Hostname: page-component-77c89778f8-m42fx Total loading time: 0 Render date: 2024-07-18T12:50:13.891Z Has data issue: false hasContentIssue false

The impact of a rehabilitation and recovery service on patient groups residing in high support community residences

Published online by Cambridge University Press:  13 June 2014

Annette Kavanagh
Affiliation:
St Ita's Hospital, Portrane, Co Dublin, Ireland
Ena Lavelle
Affiliation:
St Ita's Hospital, Portrane, Co Dublin, Ireland

Abstract

Objectives: To describe the characteristics of the patient groups with severe and enduring mental illness residing in high support community residences in Dublin North East Mental Health Service and the impact of a rehabilitation and recovery service on their outcomes since the instigation of that service.

Method: Data was collected retrospectively on current and past residents from case notes and staff interviews. Data included demographics, psychiatric history and results of rehabilitation interventions. The results were compiled and analysed using descriptive statistics.

Results: Fifty patients were identified. The majority were male (62%) with a diagnosis of paranoid schizophrenia (66%).The levels of co-morbid alcohol and drug misuse were 48% and 36% respectively. Histories of verbal/physical aggression were found in 70% and noncompliance in 60%. Two thirds of patients had a past history of being detained under the Mental Treatment Act (1945). Ninety-four per cent were unemployed at admission to the residence and following rehabilitation intervention 60% were linked with vocational training programmes and 10% with community employment schemes. ‘New long-stay’ and ‘old long-stay’ patients showed a trend towards poorer outcomes, whereas patients who had previously lived in the community showed a trend towards progressing to lower levels of support.

Conclusions: Positive outcomes were achieved following active rehabilitation interventions, but there remained a cohort of patients whose needs could not be met in a supported community rehabilitation residential programme. This highlights the need to ensure that a range of rehabilitation services from inpatient to supported community placement are provided to meet the needs of patients with severe and enduring mental illness with complex needs.

Type
Original Papers
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.A Vision for Change. Report of the Expert Group on Mental Health Policy. Department of Health and Children, 2006.Google Scholar
2.Mental Health Commission Annual Report 2004. Including the Report of the Inspector of Mental Health Services. Dublin: Mental Health Commission. 2005a.Google Scholar
3.Killaspy, H, Harden, C, Holloway, F, King, M. What do Mental Health Rehabilitation Services do and what are they for? A National Survey in England. J Mental Health 2005; 14: 157165.CrossRefGoogle Scholar
4.Mental Health Commission Annual Report 2004, including the report of the Inspector of Mental Health Services.Google Scholar
5.Central Statistics Office: Census 2006.Google Scholar
6.WHO International Statistical Classification of Diseases, 10th Revision. World Health Organisation, Geneva, 1992.Google Scholar
7.Slade, M, Thornicroft, G, Loftus, L, Phelan, M. The Camberwell Assessment of Need (CAN). The Royal College of Psychiatrists (Gaskell), 1999.Google Scholar
8. Statistical Package for the Social Sciences (Version 10.0).Google Scholar
9. Mental Treatment Act (1945).Google Scholar
10.Tedstone Doherty, D, Walsh, D, Moran, R, Bannon, F. High support community residences census 2006. Dublin: Health Research Board, 2007Google Scholar
11.Doherty, D, Walshe, D, Moran, R. Health Research Board. Happy Living Here…. A Survey and Evaluation of Community Residential Mental Health Services in Ireland. Mental Health Commission 2007.Google Scholar
12.Lelliott, P, Audini, B, Knapp, Chisholm D. The Mental Health Residential Care Study: classification of facilities and description of residents. Hospital and Community Psychiatry 1996: 37: 901907.Google Scholar
13.Killaspy, H, Rambarran, D, Bledin, K. Mental Health Needs of Clients of Rehabilitation services: a survey in one Trust (accepted by J Mental Health 2007).CrossRefGoogle Scholar
14.Trieman, N, Leff, J. The TAPS Project 36: The most difficult to place long-stay psychiatric inpatients-outcome one year after relocation. Br J Psychiatry 1996; 169: 289292.CrossRefGoogle ScholarPubMed
15.Sheperd, G. System failure? The problems of reducing long-stay beds in the UK. Epidemiogia E Psichiatria Sociale 1998; 7(2): 127134.CrossRefGoogle Scholar
16.North-eastern Health Board 2001. Cavan Monaghan Mental Health Service: A Model for a New Community Health Service – The Cavan-Monaghan Project.Google Scholar
17.Clifford, P, Morris, I. Social Functioning Questionnaire.Google Scholar
18.Clifford, P, Morris, I. Community Placement Questionnaire, 1986.Google Scholar