substantialevidence of rehabilitation is represented through this case study of a chronic schizophrenic client whoreceived these psychosocial interventions in his own community setting.Keywords: Schizophrenia, community mental health care, psychosocial interventions, rehabilitationReferences
Gadit AM. Mental health model: Comparison between a developed
and a developing country. J Med 2007;1(1). Available at:
http://www.scientificjournals.org/journals2007/articles/1047.htm
Gadit AM. Mental health first aid: Need for grass root approach?
J Pak Med Assoc 2012;62(1):192–94.
WHO. Investing in mental health. Department of Mental Health
and Substance Dependence, Non-communicable Diseases and
Mental Health, WHO, Geneva; 2003. Available at:
http://www.who.int/mental_health/en/investing_in_mnh_final.pdf
CIA. The world fact book: South Asia, Pakistan. Central
Intelligence Agency [Updated 2011 Dec 20; cited 2012 Jan 19].
Available at: https://www.cia.gov/library/publications/the-worldfactbook/geos/pk.html
Gadit AA. Economic Burden of Depression in Pakistan. J Pak
Med Assoc 2004;54(2):43–4.
Gadit AM, Khalid N. State of mental health in Pakistan –
education, service and research. Karachi: Corporate Printers;
p. 38–40.
Dawn. 400 psychiatrists for millions of patients. Dawn
Newspaper April 15, 2011. Available at: http://www.dawn.com/
/04/15/400-psychiatrists-for-millions-of-patients.html
Stuart GW, Laraia MT. Principles and practice of psychiatric
nursing. 8th ed. St. Louis: Mosby; 2005.
Hoult J. Community care of the acutely mentally ill. Br J
Psychiatry 1986;149:137–44.
Muijen M, Marks I, Connolly J, Audini B. Home based care and
standard hospital care for patients with severe mental illness: a
randomized controlled trial. BMJ 1992;304:749–54.
Rigby P, Alexander J. Understanding schizophrenia. Nurs Stand
;22(28):49–56.
Mohr WK. Johnson’s Psychiatric mental health nursing. 6th ed.
Philadelphia: Lippincott; 2006.
Kavanagh S, Opit L, Knapp M, Beecham J. Schizophrenia:
shifting the balance of care. Soc Psychiatry Psychiatr Epidemiol
;30:206–12.
Gilani AI, Gilani UI, Kasi PM, Khan MM. Psychiatric health
laws in Pakistan: from lunacy to mental health. PLoS Med
;2(11):e317.
Stuart GW. Principles and practice of psychiatric nursing. 9th ed.
St. Louis: Mosby; 2009.
Kane JM, McGlashan TH. Treatment of schizophrenia. Lancet
;346:820–5.
Brennan G. Schizophrenia: Diagnosis and an introduction to
interventions. Mental Health Pract 2001;4(7):32–7.
Akhondzadeh S, Afkham K. Pharmacotherapy of schizophrenia.
Iran J Psychiatry 2006;1:46–53.
Townsend MC. Psychiatric mental health nursing: Concepts of care
in evidence-based practice. 5th ed. Philadelphia: Lippincott; 2006.
Westman J, Gissler M, Wahlbeck K. Successful
deinstitutionalization of mental health care: increased life
expectancy among people with mental disorders in Finland. Eur J
Public Health 2012;22(4):604–6.
Kopelowicz A, Liberman RP, Zarate R. Recent advances in social
skills training for schizophrenia. Schizophr Bull
;32(S1):S12–23.
Barbato A, Agnetti G, D’Avanzo B, Frova M, Guerrini A,
Tettamanti M. Outcome of community-based rehabilitation
program for people with mental illness who are considered
difficult to treat. J Rehabil Res Dev 2007; 44(6):775–84.
Day JC, Bentall RP, Roberts C, Randall F, Rogers A, Cattell D, et
al. Attitudes toward antipsychotic medication: The impact of
clinical variables and relationships with health professionals. Arch
Gen Psychiatry 2005;62:717–24.
Dixon L, McFarlane WR, Lefley H, Lucksted A, Cohen M, Fallon
I, et al. Evidence-based practices for services to families of people
with psychiatric disabilities. Psychaitr Serv 2001;52:903–10.
Montero I, Asencio A, Hernandez I, Masanet MJ, Lacruz M,
Bellver F, et al. Two strategies for family intervention in
schizophrenia: A randomized trial in a Mediterranean
environment. Schizophr Bull 2001;27:661–70.
Hatfield AB. Family education: Theory and practice. New
Direction in Mental Health Services 1994;62:3–12.
Thornicroft G, Susser E. Evidence based psychotherapeutic
interventions in the community care of schizophrenia. Br J
Psychiatry. 2001;178:2–4.
Downloads
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.