1. Severe Mental Illness: Crisis Stabilization And Rehabilitation

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

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

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

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

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

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

8. 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

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

10. 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

11. 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

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

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