Significance of Psychosocial Rehabilitation in Mental Health-
The treatment of mental health disorders usually includes two aspects: the actual treatment itself, and rehabilitation. Treatment focuses on reducing the symptoms of an illness that are present in the patient. In the case of a person with fever, the goal of treatment is to bring down the body temperature.
Unlike in the case of physical illnesses where medication or surgery may provide a complete cure, mental disorders require medication along with other forms of treatment. The type of treatment administered to the patient depends on their diagnosis, the severity of the illness, as well as their physical and emotional state. A person may need a combination of some of these forms of treatment: medication, therapy, counselling, hospitalisation, brain stimulation treatments and psychiatric rehabilitation. Often, the lines demarcating treatment and rehabilitation may be blurred.
Psychiatric rehabilitation is an aspect of treatment that focuses on helping the person return to an optimal level of functioning and to achieve their life goals. This is brought about by providing medical, psychological and social input. There is no strict boundary between treatment and rehabilitation.
Not all persons with mental illness require rehabilitation. For many patients, medication or a combination of medication and therapy is sufficient to help them get back to a functional life. For some others, rehabilitation may be that essential final part of the treatment cycle.
Why is rehabilitation necessary?
People with severe and chronic psychiatric illnesses such as bipolar disorder and schizophrenia may be mentally disabled by their condition, and require rehabilitation to pick up basic skills. In the case of disorders such as mental retardation, a process of habilitation is followed to help patients learn skills necessary for daily functioning.
(An individual who has to re-learn skills after the onset of mental illness is said to undergo a process of rehabilitation. An individual who has not picked up certain skills due to mental illness has to learn those skills for the first time. Experts refer to this process as habilitation.)
The process of rehabilitation aims to help the patient develop the social and intellectual skills that they will need to integrate with mainstream society. This helps the person find a meaningful role for themselves, at home and at work. Rehabilitation supports the patient by providing opportunities, preventing stigma and discrimination.
Patients who have undergone treatment for their mental health disorders can be broadly classified into the following categories:
I. Persons who feel better after the treatment, but their illness leaves some impression on their functioning (eg. decreased cognitive skills)
II. Persons who are able to function independently, but are demoralised or have given up due to their circumstances, and/or the stigma they face
III. Persons who are functional, but not provided adequate opportunity by their environment.
IV. Persons who are disabled by a severe form of the illness (this is a very small number of all persons who are diagnosed with mental illnesses)
The psychiatrist or rehabilitation professional assesses which of the above categories each patient belongs to.
Most chronic mental illnesses have their onset between the ages of 18 and 25. This is the period when most people set concrete life goals and work towards achieving them. When a person is diagnosed with a severe mental illness, they have a gap of months or years during which they are unable to study or work. The situation worsens if they are denied opportunities after their treatment. Sometimes, their friends and family may be overly critical or overly protective. This adds to the disability caused by their illness.
The Rehabilitation process focuses on-
1. Assessing what the person is capable of (Their Skills, Strengths and Abilities)
2. Accepting the limitations caused by the illness.
- With a thorough understanding of these aspects, a trained professional is able to identify what support the patient needs in order to get back to a functional life.
The Rehabilitation Process-
The rehabilitation process usually begins with the psychiatrist or other mental health professional speaking to the patient and family, to find out the patient’s strengths and interests. At this point, what is most required is for the family to have a realistic understanding of the individual’s capabilities, and to set realistic expectations of them. For instance, a person with a severe mental illness may not be able to socialise or perform in certain kinds of tasks. The family needs to understand that, rather than put pressure on them to conform to their expectations.
Once the family understands the person’s skills and limitations, they may recognise that the person can lead a happy, satisfactory life according to their own preference, and with a set of expectations more suited to their circumstances.
In some cases, the psychiatrist or other mental health professional may engage repeatedly with the person to build a rapport, and understand any problems the patient may be facing, and the family’s outlook towards their illness. The psychiatrist is then able to help them envision a better life despite the limitations posed by their mental illness.
Training and development of skills-After treatment, some patients are able to use their original skills and get back to their work. If a patient is left with significant challenges, they are then offered training to help them develop the skills needed to be in alignment with their new goals, priorities or values. Once the person is able to make a breakthrough – in learning a new skill or finding a new interest – there is an aspiration value to this process. This creates what experts call a positive cycle in which the quality of the person’s life stands to improve.
