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Rehabilitation in Psychosis: Rebuilding & Transforming Lives Dr Sridevi Kalidindi PhD, FRCPsych

Rehabilitation in Psychosis: Rebuilding & Transforming Lives Dr Sridevi Kalidindi PhD, FRCPsych. Chair, Faculty of Rehabilitation & Social Psychiatry; Co-Chair, Joint Commissioning Panel –Mental Health; Consultant Psychiatrist in Rehabilitation & Recovery; Visiting Lecturer IOPPN

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Rehabilitation in Psychosis: Rebuilding & Transforming Lives Dr Sridevi Kalidindi PhD, FRCPsych

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  1. Rehabilitation in Psychosis: Rebuilding & Transforming LivesDr Sridevi Kalidindi PhD, FRCPsych • Chair, Faculty of Rehabilitation & Social Psychiatry; • Co-Chair, Joint Commissioning Panel –Mental Health; • Consultant Psychiatrist in Rehabilitation & Recovery; Visiting Lecturer IOPPN • Trust Clinical Liaison Lead for Contracts • Sridevi.kalidindi@slam.nhs.uk • http://www.rcpsych.ac.uk/workinpsychiatry/faculties/rehabilitationandsocial.aspx

  2. Rehabilitation in Psychosis – Co-producing Transformed Lives. “Thank you for giving me my life back” • Real life stories: Clinical and service user innovation – the long(er) view • Severe personality disorder and psychosis • Autistic spectrum disorder and psychosis • Substance misuse and psychosis • BME, substance misuse and psychosis

  3. People with complex psychosis and complex needs • Psychosis • Treatment resistance • Negative symptoms • Comorbidities – mental and physical health • Functional impairments • Challenging behaviour • Difficult to engage • Risk • 10-14% of EIP require rehabilitation • 10-20% of secondary care; Account for 25%-50% of the annual UK mental health budget (MH Strategies 2012)

  4. Specialist skills of rehabilitation services http://www.rcpsych.ac.uk/workinpsychiatry/faculties/rehabilitationandsocial.aspx

  5. Skills of a Community Rehabilitation Team(see guidance) • Leadership; the long(er) view • ‘Pull through’ to less restrictive, more independent, socially inclusive and meaningful lives • Public Relations • Internal to the team • Patients & carers • Working with other teams • Provider facing • Managing transition • Commissioner facing • Census, performance management; systemic blocks, challenge discrimination - educate • placements/care packages/ funding panel • OATs • local service development • cost of unmet need (Campion 2012)

  6. Whole system approach to mental health rehabilitation services

  7. A National Strategy National commissioning Guidance (Waxing and waning rehabilitation services nationally) www.jcpmh.info

  8. Out-of-Area TreatmentIn Sight, In Mind – Toolkit for OATs

  9. Setting National Standards • AIMS – Rehab; CQC • Community Rehab standards underway • NICE guidance eg. • i) Transition from Hospital • to Care Home • ii) New – NICE guidance service specification (2016!)

  10. A Pathway Approach Many local examples of good innovative pathways, both in-patient and community National pathway: High level within the commissioning guidance Detailed - under construction. Careful not to stifle local innovation, based on local needs Earlier intervention is key. Criteria – 2 acute admissions in one year, > 30 day admission

  11. Faculty of Rehabilitation & Social Psychiatry • National review of Rehabilitation (all types) • National review for Mental Health Supported Housing • National Survey of Rehabilitation Services • Employment • DWP, Expert Review; Training for assessing Doctors • Recruitment, Education and Training • International Rehabilitation

  12. International Rehabilitation Psychiatry #FundaMentalSDG United Nations Sustainable Development Goals 2015 Development Agenda www.fundamentalsdg.org

  13. Rehabilitation in Psychosis – Co-producing Transformed Lives

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