1. Psychosocial Rehabilitation model in Šiauliai District Mental Hospital The public institution Šiauliai District Mental Hospital Eugenijus Mikaliūnas Tartu International Conference 2007 10 31

2. Hospital recourse 2006-12-31d.  Number of beds – 200  Daytime Inpatient Department – 41 places  Medical staff – 120 establishments  Services provided for – 400 000 people  Income per annum – 8,5 million Lt. E. Mikaliūnas 2007.10.31 Tartu International Conference

3. The public institution Šiauliai District Mental Hospitals’ report on the activities of Year 2006  Patients treated – 2864  Bed-days – 61228  Average time of patient treatment – 21,4 days  Bed functioning – 306  Bed turnover – 14,32 E. Mikaliūnas 2007.10.31 Tartu International Conference

4. 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 2007.10.31 Tartu International Conference

5. 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 2007.10.31 Tartu International Conference

6. 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 2007.10.31 Tartu International Conference

7. Medicine Staff Recourses in Treatment Department E. Mikaliūnas 2007.10.31 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

8. Staff Recourses of Psychosocial Rehabilitation Department E. Mikaliūnas 2007.10.31 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

9. Department of Psychosocial Rehabilitation

10. 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 2007.10.31 Tartu International Conference

11. 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)

12. SERVICES PROVIDED IN THE PSYCHOSOCIAL REHABILITATION DEPARTMENT

13. 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 2007.10.31 Tartu International Conference

14. 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 2007.10.31 Tartu International Conference

17. 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 2007.10.31 Tartu International Conference

18. 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 2007.10.31 Tartu International Conference

19. 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 2007.10.31 Tartu International Conference

20. 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 2007.10.31 Tartu International Conference

21. 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) 5,201-210 E. Mikaliūnas 2007.10.31 Tartu International Conference

22. 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) 5,201-210 E. Mikaliūnas 2007.10.31 Tartu International Conference

23. The end THANK YOU FOR YOUR ATTENTION!