Psychiatric Rehabilitation: Quality of Care and Clinical Effectiveness

Abstract

There has been a resurgence of interest in mental health rehabilitation over the past decade, as it became increasingly clear that alternative services were not able to cater for the needs of patients with chronic and complex mental health issues. The study of a cohort of 80 clients was conducted in a 40-bed-inpatient rehabilitation unit retrospectively over a 1-year period, and aimed at describing the service-users’ characteristics, source of referrals and discharge destinations, along with examining the impact of an integrated medical model with psychosocial approach on Length of Stay (LOS); and investigating the sustenance of favorite outcomes over the 6-month period following discharge. Moreover, the quality of service provision on the unit was examined using QuIRC (Quality Indicator for Rehabilitative Care). The bio-psychosocial intervention model resulted in a significant reduction of LOS (p < .0001). The majority of patients were discharged to a less restrictive environment; revolving door admissions were significantly reduced, as well as the utilization of other psychiatric services (acute inpatient, p < .0001, short stay unit, p < .0001, and emergency room for mental health reasons p < .005). The quality of care provided was well above comparable average in some domains but slightly less in others. In the current climate of outcome driven services, we have demonstrated the effectiveness of an integrated model that appears to be prospectively sustainable. Investing resources and efforts on effective psychiatric rehabilitation programs for patients with enduring mental illness and complex needs, improves quality and economics that resonates throughout the wider scope of psychiatric services.