Text Size
Decrease TextReset TextIncrease Text
Print

Community Rehabilitation

Question

What is the focus of community rehabilitation and some of the challenges faced? What are the Community Psychiatry and recovery programmes available in IMH and in Singapore? As a member of the community, what can I do to understand the plight of people with mental conditions, and help them?

Answer

The focus of community rehabilitation is on empowering the patient towards independent living in the community, and strengthening family relationships. The key strategy to achieve these is through providing education and psychosocial support for patients and their caregivers to (i) enhance effective coping skills, (ii) improve compliance with medication, (iii) reduce hospital admissions or length of stay, and (iv) improve their quality of living. This means that emphasis is placed on the restoration of functioning and has moved beyond the clinical concept of recovery, which mainly targets the remission of symptoms.

community training_cooking

Mental healthcare workers involved in community rehabilitation need to be sensitive in the service delivery process, due to the nature of the illness, cultural beliefs about mental illness, and social-economic differences. Other challenges include helping our patients obtain and sustain employment as well as addressing and meeting the needs of the caregivers and our ageing patient population.

The Community Mental Health Team (CMHT) of IMH provides education, counselling and daily living skills training for patients. This multi-disciplinary team consists of doctors, medical social workers, nurses, occupational therapists and psychologists. This community-based service team communicates with the hospital and other community resources in providing occupational skills training, e.g. in car washing, being a cashier, cleaner, handicraft worker, sales worker, etc. The team also provides support and educational programmes for our partners in the community.

Thus far, the community-based psychosocial rehabilitation programme administered by the CMHThas achieved a 62% reduction in the length of hospital stay. The total intake of inpatients into the various rehabilitation programmes has increased over six-fold and the number of patients who have successfully completed the in-house programme rose from 59% in 2003 to 73% in 2007.
In addition, IMH’s Early Psychosis Intervention Programme (EPIP) won the inaugural State of Kuwait Health Promotion Award, presented by the World Health Organization, in 2006. For younger patients, treatment has started earlier along with appropriate rehabilitation and goals for them to return to the community and employment. Results have been positive, with reduced default rates, improved functioning, increased employment, high patient satisfaction rating, reduction in duration of untreated psychosis as well as prolonged hospitalisation.

Local voluntary welfare organisations (VWOs) such as the Singapore Association for Mental Health (SAMH), Singapore Anglican Community Services (SACS), etc also provide rehabilitation services. IMH works hand-in-hand with these agencies to ensure better coordination in the provision of psychosocial rehabilitation services to persons with mental illness.
Members of the community can attend public forums on mental health or arrange for a group visit to IMH to have a better understanding of mental illness. Gaining awareness is helpful in allaying one’s fears of persons with mental illness.

  • The community can also choose to volunteer at IMH and befriend our patients, visit them at home or in the hospital, or accompany them for some social activity or to the clinic for consultation. As the illness can make the patient feel inferior or neglected, giving someone with a mental illness a smile or saying “hello” when meeting them are some simple ways you can convey your acceptance of and concern for them.
A member of National Healthcare Group ISO   Comm Chest Award Bronze