Psychiatric rehabilitation in Switzerland

Abstract

SummaryPsychiatric rehabilitation at present has a focus on the prevention of chronic disability and on active rehabilitation of socalled new long-stay patients. This is a major public health problem, concerning about one-third of all disabled persons in need of rehabilitation. Close co-operation between the various agencies concerned, with funding organizations, patients organizations etc, is of high priority in assuring effective rehabilitation. Various structures and models have been realized in order to facilitate such cooperation. The main axes of rehabilitation are lodging, occupation, financial independence/support, need for out-patient psychiatric care and quality of life. Rehabilitation results are measured along those axes, based on an assessment of patients' needs and satisfaction. Specific programmes have been implemented for various diagnostic groups, especially schizophrenic psychosis, mental retardation, substance dependence and organic brain damage. Specifications of these diversified programmes are described. Evaluation of rehabilitation efforts uses different designs, methods and instruments; a harmonization on the level of instruments is intended. A few examples regarding evaluation results (concerning schizophrenic and drug dependent patients) are presented. Finally, external factors limiting the efficacy of rehabilitation efforts are described.