Nuts and Bolts of Starting and Running Psychiatric Rehabilitation Services

Abstract

This book is published as a part of fellowship in psychiatric rehabilitation program by NIMHANS. Dr. Chethan Basavarajappa and Mr. P. C. Ashfak Ahamed were the first fellows in the same. It is in continuation with the proceedings of “Nuts and Bolts of Starting and Running Psychiatric Rehabilitation Services – A Symposium” conducted on April 4, 2015, to address the challenges in setting up and running a rehabilitation center. Rehabilitation has gained importance, especially in psychiatric context, as the illnesses are chronic and also have a lot of stigma attached, both of which can be addressed by proper rehabilitation. This is an unexplored area, especially in India, where rehabilitation psychiatry is still in the nascent stages. This book consists of twenty chapters. Subject experts on different aspects of psychiatric rehabilitation have contributed which adds to the rich flavor and the content offered in the book. Prof. Mohan Isaac, who has done extensive work and published a lot of original work in the field of community mental health, wrote the foreword to this book. The first three chapters introduce the concept of psychiatric rehabilitation and the current Indian scene. The next six chapters describe the various settings of a rehabilitation center such as inpatient services, outpatient services, long stay homes, and halfway homes. It emphasizes the fact that rehabilitation should start as soon as the patient comes to the psychiatrist for the first time. They have highlighted some initiatives started at NIMHANS such as SERWICE (OPD basis rehabilitation), Family Fellowship Society (long stay homes), and Virtual Learning Center-NIMHANS ECHO. These successful initiatives serve as guidelines for those interested in starting similar services. The roles of various specialties have been covered in the Chapters 11–15. Very clear description of the roles of various professionals such as psychiatrist, clinical psychologist, psychiatric social worker, psychiatric nurses, and lay counselors has been laid out. The last few chapters deal with other useful topics such as use of technology in psychiatric rehabilitation, legal and financial aspects, supported employment, and government schemes for persons with psychiatric disability. On the flip side, research in psychiatric rehabilitation and training human resources in this field have not been adequately covered. Most of the contributions have come from the NIMHANS experience and services in Karnataka. It would have been more comprehensive to have information on such services from other parts of the country too. Further, a section on frequently asked questions on some of the common dilemmas and challenges in running a rehabilitation center would make it more informative. An appendix listing all the rehabilitation centers across India would have been beneficial for further reference. The book is written in a very simple language and hence, serves as a layman's guide to setting up a rehabilitation center. It is not just for psychiatrists but also for anyone related to the field of rehabilitation. The authors suggested a change in the nomenclature from psychiatric rehabilitation to a more dynamic and positive term like “recovery-oriented services” which is the true essence of any rehabilitation. It describes in a very concise and precise manner all the aspects related to rehabilitation which can serve as a benchmark for future books to be written on the same theme. The tables and charts in the book are a quick and easy way to understand the information given in the chapters. All in all, one must read for anyone connected to psychiatric rehabilitation.