Psychiatric Bulletin (2004) 28: 151. doi: 10.1192/pb.28.4.151
© 2004 The Royal College of Psychiatrists
Psychiatric Bulletin (2004) 28: 151
© 2004 The Royal College of Psychiatrists
Rehabilitation and recovery now
Council Report CR121, January 2004, Royal College of Psychiatrists, £5.00, 22 pp.
Rehabilitation and recovery services are a rewarding area of psychiatric
practice; these services are in a continuing process of development, in
response to the changing needs of the target population and to the changing
political climate of mental health care delivery. The developmental journey
for rehabilitation and recovery services is at a particularly interesting
stage and offers many opportunities for psychiatrists to develop new skills
over the course of their careers.
There are new developments in the way in which services are provided in
partnership with service users, their families and other agencies.
Rehabilitation and recovery services now provide unique opportunities for the
development of longer-term therapeutic relationships with patients and their
partners in care, and also offer the rewarding challenge of practical service
development.
Most rehabilitation services have a developmental history that bridges
deinstitutionalisation, reprovision in its many forms, community care and now
social inclusion, working to reduce the impact of stigma and to promote
recovery. Embracing the concept of recovery, and promoting the recovery ethos
throughout rehabilitation service provision, probably represents a clear new
direction.
This report describes the philosophy underpinning a modern approach to
rehabilitation and recovery. It defines the service user population and gives
a description of the range of service provision, together with the guiding
principles that inform service development. These principles are based
upon:
- enhancing the strengths and resilience of long-term service users and their
families
- maintaining optimism for individual growth and recovery
- treating disability with respect and acceptance
- improving the holistic quality of life for those with the most severe
disabilities
- reducing stigma and promoting social inclusion
- therapeutic risk-taking to promote personal responsibility.
New ways of working with service users and their carers lie at the heart of
the specialty. The journey towards individual recovery while respecting
individual disabilities must inform rehabilitation service development. The
perspective of service users and their families, together with their many
partners in care, can provide a powerful force for development and should be
the starting-point for new work.
This report describes how services can be developed, monitored and
evaluated, and gaps in services identified through collaborative partnership
working. Assessment, treatments and interventions are described and the need
to improve the evidence base for rehabilitation is outlined. Suggestions for
an audit focus in local rehabilitation services are made, together with the
latest recommendations for workforce planning.
Collaborative work with service users, peer group and inter-agency
networking, research, service development and evaluation, and the training of
other staff, all offer significant rewards to psychiatrists keen to respond to
the challenge of providing a modern rehabilitation and recovery service. These
services should lie at the heart of comprehensive community care, responding
to the needs of those most at risk of living with severe disability, and
aiming to promote their recovery.
