Psychiatric rehabilitation, also known as psychosocial rehabilitation, and sometimes simplified to psych rehab by providers, is the process of restoration of community functioning and well-being of an individual diagnosed in mental health or mental or emotional disorder and who may be considered to have a psychiatric disability. Psychiatric rehabilitation work is undertaken by rehabilitation counselors (especially the individuals educated in psychiatric rehabilitation), licensed professional counselors (who work in the mental health field), psych rehab consultants or specialists (in private businesses), university level Masters and PhD levels, classes of related disciplines in mental health (psychiatrists, social workers, psychologists, occupational therapists) and community support or allied health workers represented in the new Direct Support Professional Workforce in the US (e.g., psychiatric aides).
These workers seek to effect changes in a person's environment and in a person's ability to deal with his/her environment, so as to facilitate improvement in symptoms or personal distress and life outcomes. These services often "combine pharmacological treatment (often required for program admission), independent living and social skills training, psychological support to clients and their families, housing, vocational rehabilitation and employment, social support and network enhancement and access to leisure activities." There is often a focus on challenging stigma and prejudice to enable social inclusion, on working collaboratively in order to empower clients, and sometimes on a goal of full recovery. The latter is now widely known as a recovery approach or model.
Psychiatric or psychosocial rehabilitation drastically differs from the medical model of mental health treatment. It changes the traditional illness-centered perspective to a type of person-centered treatment model that makes it possible for the severely mentally ill to live successfully with their disorder. As such, these types of rehabilitation programs address the various needs of the entire person, from housing and employment to therapy, medication management and activities of daily living with which a person needs assistance. Setting up a business or organization around psychosocial rehabilitation involves orchestrating resources for the benefit of the mental health client.
Services
Psychiatric rehabilitation services may include: workplace accommodations, supported employment or education, social firms, assertive community (or outreach) teams assisting with social service agencies, medication management, housing, employment, family issues, coping skills and activities of daily living and socializing. Traditionally, "24-hour" service programs (supervised and regulated options) were based upon the concept of instrumental and daily living skills as formulated in the World Health Organization (WHO)definition.
Psychiatric rehabilitation is illustrated by community models (e.g., Fountain House Model, MHA Village in Long Beach, CA), cross-field best practices (e.g., supported work), consumer voices (e.g., Rae Unzicker), multiple disabilities (e.g., chemical dependency), training of community residential, employment, education and support service professionals, rehabilitation outcomes, and management and evaluation of services.
Core principles of effective psychiatric rehabilitation (how services are delivered) must include:
- providing hope when the client lacks it,
- respect for the client wherever they are in the recovery process,
- empowering the client,
- teaching the client wellness planning, and
- emphasizing the importance for the client to develop social support networks.
Psychiatric rehabilitation (what services are delivered) consists of eight main areas:
- Psychiatric (symptom management)
- Health and Medical (maintaining consistency of care)
- Housing (safe environments)
- Basic Living Skills (hygiene, meals, safety, planning, chores)
- Social (relationships, family, boundaries, communications & community integration)
- Vocational and/or Educational (coping skills, motivation)
- Financial (personal budget)
- Community and Legal (resources)
In 2013, it is expected that areas such as supported housing, household management, quality medical plans, advocacy for rights, counseling, and community participation be part of the available package of options for services. Modernization in these fields includes better health care, such as women and men's health (e.g., heart disease), public and private counseling services in mental health, integrated services (for dual and multiple diagnoses), new specialized treatments (e.g., eating disorders), and understanding of trauma services and mental health. Psychiatric rehabilitation is typically associated with long term services and supports in the community, and are described in "Public Administration and Disability: Community Services Administration in the US" (Racino, in press, 2014).
Instruction:
How to Start a Psychosocial Rehabilitation Business
Step 1
Research the different psychosocial rehabilitation models and decide which one might best fit how you want to set up your business or organization. For example, read about the Clubhouse Model, the Individual Placement and Support model and the Community Support System models. All models direct treatment goals at the individual but function slightly differently and emphasize various treatment components.
Step 2
Collaborate with other mental health practitioners in the area. Form a team or "board of directors" so you can use everyone's ideas and expertise concerning the development of the organization. Document the agreed-upon psychosocial rehabilitation services you want to offer, the community resources you need and the treatment or rehabilitation model you'll follow. Write down how community outreach will take place and the different entry points or participants into the rehabilitation program. Decide on the stages of the recovery model for these mental health consumers and discuss how clients interact with the program.
Step 3
Find a place from which to run the program or business. The type of place you look for may depend on the psychiatric rehabilitation model you choose to run. For example, you may want to find a large center with lots of building space if you're operating the Clubhouse Model, while the Community Support System model may not need as large a space. On the other hand, operating state-certified treatment programs and workshops may necessitate a large space. You also may need space for practitioners' offices and business offices.
Step 4
Register your business name and structure with your state. Requirements vary by state, but generally involve completing registration paperwork with the Secretary of State and filing a business name certificate. Check with the county in which you intend to operate and ask if any further licenses or permits are needed.
Step 5
Contact the agency or department of your state in charge of certifying mental health services and programs. Find out the standards your business must meet to obtain licenses to run drug and alcohol rehabilitation programs, outpatient mental health programs and psychiatric rehabilitation services.
Step 6
Contract with other mental health practitioners and resources in the community. Locate one or more staff psychiatrists, social workers, employment specialists and other mental health professionals that can provide the services you need for your clients. Contact job training centers, vocational schools and employers if you're setting up supported education and employment services.
Step 7
Train your staff in psychosocial rehabilitation practices and their role in client-centered programs. Go to the U.S. Psychiatric Rehabilitation Association's website for group training resources. Consider requiring each practitioner in your psychosocial rehabilitation business to attain the Certified Psychiatric Rehabilitation Practitioner credential.
Step 8
Assign duties and roles for each of the professional staff, based on their capabilities and credentials. For example, appoint one or more practitioners as intake coordinators, some as crisis intervention personnel and others as supervisors, depending on the type of staff you need for the specific psychosocial rehab model. Hire administrative personnel, business managers and therapeutic aides to assist with case management activities, billing and financial duties.
Step 9
Advertise your psychiatric rehabilitation program. Contact local media outlets to announce your center's opening and the services it offers. Contract community mental health centers and hospitals and ask to be placed on a list of "resources" or "referrals" for psychiatric patients and clients.
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