Specialist psychiatric rehabilitation teams – a historical anomaly?

For many years, psychiatric rehabilitation teams worked to resettle patients from the long-stay ‘asylums’ into the community. This process is now virtually complete and with rising financial pressures in the National Health Service specialist rehabilitation services are under threat in many parts of the UK (Holloway, 2005).

In 2004 a review was undertaken of all people in high-support placements, largely residential homes, funded by the London Borough of Newham, and 30 people, most with chronic schizophrenia, were felt to no longer need the level of support they were receiving. Community mental health teams were encouraged to refer these people to the Newham Rehabilitation and Recovery Team, with aim of aiding their resettlement in more independent accommodation.

Two years on we reviewed the case notes of the 30 people that were originally identified. Nine had successfully moved on, mainly to housing schemes offering a few hours of support each week. Two placements had failed within a short period; both people had alcohol problems. Cost savings were estimated to be in excess of £200 000. Team members felt that a person's enthusiasm to move was related to the likely success. Close links with the council housing department were also thought to be important.

Our small study suggests that specialist rehabilitation teams can be effective in moving people with mental health problems into more independent placements. This can produce substantial financial savings and fits the College's vision for rehabilitation services to reduce secondary handicap and promote social and cultural reintegration (Royal College of Psychiatrists, 2004).