Severe Mental Illness: Crisis Stabilization And Rehabilitation

Chronic Mental Illness Long-term Persistent impairment of functioning Severe mental illness De-institutionalization Older us. Younger populations

Severe Mental Illness Schizophrenia Schizo-affective disorder Bipolar disorder Major depression Social, vocational and functional impairment Common with long term physical illness

Rehabilitation Early Community based Barriers –Lack of insurance –Transportation –Availability –Illness

Barriers to Maintaining Health Housing Noncompliance to treatment Transportation Community and family support Qualified care providers Resources in the community Comorbidity –Dual diagnosis

Resources Adult outpatient services Day care Case managers Alcoholic and drug rehabilitative services Community Outreach programs Temporary shelters Churches Multiservice centers

Rehabilitation Maintain positive coping in time of stress Maintain optimum level of functioning Remain in own community Reduce numbers of exacerbations

Crisis Stabilization Poor crisis management –Vulnerable to stress –Poor cognitive functioning –Lack of problem solving skills –Inadequate communication skills –Low self-esteem –Poor work and interpersonal relations

Potential Crisis Situations Changes in treatment Work Interpersonal Lack of transportation, money, housing, etc. Problems meeting ADL’s Sexual concerns Adapting the crisis model

Client and Family Education Written Follow up Home visits Multiple support –Support groups –Physical, emotional and financial resources –Stress management –Lieberman’s five basic aims

Five Basic Aims Develop a genuine working relationship Develop a structure and stable teaching plan Support family members efforts Develop day by day communication and problem solving skills Help family develop a supportive network

Social Skills Training Living skills –ADL’s –Recreational –IPR’s Learning skills –Money management Working skills –dressing

Other Rehabilitation Models Vocational Rehabilitation Programs Supportive Group Therapy Cognitive-Behavioral Therapy