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      First 2 Years of Experience of “Residential Care” at “Sakalawara Rehabilitation Services,” National Institute of Mental Health and Neurosciences, Bengaluru, India

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          Abstract

          Introduction:

          There is an unmet need for continuity-of-care is well known for those with severe mental disorders (SMDs) after acute care at hospitals in India. The “Sakalawara Rehabilitation Services (SRS)” functioned from March 2014 at “Sakalawara Community Mental Health Centre” (SCMHC) of “National Institute of Mental Health and Neurosciences,” Bengaluru, India in the concepts of residential care (half-way-home) with the aim to develop a replicable model.

          Aim:

          To review the inpatient records after the initial 2 years of experience in residential care at SCMHC.

          Methodology:

          Retrospective file review of inpatients at SCMHC from March 2014 to March 2016 in a semi-structured proforma designed for the study. Ethical committee of NIMHANS Bengaluru has approved the study.

          Results:

          The total number of inpatients during this period was 85. It was found that Schizophrenia spectrum disorders were the most common diagnosis among these patients. The activity of daily living and psycho-education were the most common individual interventions. The majority of families underwent structured family psycho-educational interventions. This review also demonstrated the feasibility of tele-aftercare in continuity of care after discharge of patients.

          Conclusion:

          SRS kind of residential set-up is feasible and demonstrated effectiveness in maintaining continuity of care of SMDs. There is a need for better structured and customized interventions. There is further a scope for tele (video) aftercare for those with SMDs.

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          Most cited references11

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          Continuity of care and health outcomes among persons with severe mental illness.

          Continuity of care is considered to be essential to the effective treatment of persons with severe mental illness, yet evidence to support the association between continuity and outcomes is sparse because of a lack of longitudinal studies and of comprehensive continuity measures. The purpose of this study was to examine the relationship between continuity of care and outcomes. A new multilevel measure of service continuity, the Alberta Continuity of Services Scale for Mental Health (ACSS-MH), was used in a 17-month follow-up study of 486 adults with severe mental illness in three health regions of Alberta, Canada. Endpoint information was obtained for 411 participants (85 percent). The mean continuity score reported by patients was 131+/-20 out of a possible 185. The mean continuity score as rated by observers was 39+/-10 out of a possible 59. Higher levels of observer-rated continuity were associated with older age, lower annual household income, a diagnosis of psychotic disorder, and no suicidality or alcohol use. Continuity was also significantly associated with a better quality of life at endpoint (generic and disease specific), better community functioning, lower severity of symptoms, and greater service satisfaction. The associations between continuity and quality of life held after adjustment for empirically identified confounders. Positive relationships between continuity of care and health outcomes among persons with severe mental illness suggest that efforts at improving continuity in and among mental health services are worthwhile.
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            Psychiatric rehabilitation today: an overview.

            All patients suffering from severe and persistent mental illness require rehabilitation. The goal of psychiatric rehabilitation is to help disabled individuals to develop the emotional, social and intellectual skills needed to live, learn and work in the community with the least amount of professional support. The overall philosophy of psychiatric rehabilitation comprises two intervention strategies. The first strategy is individual-centered and aims at developing the patient's skills in interacting with a stressful environment. The second strategy is ecological and directed towards developing environmental resources to reduce potential stressors. Most disabled persons need a combination of both approaches. The refinement of psychiatric rehabilitation has achieved a point where it should be made readily available for every disabled person.
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              Role of non-governmental organizations in mental health in India

              The paucity of treatment facilities and psychiatrists in the Government sector has widened the treatment gap in mental health. Non-governmental organizations (NGOs) have played a significant role in the last few decades in not only helping bridge this gap, but also by creating low cost replicable models of care. NGOs are active in a wide array of areas such as child mental health, schizophrenia and psychotic conditions, drug and alcohol abuse, dementia etc. Their activities have included treatment, rehabilitation, community care, research, training and capacity building, awareness and lobbying. This chapter outlines the activities of NGOs in India. This is a revised version of the chapter in the book on mental health to be brought out by Government of India.
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                Author and article information

                Journal
                Indian J Psychol Med
                Indian J Psychol Med
                IJPsyM
                Indian Journal of Psychological Medicine
                Medknow Publications & Media Pvt Ltd (India )
                0253-7176
                0975-1564
                Nov-Dec 2017
                : 39
                : 6
                : 750-755
                Affiliations
                [1]Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
                [1 ]Department of Nursing, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
                [2 ]Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
                [3 ]Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
                Author notes
                Address for correspondence: Dr. Narayana Manjunatha Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru - 560 029, Karnataka, India. E-mail: manjunatha.adc@ 123456gmail.com
                Article
                IJPsyM-39-750
                10.4103/IJPSYM.IJPSYM_40_17
                5733423
                2e1e4fe8-a7c0-4ca3-a1df-b485f7885333
                Copyright: © 2017 Indian Psychiatric Society

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                Categories
                Original Article

                Clinical Psychology & Psychiatry
                aftercare,continuity of care,rehabilitation services,residential care,severe mental disorders

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