M243. EFFECTIVENESS AND SATISFACTION WITH A SCHIZOPHRENIA RECOVERY DAY PROGRAM

Abstract

BackgroundSchizophrenia is a complex disorder typically defined by the presence of positive symptoms that include hallucinations, delusions, and disorganisation in speech and behaviour, negative symptoms of avolition and social withdrawal, and a decline in functioning. Despite an ability to treat clinical symptoms, functional recovery in schizophrenia remains poor. The Recovery Day Program at the Royal Ottawa Mental Health Centre is a multi-disciplinary intervention tailored to help people living with schizophrenia attain recovery goals, lead more satisfying lives, engage in activities, develop a social network and assist in community reintegration. Eligibility criteria are: 18 years of age or older, meet DSM V criteria for Schizophrenia Spectrum illness, have clinical needs that cannot be met in the community, have housing, require intensive recovery support/integration into community, be able to engage in day hospital programming and develop recovery goals. Maximum number of day clients in Day Program is 20. Client admissions began in June 2016. As of November 2019, there have been 50 admissions with 29 discharges. Age range of clients was 20–60 years (mean 36.5). Clients were invited to provide feedback on their experience with the Day Program for program evaluation and improvement of service.MethodsA qualitative and quantitative evaluation of functional outcomes and patient satisfaction was conducted. Measures were administered at admission and discharge: The Illness Management and Recovery Scale (IMRS), a custom-generated activity and goal attainment scale, Quality of Life Scale, The World Health Organization Disability Assessment Schedule 2.0, the Modified Global Assessment of Functioning Scale and the Clinical Global Impression Scale. The Ontario Perception of Care Survey for Mental Health and Addictions (OPOC) was administered during a two month period from January 2019.ResultsDischarge results were available for 29 individuals out of 50 admissions. Clients identified goals in areas including vocational, social, educational, symptom management, optimizing independence, minimizing substance use, managing finances and stable housing; group and individual interventions targeted these areas. Interventions occur at the hospital and in the community. Results of the activity summary identify significant change in community integration in the following areas: employment (admission 5% and discharge 47%), unpaid/volunteer work (admission 11% and discharge 42%), course or study (admission 0% and discharge 32%), social/recreation/group activities (admission 63% and discharge 100%). Results show a significant increase in IMRS scores over time. Goal achievement was statistically significant according to the goal attainment scale (mean at intake 3.4 and at discharge 8.6). Results show that goal importance did not change over time.Open ended questions about day programming were added to the OPOC. Of 15 respondents, the average length of time in the Program was 16 months. Majority of respondents attended as much as they liked, while those unable to attend as much as they wanted, identified that increased attendance may have been helpful to achieving their goals.DiscussionOverall, clients were very satisfied with services provided. There were significant achievements in goal attainment over time with targeted interventions provided in functional domains including employment, unpaid/volunteer work, course of study and social/recreation activities. Our data suggest that a medium term, intensive day program increases functional outcomes and personal satisfaction for individuals with a Schizophrenia Spectrum disorder. Further study would be important to assess how these changes are sustained over time.