Psychosocial Rehabilitation model in Šiauliai District Mental Hospital

1. The public institution Šiauliai District Mental Hospital Eugenijus Mikaliūnas Tartu International Conference 2007 10 31 Psychosocial Rehabilitation model in Šiauliai District Mental Hospital

2. Hospital recourse 2006-12-31d. Number of beds – 200 Daytime Inpatient Department – 41 places Medical staff – 120 establishments Services provided for – 400 000 people Income per annum – 8,5 million Lt. E. Mikaliūnas 2007.10.31 Tartu International Conference

3. The public institution Šiauliai District Mental Hospitals’ report on the activities of Year 2006 Patients treated – 2864 Bed-days – 61228 Average time of patient treatment – 21,4 days Bed functioning – 306 Bed turnover – 14,32 E. Mikaliūnas 2007.10.31 Tartu International Conference

4. Partners Primary health care level Secondary health care level Public institution Šiauliai District Hospital Family doctors Department of Psychotherapy Psychiatric department of children and adolescent. Mental health care centres Public institution ŠDMH Šiauliai public institution Nursing Hospital, Psycho geriatric subdivision Šiauliai public institution Center for Addictive Disorders Public institution Šaukėnai Mental Hospital E. Mikaliūnas 2007.10.31 Tartu International Conference

5. Schema of Provided Services THE RECEPTION AND CONSULTATIVE DEPARTMENT Department of Psychiatric Crises services Departments of General Psychiatry services Department of Daytime Psychiatric services Department of Psychosocial Rehabilitation services E. Mikaliūnas 2007.10.31 Tartu International Conference

6. Departments of Provided Services • Reception • Planned and urgent consultations • Consultations in general medicine hospitals THE RECEPTION AND CONSULTATIVE DEPARTMENT • Consultation in Reception and Consultative Department (psychiatrist, mental health nurse, social worker) • 100 beds Inpatient Department CRISIS DEPARTMENT DEPARTMENT OF GENERAL PSYCHIATRY 100 beds Inpatient Department DEPARTMENT OF PSYCHOSOCIAL REHABILITATION 41 places, 16 of them - seasonal DAYTIME IMPATIENT DEPARTMENT E. Mikaliūnas 2007.10.31 Tartu International Conference

7. Medicine Staff Recourses in Treatment Department Psychiatrists – 17 Nurses – 44 : Reception and Consultative Dep. – 6 Emergency State Dep. – 18 General Psychiatry Dep. – 15 Care administrators – 5 Nurse assistants – 41 : Emergency State Dep.– 28 General Psychiatry Dep.– 13 In total: 102 E. Mikaliūnas 2007.10.31 Tartu International Conference

8. Staff Recourses of Psychosocial Rehabilitation Department Head of the department Administrator Psychiatrist Social worker Medicine psychologist Specialist of psychosocial rehabilitation Mental state nurse (for occupation) Occupational therapist (ergo therapist) Arttherapist Occupational therapist for physical preparation Music therapist Physical medicine and rehabilitation nurse Occupational nurses In total: 30 E. Mikaliūnas 2007.10.31 Tartu International Conference

9. Department of Psychosocial Rehabilitation

10. Aims of Psychosocial Rehabilitation Department Establish a multidisciplinary team, that applies methods, alternative to pharmacological treatment for the inpatients in the hospital and Day Department. Help people with severe and long-lasting mental disturbances to improve life quality. Help to adjust successfully to the environment and feel life satisfaction with the minimal specialists' supervision. Help to restore and maintain lost skills and acquire new one's. E. Mikaliūnas 2007.10.31 Tartu International Conference

11. Team of the Psychosocial Rehabilitation Department: Psychiatrist (1) Psychologist - psychotherapist (1) Medical psychologists (3) Social workers (5) Mental health nurses for occupation (5) Occupational therapists (3)

12. SERVICES PROVIDED IN THE PSYCHOSOCIAL REHABILITATION DEPARTMENT

13. SERVICES: Long-term psycho pharmacological treatment Psychotherapy (group and individual) Psychosocial rehabilitation: Restoration and teaching of domestic skills: Personal budget planning Individual food preparation Food preparation in a group Buying, composing menu Ware washing and care Knitting, sewing Drawing, clay modelling E. Mikaliūnas 2007.10.31 Tartu International Conference

14. SERVICES: Hygiene skills restoration Social skills training Developing leisure time spending skills and integrated living in a community skills: Swimming pool Social services centre Exhibitions Theatre Computer skills training Discussions about ethics E. Mikaliūnas 2007.10.31 Tartu International Conference

17. Community – as a roof, where we hide during slasher rain, as a fireplace where we get warm in a cold winter day. Z. Bauman Social thinker E. Mikaliūnas 2007.10.31 Tartu International Conference

18. MODELS of Psychosocial Rehabilitation CONSERVATIVE MODEL Treatment supplement applying special interventions with the aim to prevent handicap. E.g. Psychological programme for the client and his family, occupational therapy, leisure time therapy. E. Mikaliūnas 2007.10.31 Tartu International Conference

19. MODELS of Psychosocial Rehabilitation CLIENTS' CHOSEN GOAL MODEL Highly specialized treatment, when a client has a need to develop specific skills and specialists formulate tasks an interventions to reach this goal. E.g.: social skills training. E. Mikaliūnas 2007.10.31 Tartu International Conference

20. MODELS of Psychosocial Rehabilitation INTEGRATIVE MODEL OF SERVICES AND INTERVENTIONS: Long term support after treatment. Integration of services and interventions. Specialists evaluate client's needs and help is assigned according to the conditions and demands. E.g.: long-termed and thorough community treatment. E. Mikaliūnas 2007.10.31 Tartu International Conference

21. Psychosocial rehabilitation of patients with schizophrenia Community based methods of treatment Rehabilitation Family therapy Methods of psychosocial rehabilitation Individual psychotherapy Group therapy Self-help group Maurizio Pompili et. all World J Biol Psychiatry, (2004) 5,201-210 E. Mikaliūnas 2007.10.31 Tartu International Conference

22. Psychosocial interventions for patients with schizophrenia Individual therapy Psychosocial interventions Family therapy Psychotherapy Group therapy Social therapy Problem solving strategies Community-based methods of treatment Crisis centers Hospitalisation Self-help groups Supported employment Assertive community treatment Social skills training Occupational rehabilitation E. Mikaliūnas 2007.10.31 Tartu International Conference Maurizio Pompili et. all World J Biol Psychiatry, (2004) 5,201-210

23. The end THANK YOU FOR YOUR ATTENTION!