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

Abstract

AbstractObjectives: 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.