What do mental health rehabilitation services do and what are they for? A national survey in England

Abstract

Background: The specialty of rehabilitation is under represented in current national policy, current service provision is unclear and there are no guidelines on what constitutes a standard rehabilitation service.Aim: To carry out a national survey of rehabilitation services in order to describe current service provision and to formulate a consensus definition of the term “rehabilitation”.Method: A structured telephone survey was carried out with consultants in rehabilitation psychiatry or senior service managers in all Trusts in England. As well as information about their services, interviewees were asked to give a definition of the term “rehabilitation”.Results: A response rate of 89% (65/73 Trusts) was achieved constituting interviews with representatives from 93 local authority regions (75% consultants, 25% service managers). The majority (77%) had short term (length of stay up to 12 months) rehabilitation units with a mean 13 beds. There were no differences between urban and rural services in bed numbers. Most services had input from all members of a multidisciplinary team and where services had short and longer term units, staff tended to cover both. The majority (79%) had specific referral criteria, 42% had exclusion criteria and 85% carried out a preadmission assessment. Over half (56%) had a community rehabilitation team and in 29%, assertive outreach teams were considered part of the rehabilitation service. Two models of community rehabilitation service provision emerged and a consensus definition of “rehabilitation” was formulated.Conclusions: This is the first national survey of rehabilitation services which has allowed the description of current service provision in some detail as well as two models of community rehabilitation services.Declaration of Interest: None.