RESUMO
Through the Federal German Government's incentives (1976-1985) brought about considerable experience with community based psychiatric services many desideratas and shortcomings stood the reformist efforts: above all, the needs of long term patients remained unmet. At the same time a necessary integration into communities' everyday life culture still is out of reach. The author stresses the biases of the natural-science-medical paradigm when confronted with the demands of social psychiatry. The author suggests some organizational measures to help community related services on their ways.
Assuntos
Serviços Comunitários de Saúde Mental/tendências , Comparação Transcultural , Transtornos Mentais/reabilitação , Serviço Social em Psiquiatria/tendências , Desinstitucionalização/tendências , Alemanha Ocidental , Necessidades e Demandas de Serviços de Saúde/tendências , HumanosRESUMO
With reference to a recent reader on rehabilitation for the chronically mentally ill in the German Democratic Republic and the USSR the authors travelled to Leningrad, USSR, to learn about the efforts to integrate rather than add up multidisciplinary approaches to work rehabilitation. The authors found a sheltered workshop for about 400 patients where much of the principles of work rehabilitation obviously work: flexible and manyfold work, well adapted to the varying standards of the patients both unskilled workers and patients with academic background. The workshop being one branch of the nationally significant Bechterev Institute for Psychiatry and Neurology also transfers patients to the general workforce where rehabilitation patients are paid a 125% salary. Both the optimistic atmosphere and the economically self supporting shop give good reason to learn more about rehabilitation for the chronically ill in the USSR and the efforts to progress.
Assuntos
Transtornos Neurocognitivos/reabilitação , Terapia Ocupacional/tendências , Reabilitação Vocacional/tendências , Terapia Combinada , Humanos , U.R.S.S.RESUMO
Community based out-care systems for the long term patient has been a concern ever since deinstitutionalization and rehabilitation became a task in the 60's. Much of our efforts failed. Here we try to make the point of organizational factors and their impact on motivation and cooperative incentives both for the staff in the wards, and in the community based clinics. Exchange theory is offered as a base to outline better planning.
Assuntos
Assistência ao Convalescente/organização & administração , Serviços Comunitários de Saúde Mental , Transtornos Mentais/reabilitação , Ajustamento Social , Serviços Comunitários de Saúde Mental/organização & administração , Desinstitucionalização , Recursos em Saúde , Necessidades e Demandas de Serviços de Saúde , Humanos , Equipe de Assistência ao Paciente/organização & administraçãoRESUMO
During the past decades much effort has been taken to encourage community - based treatment and service for mental patients, and to reduce the share of the large custodial institutions within mental health care systems. Both in the United States and in W-Germany (FRG) there has been a growing awareness that major inadequacies occur especially with providing community--based out-care for the seriously mentally ill. Much of these inadequacies refer to those released from the mental hospital with such needs as help to structure their everyday lives, adequate housing, nutrition, support for the families and neighborhoods involved, financial support, and further treatment. Part 1 delines the growing awareness of these problems with reference to the expectations of "reformists" both for the U.S. and the F.R.G. The paper then describes empirical data about the care given to patients released from the psychiatric hospital within a 90 days' period in the State of Hawaii, U.S.A. It also gives a structural description of agencies involved in the aftercare services, and relates this both to the empirical findings and reformists' views on aftercare needs.