What is the family’s involvement in rehabilitation?
When a person is diagnosed with a mental health disorder, the family or caregiver also has to cope with the diagnosis. In addition, there are other factors that make coping difficult: a changed perception of who the patient is, what they are capable of, and what their role in the family will be. The caregivers and family also need additional support to help them live with the diagnosis. Rehabilitation helps the family come to terms with the diagnosis, the altered circumstances, and their expectations of the person with the illness. It also helps the family to understand the person’s strengths and create opportunities for them to make a meaningful contribution at home, or in the society.
The involvement of the family is an extremely important aspect of the rehabilitation process. Psychiatrists say that the positive and active support of family members forms the most effective part of the rehabilitation process. When a family spends a considerable amount of time and effort assisting their loved one, it increases the person’s chances of picking up new skills or setting new goals. This will, in turn, help the family as well.
Source: White Swan Foundation
At present ,Ankur Rehab Centre (ARC) is providing Psychosocial Rehabilitation for Schizophrenia, Bipolar Mood Disorder ,Schizoaffective Disorder, Substance Used Disorder(Addiction),Special care come Rehabilitation for Old age with psychiatric disorders and Child with Behavioural and Psychiatric Disorder/s. There are n numbers of psychiatric Disorders. So we are providing here some common name for Psychiatric illnesses. If you find any symptom from the list, kindly visit our Centre for the treatment.
Popular term/Name for Psychiatric Disorders in our Society-
1. Psychosis – शंका करना(Morbid Suspiciousness), अपनी साफ़ सफाई पर ध्यान न देना (Poor Self Care), हवा से बातें करना (Talking in isolation/Hallucinations),बड़ी बड़ी बाते करना (Grandiosity),अकेले रहना (socially Withdrawal),किसी भी काम में मन नहीं लगना (Not working at all),घर से बार बार भागना (Absconding Tendencies),चिड़चिड़ापन (Irritability),नींद न आना (Decreased Sleep),मनोदशा में बिना किसी कारण के परिवर्तन होना (mood swings )
2. Depression- आत्महत्या के विचार आना (Sucidal Thoughts),किसी भी काम में मन नहीं लगना (Lack of interest in daily routine),जीवन मे खालीपन लगना (Emptiness in life),जीवन के प्रति निराशाजनक सोच (Negative thoughts toward life),चिड़चिड़ापन (Irritability),नींद और भूख की अनियमितता (disturbed sleep and Appetite).
3. OCD- अवांछित विचारों का बार बार आना(unwanted Thoughts in mind), किसी भी काम को बार बार दोहराना (Repetitive actions), बार बार हाथ धोना (Repetitive hand wash),अत्याधिक साफ़ सफाई रखना (Overtly Clean) etc
4. Dementia- यह लक्षण55 वर्ष के बाद आते है जैसे भूलने की बीमारी जैसे खाना खाया या नहीं ये भूल जाना(Forgetfulness),समय या तारीख भूल जाना(Not able to remember the date or time)जिद करना(Stuborn behaviour ),घर छोड़ कर भागना(Absconding tendencies), नींद न आना(Decrease Sleep), अकेले में बड़बड़ाने की आदत(Talking in isolation),आक्रान्त व्यवहार(Violent behaviour), भूतकाल की हर बात को याद रख पाना परंतु वर्तमान की बातों को याद नहीं रख पाना ( Not able to recall incidents of present but retrieve past information/incidences ),कपडों में पेशाब या potty कर लेना ( Urine or stool incontinence) etc
5. Learning Disorders- किसी भी विषय को सीखने में जरूरत से ज्यादा समय लगाना या सीख ही न पाना(Unable to understand any subject or taking more time to understand), अक्षर को उल्टा या गलत समझना (Unable to understand pattern of letter or recognise wrong shape or pattern)etc
6. Childhood related Psychiatric or behavioural disorders- अत्याधिक चंचलता(Excessive restlessness) , अत्यधिक शरारती(Excessive Mischievous), ध्यान न लगापाना(Unable to concentration), पढ़ने में कमजोर होना(Weak in studies), स्कूल में कक्षा के अन्य छात्रों से लड़ना (Fighting with other students of class ),समान चुराना(steal stuff), बड़ो का सम्मान न करना(Don’t respect their elders), गालियां देना(Using abusive words),घर खाना न खाना(Demanding for outside food), बहुत ज्यादा झूठ बोलना (Compulsive/Pathological Lier ),स्कूल से बंक मारना (Bunking in the school),नशे करना ( addiction ),तोड़ फोड़ करना (Throwing tantrums) ,अपने आप को नुकसान पहुंचाना (Deliberating Self Harm) etc
Substance Use Disorder (Addiction)- .
