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Padmavathi J, Gandhi S, Siva Kumar T. Systematic Review on End-Users' Perception of Facilitators and Barriers in Accessing Tele-Rehabilitation Services. JOURNAL OF PSYCHOSOCIAL REHABILITATION AND MENTAL HEALTH 2023; 10:1-12. [PMID: 37360916 PMCID: PMC10041503 DOI: 10.1007/s40737-023-00333-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 02/04/2023] [Indexed: 03/29/2023]
Abstract
Psychiatric rehabilitation is a therapeutic approach that encourages people with mental illness and intellectual disabilities to develop their inherent capacities through learning and environmental support. Psychiatric treatment (pharmacological and psychological) controls psychiatric symptoms; psychiatric rehabilitation focuses on functioning and role outcomes. The review aimed to explore the end-user's perception of facilitators and barriers in accessing psychiatric tele-rehabilitation services. Various electronic databases like Web of Science, Scopus, PubMed, Research Gate, Science Direct, ProQuest, Springer, Wolters-Taylors, Elsevier, PsycINFO, and Wiley online library were searched using Google scholar. Inclusion criteria were studies including psychiatric rehabilitation, web-based interventions, and facilitators and barriers in accessing psychiatric tele-rehabilitation services. A systematic search identified 13 studies, including quantitative, qualitative, and mixed-method approaches. The results identified were based on the facilitators and barriers in accessing telerehabilitation. The common themes identified in this review are (1) facilitators of telerehabilitation, (2) barriers of tele-rehabilitation, and (3) expectations in tele-rehabilitation. The facilitating factors include an internet-enabled device, cost/financial benefits, ehealthcare knowledge, technology as a valuable and accessible tool, motivational factors, satisfaction and willingness. The barriers include affordability to the internetenabled device, network connectivity, lack of technical skills, and digital literacy. Expectations include some modifications needed to carry out effective practices of psychiatric tele-rehabilitation. Effective tele-rehabilitation helps people with mental illness and intellectual developmental disorders for their optimal functioning/quality of life.
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Affiliation(s)
- J. Padmavathi
- Department of Nursing, National Institute of Mental Health and Neurosciences (An Institute of National Importance), Bengaluru, Karnataka India
| | - Sailaxmi Gandhi
- Department of Nursing, National Institute of Mental Health and Neurosciences (An Institute of National Importance), Bengaluru, Karnataka India
| | - T. Siva Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (An Institute of National Importance), Bengaluru, Karnataka India
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Singhai K, Vanishree BNG, Sivakumar T. Affordable residential rehabilitation facilities for persons with chronic mental illness: An emerging need. Indian J Psychiatry 2022; 64:520-524. [PMID: 36458091 PMCID: PMC9707657 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_128_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 05/28/2022] [Accepted: 06/22/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- Kartik Singhai
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | | | - Thanapal Sivakumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Thekkumkara SN, Jagannathan A, Sivakumar T. Pradhan Mantri Kaushal Vikas Yojana (PMKVY): Implications for Skills Training and Employment of Persons With Mental Illness. Indian J Psychol Med 2022; 44:173-176. [PMID: 35655990 PMCID: PMC9120997 DOI: 10.1177/0253717621997180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Sreekanth Nair Thekkumkara
- Dept. of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Aarti Jagannathan
- Dept. of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Thanapal Sivakumar
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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Roy A, Jayarajan D, Sivakumar T. Income Generation Programs for Persons with Mental Health Challenges: Practices from 13 Indian Mental Health Rehabilitation Centers. Indian J Psychol Med 2022; 44:160-166. [PMID: 35655965 PMCID: PMC9120983 DOI: 10.1177/0253717620959759] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND In India, mental health rehabilitation centers run income generation programs (IGP) for therapeutic engagement, skills training, and income generation of clients. The centers have evolved IGP models relevant to their settings. There is a paucity of published literature on practices employed by the centers. METHODS This paper compiles data gathered from visits to 13 centers between November 2018 and April 2019. Information was collected through observation and interviews with staff involved in IGP, using a semi-structured pro forma designed for study. RESULTS Most centers were based in south India (n = 11) and urban areas (n = 12). Each center ran two to seven IGP. Each center involved 20-50 clients in IGP. Clients involved in IGP were aged 20-60 years. The centers ran a range of IGP, including the manufacturing of household consumables, paper products, textile products, handicraft products, food products, and jute products; animal husbandry and horticulture initiatives; and running cafeterias and petty shops. IGP were mostly selected based on market demand and sales value of products (n = 11); ease of doing (n = 5); interests, abilities, exposure, and experience of clients (n = 5); and availability of resources (n = 3). Products were priced primarily to cover input and labor costs (n = 8), and many centers sold products below the market rates (n = 5). Running stalls during public events was a common strategy for the sale of products (n = 9). Personal contacts and "word of mouth" publicity were used for advertisement (n = 6). Four centers involved family members in IGP. CONCLUSION The nature of IGP varied in terms of setting, available resources, and profile of clients availing the services. Marketing and sales were a challenge. A supportive framework of policies and schemes is essential to promote IGP at mental health rehabilitation centers. This report may be helpful for professionals and centers planning to set up an IGP.
