Psychiatric Rehabilitation Centres in Delhi

Rehabilitation is a goal of the treatment carried out using the bio-psycho-social approach. Psychiatric rehabilitation is positive in focus, reflecting the individual’s possibilities rather than his or her limitations. Psychiatric rehabilitation is the process that facilitates opportunities for individuals who are impaired, disabled or handicapped by mental disorders in order to reach their optimal level of independent functioning in the society. It implies both improving individual competencies and introducing environmental changes in order to create a life of the best quality possible for people who have experienced a mental disorder or who have had an impairment of their mental capacity, which produces a certain level of disability.

Psychiatric rehabilitation is synonymous with recovery; it means helping people get back to work and living on their own; it requires comprehensive understanding of symptoms and cognitive deficits, it is most effective when integrated with 'appropriate' pharmacological regimen. The overall goal of psychiatric rehabilitation is to assure that persons with psychiatric disabilities can perform those cognitive, emotional, social, intellectual and physical skills needed to live, learn, work and function with as few symptoms as possible in the community. Psychoactive medications are primarily effective for symptom control and relapse-prevention while psychosocial treatments are primarily effective for personal, social, and vocational functioning. Combinations of Pharmacological and psychosocial interventions are recommended for persons with psychiatric disability; to reach optimal levels of independent functioning in the community.

Psychiatric rehabilitation is an essential component of management of persons with chronic mental illnesses along with pharmacological management. Awareness of the importance and feasibility of rehabilitation psychiatry is increasing amongst professionals in Delhi. It is now universally accepted that psycho social rehabilitation interventions should be part of treatment from the very first meeting with the client and with the client’s family. Lack of coordination of the multiple services needed by the persons with chronic mental illnesses has been cited as a major barrier to the continuity of care. We just over-discuss these topics in various conferences and do very little to improve the ward facility for those who come forward for treatment. It is the consumer’s right to receive a comprehensive treatment even during the acute stage of illness when the patient requires additional support through psycho-education, supportive therapy, expressed emotion management, etc. Psychiatric rehabilitation can be viewed from different perspectives.

Firstly, the efficacy of such interventions will be more, if provided in the patients’ own inhabited territory/vicinity of residence.

Secondly, Psychiatric rehabilitation is feasible and realistic when considering the current mental health care system of Delhi NCR.

Though it is ideal to focus on community based rehabilitation, the majority of the mentally ill in Delhi are being taken care of by GHPUs. General hospital psychiatry units (GHPUs) are the major providers of mental health services in Delhi. Unlike in high-income countries, GHPUs in Delhi are also the main training centers for providing postgraduate training in psychiatry and allied disciplines. This may be due to the fact that GHPUs are more accessible, approachable, less stigmatizing and in GHPUs, families are allowed to visit and stay with their ill family members. Proximity of other medical departments assures high quality of care for the ill member, if the member is suffering from other physical problems in addition to suffering from mental disorders. Community based interventions are also possible by associating with Community Medicine / MSW Unit in a GHPU. It is best for each GHPU to adopt a community each to make these interventions accessible to most of the community. Starting up a "Day Care Centre" attached to each GHPU will be helpful in providing structured psychosocial interventions or therapies to the persons with psychiatric disability.

Conducting regular group meetings for the caregivers in a GHPU is also feasible for the care providers and beneficial for the treatment of patients. Generally in the National Capital Region, once the symptom improves the client gets discharged from a GHPU to the community but is usually left with disability in psychosocial role functioning; simply because the hospitalization does not focus much on the skill-development program. Persons with psychiatric disability are usually idle in their homes, and may require assistance or prompting even to do everyday chores & activities. This eventually poses a challenge for the caregivers and burdens them with additional duties of assisting the unproductive family member after discharge. This could deteriorate the family functioning and can even develop negative expressed emotions in primary care givers due to their distress. It may promote revolving door syndrome and ultimately poor progress & functional deficits or disability.

This vicious cycle continues unless we provide comprehensive care for those who avail of treatment from rehabilitation centres. Hence, the aim of the Psychiatric rehabilitation in a rehabilitation centre has to be focused on enabling the affected individual to function to the fullest extent of his or her capabilities despite his or her limitations, with the modest aim of preventing further deterioration. Learn more about this topic, Kindly click Rehabilitation Centres in Delhi.

Anupam Gupta is a doctor who is associated with Tulasi Psychiatric & Rehab Centre