IS PSYCHIATRIC REHABILITATION SOMETHING SPECIAL TO MANAGED CARE IN THE USA

Psychiatric (a term we prefer to psychosocial, because we acknowledge the biological component) rehabilitation (PSR) is well defined in an excellent consensus statement from the World Health Organization (WHO) and World Association for Psychosocial Rehabilitation (WAPR).1 That statement notes “previously considered as tertiary prevention, has evolved into a concept, a body of knowledge, on ways of organizing services and methods subject to empirical validation, and is concerned with the prevention and/or reduction of disability associated with mental and behavioral disorders.” It lists objectives and strategies. At the level of the individual, the principal strategies are: psychopharmacological treatment, independent living, and social skills, psychological support to patients and families, housing, vocational rehabilitation and employment, social support networks, and leisure time use. At the mental health services and human resource level, the strategies are mental health service policy and fund allocation, improvement of institutional and residential settings, training for staff, and quality assurance. At the societal level, the strategies include improvement of pertinent legislation, consumer empowerment, and improvement of public opinion and attitudes related to mental illness.