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Affiliation(s)
- Amrita Roy
- Psychiatric Rehabilitation Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Deepak Jayarajan
- Psychiatric Rehabilitation Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Thanapal Sivakumar
- Psychiatric Rehabilitation Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Sharma M, Nischal A, Nischal A, Agarwal M, Gupta B, Kar SK, Pahuja E. Disability in clinically stable patients of schizophrenia. Ind Psychiatry J 2020; 29:61-67. [PMID: 33776277 PMCID: PMC7989458 DOI: 10.4103/ipj.ipj_82_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/25/2020] [Accepted: 07/11/2020] [Indexed: 11/04/2022] Open
Abstract
PURPOSE Disability associated with schizophrenia affects every aspect of life. In India, persons with schizophrenia are eligible for disability benefits. Only a handful of patients are aware and able to avail the benefits. We intended to assess disability in clinically stable patients of schizophrenia as even though they are stable but are disabled and may benefit from disability benefits and rehabilitation. METHODS Sixty-two clinically stable patients of schizophrenia were assessed on the Mini-International Neuropsychiatric Interview, Positive and Negative Syndrome Scale (PANSS), and Schizophrenia Cognition Rating Scale. Disability was assessed on the Indian Disability Evaluation and Assessment Scale (IDEAS). RESULTS Nearly one-fourth of the "stable patients" had moderate-to-severe disability (22.6% - moderate and 1.6% - severe), i.e., certifiable disability as per IDEAS. Disability had a significant correlation with all three domains of PANSS as well as total PANSS score. The correlation was stronger with negative than with positive symptom scores. Disability also strongly correlated with cognitive impairment. "Work," "communication and understanding," and "interpersonal relationship" domains of IDEAS had a strong correlation with cognitive impairment. CONCLUSION Nearly 25% of the stable patients had certifiable disability. The "work" domain of IDEAS was most affected. It demonstrates that the rehabilitation of this population may contribute to reducing disability.
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Affiliation(s)
| | - Anil Nischal
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Anuradha Nischal
- Department of Pharmacology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Manu Agarwal
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Bandna Gupta
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sujit Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Erika Pahuja
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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Abstract
PURPOSE OF REVIEW To review the evolution of family support movement for schizophrenia in India and to report perspectives of family caregivers who are running family support groups across the country in the backdrop of recent legislations in India. RECENT FINDINGS Family support movement started in the 1990s, mostly by family caregivers independently in multiple cities across the country. Apart from periodic support meetings, they have successfully influenced recent legislations to address the felt needs of families. Mental health professionals need to gain skills to work collaboratively with assertive family caregivers to develop services to support those diagnosed with mental illness. Though there is a need for such movement, funding is poor and very few caregivers of persons with schizophrenia are forthcoming to participate. The formation of national federation with government and non-government partnership could help give the required impetus to the family support movement for persons with schizophrenia in India.