Substance use disorder (SUD) is complex a condition in which there is uncontrolled use of a substance despite harmful consequence. People with SUD have an intense focus on using a certain substance(s) such as alcohol, tobacco, or illicit drugs, to the point where the person’s ability to function in day to day life becomes impaired. People keep using the substance even when they know it is causing or will cause problems. The most severe SUDs are sometimes called Addictions.
People can develop an addiction to-: Alcohol, Cannabis (Marijuana), PCP, LSD and other hallucinogens, Inhalants, such as, paint thinners and glue, Opioid pain killers, such as codeine and oxycodone, heroin, Sedatives, hypnotics and anxiolytics (medicines for anxiety such as tranquillisers), Cocaine, methamphetamine and other stimulants, Tobacco
Common Name of Addictive Substance (Also known as street names)-
1. Alcohol— This is the most commonly used substance by adults. Slang terms may refer to the brand or variety of alcohol or may be more general. Non brand-specific street names include: Madira , Deshi ,Videshi, Tharra, Beer, Booze, Juice , Hooch, Sauce, Rotgut etc.
2. Cannabis (Marijuana) – This psychoactive drug substance with the active ingredient delta-9-tetrahydrocannabinol (THC) is used frequently with increased legal status. It is referred to by numerous street names, including: Weed , Ganja , Grass, Green Herb, Aunt Mary, Blunt, Bud, Chronic, Dope, Hydro,Indo, Joint, Kif, Mary Jane, Pot, Reefer, Sense, Sinsemilla, Skunk, Smoke, Trees, 420, Ashes, Atshitshi, Bammy, Baby Bhang, Blanket, Bo-Bo, Bobo Bush, Bomber, Boom, Broccoli, Cheeba, Cripple, Dagga, Dinkie Dow, Ding, Dona Juana, Dona Juanita, Flower, Flower Power, Flower Tops, Ganja, Gasper, Giggle Smoke, Giggle Weed, Good Giggles, Good Butt, Grass, Green, Hash, Herb, Hot Stick, Jane, Jay, Jolly Green, Jolly Green Giant, Joy Smoke, Joy Stick, MJ, Roach, Skunk, Smoke, Trees,
3. Hashish—A concentrated form of delta-9-tetrahydrocannabinol (THC) produced from the same plants that produce marijuana, it is available as an oily substances or a hard resin. It may be called :Boom, Dabs, Gangster, Hash, Hemp
4. Benzodiazepines-Also known as Bars, Benzos, Blues, Chill Pills, Downers, Nerve Pills, Planks, Tranks, and Zannies, Candy, Downers, Sleeping Pills, Tranks, Bars, Circles, Date Rape Drug, Forget-Me Pill, La Rocha, Lunch Money, Mexican Valium, Mind Eraser, Roofies, Wolfies, Eggs, Jellies, Moggies, Vallies, Bars, Bicycle Handle Bars, Footballs, French Fries, Hulk, Ladders, School Bus, Xan, Xanies, Zan, Zannies, Zanbars, Z-Bars, Liquid X, Soap, Scoop
5. Cocaine— This white powdery substance is commonly abused for its euphoric stimulant effects. Some street names include: Blow, Bump, C, Charlie, Coke, Snow, Toot, Coca, Soda Cot etc.
6. Crack Cocaine—The yellowish rock known as “crack” is a version of cocaine that is smoked to produce an intense, immediate, and short-lasting high. It will share some street names with the powder form, as well as specific names like: Candy, Flake, Rock etc.
