Download Severe Mental Illness:

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