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Affiliation(s)
| | - Thanapal Sivakumar
- Psychiatric Rehabilitation Services, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Aarti Jagannathan
- Department of Psychiatric Social Work (Psychiatric Rehabilitation Services, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
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Hill H, Killaspy H, Ramachandran P, Ng RMK, Bulman N, Harvey C. A structured review of psychiatric rehabilitation for individuals living with severe mental illness within three regions of the Asia-Pacific: Implications for practice and policy. Asia Pac Psychiatry 2019; 11:e12349. [PMID: 30734499 DOI: 10.1111/appy.12349] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Accepted: 12/27/2018] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Psychiatric rehabilitation can provide and support recovery-oriented care by assisting individuals living with severe mental illness to lead full lives. Despite a well-established evidence-base, implementation and access to these interventions in clinical practice for people with severe mental illness in the Asia-Pacific region is low. We therefore aimed to evaluate prominent themes impacting on clinical practice, policy, and the implementation of psychiatric rehabilitation across the Asia-Pacific region. METHODS A comprehensive review of relevant literature on psychiatric rehabilitation of three regions within the Asia-Pacific was conducted using a structured search of PubMed and other databases. Eligible articles were selected which focussed on how psychiatric rehabilitation is defined and implemented across the Asia-Pacific region, as well as the associated successes and challenges. Common themes were generated. RESULTS Six themes emerged: the impact of policy, legislation, and human rights; access difficulties; the important role of family; the significance of culture, religion, and spiritual beliefs; the widespread impact of stigma; and the indigenous models of excellence being developed. DISCUSSION Consideration of the six themes and their implications should help raise awareness of the issues involved in the provision of psychiatric rehabilitation in the Asia-Pacific region and may improve outcomes for people living with severe mental illness. Suggested strategies include: developing a shared understanding of psychiatric rehabilitation; establishing quality legislation that's well implemented; adapting evidence-based models to develop culturally appropriate services; implementing stigma reduction and empowerment-based interventions; and, ensuring coordinated action among all stakeholders, combined with effective leadership.
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Affiliation(s)
- Harry Hill
- Mental Health, Drugs & Alcohol Service, Barwon Health, Geelong, Australia.,Department of Psychiatry, The University of Melbourne, Parkville, Australia.,School of Medicine, Deakin University, Geelong, Australia
| | - Helen Killaspy
- Division of Psychiatry, University College London, London, UK
| | | | | | - Nicole Bulman
- Mental Health, Drugs & Alcohol Service, Barwon Health, Geelong, Australia
| | - Carol Harvey
- Department of Psychiatry, The University of Melbourne, Parkville, Australia.,North West Area Mental Health Service, NorthWestern Mental Health, Melbourne, Australia
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Affiliation(s)
- B. R. Sahithya
- Department of Psychiatry, St. John’s National Academy of Health Sciences, Bangalore, India
| | - R. P. Reddy
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bangalore, India
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Manjunatha N, Agarwal PP, Shashidhara HN, Palakode M, Raj EA, Mary Kapanee AR, Nattala P, Kumar CN, Sudhir P, Thirthalli J, Bharath S, Sekar K, Varghese M. First 2 Years of Experience of "Residential Care" at "Sakalawara Rehabilitation Services," National Institute of Mental Health and Neurosciences, Bengaluru, India. Indian J Psychol Med 2017; 39:750-755. [PMID: 29284806 PMCID: PMC5733423 DOI: 10.4103/ijpsym.ijpsym_40_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION There is an unmet need for continuity-of-care is well known for those with severe mental disorders (SMDs) after acute care at hospitals in India. The "Sakalawara Rehabilitation Services (SRS)" functioned from March 2014 at "Sakalawara Community Mental Health Centre" (SCMHC) of "National Institute of Mental Health and Neurosciences," Bengaluru, India in the concepts of residential care (half-way-home) with the aim to develop a replicable model. AIM To review the inpatient records after the initial 2 years of experience in residential care at SCMHC. METHODOLOGY Retrospective file review of inpatients at SCMHC from March 2014 to March 2016 in a semi-structured proforma designed for the study. Ethical committee of NIMHANS Bengaluru has approved the study. RESULTS The total number of inpatients during this period was 85. It was found that Schizophrenia spectrum disorders were the most common diagnosis among these patients. The activity of daily living and psycho-education were the most common individual interventions. The majority of families underwent structured family psycho-educational interventions. This review also demonstrated the feasibility of tele-aftercare in continuity of care after discharge of patients. CONCLUSION SRS kind of residential set-up is feasible and demonstrated effectiveness in maintaining continuity of care of SMDs. There is a need for better structured and customized interventions. There is further a scope for tele (video) aftercare for those with SMDs.
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Affiliation(s)
- Narayana Manjunatha
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Preeti Pansari Agarwal
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Harihara N. Shashidhara
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Mohan Palakode
- Department of Nursing, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - E. Aravind Raj
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Aruna Rose Mary Kapanee
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Prashanthi Nattala
- Department of Nursing, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - C. Naveen Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Paulomi Sudhir
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Jagadisha Thirthalli
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Srikala Bharath
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Kasi Sekar
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Mathew Varghese
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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