MMHA runs two rehabilitation programmes for people with mental disorders to help reintegrate them into their communities and recover from the symptoms that have excluded them from leading productive lives.
The older programme was designed to keep those mentally ill occupied with activities, socialize, develop independent living skills like learning to take public transport, managing money and engaging in daily living activities like marketing and cooking. Art and craft, dancing, singing and games were some of the activities being carried out.
In December 2007, a new Illness Management and Recovery (IMR) Programme was introduced. This is a structured programme which originated in the US as an evidence-based practice. It consists of 10 modules covering the following areas:
- Introduction to the concept of Recovery
- Explaining common psychiatric disorders – schizophrenia, bipolar disorders, depression
- Stress vulnerability model for illness causation
- Building social support
- Using medications effectively
- Drug and alcohol abuse
- Reducing relapses
- Coping with stress
- Coping with problems and persistent symptoms
- Getting your needs met in the mental health system
The modules consist of instructions/lessons by Mental Health Rehab Officers (MHRO); group discussion and sharing of experiences; reflections and workbook exercises. The programme generally takes between 6 months to a year to complete. The IMR sessions are carried out 2-3 times a week.
IMR is a psycho-social education programme aimed primarily at helping those who are mentally ill to recover and specifically at:
- Helping clients to understand their mental condition
- Teaching them methods to cope with distressing symptoms and stress
- Teaching them to communicate and verbalize their problems
- Teaching them to manage their emotions
- Teaching them to be compliant with their medications, and recognize and report relapsing symptoms
- Teaching them to set goals for socialization, and return to work
While undergoing the IMR programme, clients are reviewed by the visiting psychiatrist at least once in 6 months to chart their progress, and as and when necessary if they encounter problems that need professional help. Clients with difficulties are also given counseling by the MHROs.
Wellness Recovery Action Plan (WRAP) developed by Mary Ellen Copeland, PhD. was integrated into the MMHA’s IMR in 2016. WRAP is a self-designed prevention and wellness process that is applicable to anyone who wishes to get well and stay well. It is used extensively by the health care and mental health systems throughout the world. The overview of the WRAP covers the area as below:
- Wellness Toolbox
- Daily Maintenance Plan
- Early Warning Signs
- When things are breaking down
- Crisis Plan
- Post Crisis Plan
Apart from that, there are also 5 key recovery concepts in WRAP:
- Personal Reponsibility
- Self Advocacy
In addition to activities conducted at the centre, clients are also taken for outings like visit to the zoo, the museum, and other interesting places. This is part of developing socializing skills, and helping them to gain confidence in dealing with the outside world.
Success of the rehabilitation is indicated by progress made in the Personal Social Performance (PSP) score which is a universal tool used to chart recovery in 4 areas as follows:
- Personal care
- Personal and social relationships
- Useful social activities
- Aggressive and disruptive behaviours
Clients undergoing the IMR programme would have an assessment on entry into the programme, and every 6 monthly or upon exit from the programme. The ultimate success of the programme is client’s ability to return to work. For this, clients are taught how to prepare a resume, how to conduct oneself in a job interview, how to manage stress in a job setting, and how to ask for a break as examples.
The rehabilitation programme is opened to those who have been diagnosed with a mental illness and are currently being treated by a psychiatrist. It is run daily from Monday to Friday, from 9 am to 4 pm. A small monthly fee is collected to partially cover the costs of the programme, including lunch on Thursdays and Fridays. Those who are interested are advised to call us at our centre during office hours (telephone no. 03-77825499). They have to submit an Application for Admission Form and obtain a Rehabilitation Service Referral Form from the psychiatrist who is treating the mentally ill person.