7. Heroin—This substance, which is essentially a modified form of the morphine alkaloid derived from opium poppies, can be consumed numerous ways (e.g., snorting, smoking, or injection) leading to an intense and addictive high. Common street names include:Brown Sugar, Smack, China White, Chiva, Dope, H, Hell Dust, Horse, Junk, Negra, Skag, Skunk, Tar, Thunder, White Horse, Heroin w/ OTC Cold Meds & Antihistamine: Cheese
8. Dextromethorphan—Found in certain over-the-counter cough and cold medicines, this substance produces hallucinations and paranoia when taken in large doses. Street names include: CCC, Dex, Poor man’s PCP, Robotripping, Robo, Skittles, Triple C, Velvet
9. Phencyclidine(PCP)—Previously used as a surgical aesthetic, PCP can create a sense of profound dissociation and can sometimes elicit psychotic symptoms such as delusions and hallucinations. Users may refer to it as: Angel Dust, Boat, Hog, Love Boat, Peace Pill, Sherm, Mixed with marijuana: Zombie Weed.
10. Psilocybin—Grown in North and South America, these mushrooms can trigger hallucinations, the inability to track time, and an altered sense of reality. They may be called:Little Smoke, Magic Mushrooms, Purple Passion, Shrooms
11. Hallucinogenic Substance-This hallucinogenic substance distorts reality and can produce drug-induced psychosis. Profoundly negative effects are often referred to as “bad trips.” Street names include: Lysergic Acid Diethylamide(LSD), Acid, Blotters, Blue Heaven, Cubes, Dots, Mellow Yellow, Microdot, Window Pane, Yellow Sunshine Dimethyltryptamine, DMT, Dimitri, Businessman’s Trip, Methylenedioxy-Methamphetamine (MDMA), Ecstasy, Adam,Beans, Clarity, Disco Biscuit, E, Eve, Molly, Lover’s Speed, Peace, STP, X, XTC, Uppers, Liquid Ecstasy,Mescaline, Cacti, pleasurable mood changes. Slang names include: Peyote, Buttons, Cactus, Mesc, Salvia, Magic Mint, Maria Pastora, Sally-D, Shepherdess’s Herb, Diviner’s Sage.
11. Ketamine- This dissociative drug is mainly used in veterinary medicine and results in feelings of detachment from reality. It is often called:Cat Tranquilliser, Cat Valium, Jet K, K, Kit Kat, Purple, Special K, Vitamin K.
12. Inhalants—A group of abused substances that comprises a wide range of solvents, glues, Gases (Laughing gas, Spray, Paints, Markers, Glues, Cleaning Fluids /Whitener ) and other volatile products often found around the home. Inhalants give off fumes or vapours, which are then inhaled by the user, providing them with a short-lived but dangerous high. Depending on the type, they may be referred to as: Dusters, Gluey, Huff, Poppers, Rush, Snappers, Whippets, Aerosols etc
13. Khat (Stimulant Drug)—This plant grown in Africa and the Middle East can be chewed to produce a sense of euphoria and increased energy. Commonly referred to as: Abyssinian Tea, African Salad, Catha, Chat, Cat, Oat
14. Methamphetamine—This powerful stimulant increases energy and activity levels while decreasing the need for sleep. This substance is associated with poor decision-making, violence, and dangerous, erratic behaviours. Users are often called “tweakers,” while the substance is commonly called: Batu, Bikers’ Coffee, Black Beauties, Chalk,Chicken Feed, Crank, Crystal, Fire, Glass, Go Fast, Ice, Meth, Methlies Quick, Shards, Speed,Stove Top, Tina, Trash, Tweak, Whiz, Yellow barn
15. Steroids—Legally available to treat hormone deficits, anabolic steroids are abused by those looking to add muscle mass or aid recovery following exercise. Commonly referred to as: Arnolds, Juice, Gym Candy, Pumpers, Roids, Stackers, Weight Gainers
16. Synthetic Cannabinoids—A combination of herbs with chemicals added to produce a “high,” this “synthetic marijuana” can be more potent and more problematic than marijuana. Synthetic Cannabinoids are generally referred to by their many brand names, including: K2, Spice, Black Mamba, Bliss, Bombay Blue, Fake Weed, Fire, Genie, Moon Rocks, Smacked, Yucatan, Zohai
17. Synthetic Cathinones (Bath Salts)—these substances are man-made chemicals that are related to the natural substances found in khat. They can produce a strong sense of euphoria as well as dangerous and erratic behaviours. Bath salts are generally referred to by their many brand names, including: Bloom, Cloud Nine, Cosmic Blast, Flakka, Ivory Wave, Lunar Wave, Scarface, Vanilla Sky, White Lightning.