Psychosocial Rehabilitation model in Šiauliai District Mental Hospital The public institution Šiauliai District Mental Hospital Eugenijus Mikaliūnas Tartu International Conference

Hospital recourse d.  Number of beds – 200  Daytime Inpatient Department – 41 places  Medical staff – 120 establishments  Services provided for – people  Income per annum – 8,5 million Lt. E. Mikaliūnas Tartu International Conference

The public institution Šiauliai District Mental Hospitals’ report on the activities of Year 2006  Patients treated – 2864  Bed-days –  Average time of patient treatment – 21,4 days  Bed functioning – 306  Bed turnover – 14,32 E. Mikaliūnas Tartu International Conference

Partners Family doctors Mental health care centres Public institution Šiauliai District Hospital Department of Psychotherapy Psychiatric department of children and adolescent. Public institution ŠDMH Šiauliai public institution Center for Addictive Disorders Primary health care level Secondary health care level Šiauliai public institution Nursing Hospital, Psycho geriatric subdivision Public institution Šaukėnai Mental Hospital E. Mikaliūnas Tartu International Conference

Schema of Provided Services THE RECEPTION AND CONSULTATIVE DEPARTMENT Department of Psychiatric Crises services Departments of General Psychiatry services Department of Daytime Psychiatric services Department of Psychosocial Rehabilitation services E. Mikaliūnas Tartu International Conference

Departments of Provided Services Reception Planned and urgent consultations Consultations in general medicine hospitals Consultation in Reception and Consultative Department (psychiatrist, mental health nurse, social worker) 100 beds Inpatient Department 41 places, 16 of them - seasonal THE RECEPTION AND CONSULTATIVE DEPARTMENT CRISIS DEPARTMENT DEPARTMENT OF GENERAL PSYCHIATRY DEPARTMENT OF PSYCHOSOCIAL REHABILITATION DAYTIME IMPATIENT DEPARTMENT E. Mikaliūnas Tartu International Conference

Medicine Staff Recourses in Treatment Department E. Mikaliūnas Tartu International Conference   Psychiatrists – 17   Nurses – 44 :   Reception and Consultative Dep. – 6   Emergency State Dep. – 18   General Psychiatry Dep. – 15   Care administrators – 5   Nurse assistants – 41 :   Emergency State Dep.– 28   General Psychiatry Dep.– 13 In total: 102

Staff Recourses of Psychosocial Rehabilitation Department E. Mikaliūnas Tartu International Conference   Head of the department   Administrator   Psychiatrist   Social worker   Medicine psychologist   Specialist of psychosocial rehabilitation   Mental state nurse (for occupation)   Occupational therapist (ergo therapist)   Art therapist   Occupational therapist for physical preparation   Music therapist   Physical medicine and rehabilitation nurse   Occupational nurses In total: 30

Department of Psychosocial Rehabilitation

Aims of Psychosocial Rehabilitation Department  Establish a multidisciplinary team, that applies methods, alternative to pharmacological treatment for the inpatients in the hospital and Day Department.  Help people with severe and long-lasting mental disturbances to improve life quality.  Help to adjust successfully to the environment and feel life satisfaction with the minimal specialists' supervision.  Help to restore and maintain lost skills and acquire new one's. E. Mikaliūnas Tartu International Conference

Team of the Psychosocial Rehabilitation Department:  Psychiatrist (1)  Psychologist - psychotherapist (1)  Medical psychologists (3)  Social workers (5)  Mental health nurses for occupation (5)  Occupational therapists (3)

SERVICES PROVIDED IN THE PSYCHOSOCIAL REHABILITATION DEPARTMENT

SERVICES:  Long-term psycho pharmacological treatment  Psychotherapy (group and individual)  Psychosocial rehabilitation: Restoration and teaching of domestic skills:  Personal budget planning  Individual food preparation  Food preparation in a group  Buying, composing menu  Ware washing and care  Knitting, sewing  Drawing, clay modelling E. Mikaliūnas Tartu International Conference

SERVICES:  Hygiene skills restoration  Social skills training  Developing leisure time spending skills and integrated living in a community skills:  Swimming pool  Social services centre  Exhibitions  Theatre  Computer skills training  Discussions about ethics E. Mikaliūnas Tartu International Conference

Community – as a roof, where we hide during slasher rain, as a fireplace where we get warm in a cold winter day. Community – as a roof, where we hide during slasher rain, as a fireplace where we get warm in a cold winter day. Z. Bauman Z. Bauman Social thinker E. Mikaliūnas Tartu International Conference

MODELS of Ps y chosocial Rehabilitation CONSERVATIVE MODEL CONSERVATIVE MODEL  Treatment supplement applying special interventions with the aim to prevent handicap. E.g. Psychological programme for the client and his family, occupational therapy, leisure time therapy. E. Mikaliūnas Tartu International Conference

MODELS of Ps y chosocial Rehabilitation  CLIENTS' CHOSEN GOAL MODEL Highly specialized treatment, when a client has a need to develop specific skills and specialists formulate tasks an interventions to reach this goal. E.g.: social skills training. Highly specialized treatment, when a client has a need to develop specific skills and specialists formulate tasks an interventions to reach this goal. E.g.: social skills training. E. Mikaliūnas Tartu International Conference

MODELS of Psychosocial Rehabilitation  INTEGRATIVE MODEL OF SERVICES AND INTERVENTIONS: Long term support after treatment. Integration of services and interventions. Specialists evaluate client's needs and help is assigned according to the conditions and demands. E.g.: long-termed and thorough community treatment. Long term support after treatment. Integration of services and interventions. Specialists evaluate client's needs and help is assigned according to the conditions and demands. E.g.: long-termed and thorough community treatment. E. Mikaliūnas Tartu International Conference

Psychosocial rehabilitation of patients with schizophrenia Rehabilitation Community based methods of treatment Self-help group Individual psychotherapy Methods of psychosocial rehabilitation Family therapy Group therapy Maurizio Pompili et. all World J Biol Psychiatry, (2004) 5, E. Mikaliūnas Tartu International Conference

Psychosocial interventions for patients with schizophrenia Social skills training Psychosocial interventions Occupational rehabilitation Individual therapy Family therapy Supported employment Assertive community treatment Self-help groups Crisis centers Hospitalisation Group therapy Social therapy Psychotherapy Community-based methods of treatment Problem solving strategies Maurizio Pompili et. all World J Biol Psychiatry, (2004) 5, E. Mikaliūnas Tartu International Conference

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