This paper aims at sharing the information and insights gained from the international conference "Schizophrenia 1992: Poised for Change", with particular reference to social treatment for people with schizophrenia. A brief account of the conference will be depicted, followed by a discussion of social treatment for schizophrenic patients.
This international conference was organized by the British Colombia Mental Health Society and the Department of Psychiatry, The University of British Columbia. It was held in Vancouver Trade and Convention Centre, Canada from July 19-22, 1992. About 1500 delegates of various different professionals, viz, psychiatrists, social workers, nurses, occupational therapists, mental health administrators and academicians, came from 33 countries and districts to attend this four-day conference.
The conference featured a faculty of internationally renowned scientists and mental health practitioners to present their views, experiences and research findings in the study of treatment and rehabilitation approaches to schizophrenia. In each plenary session, a set of three distinguished speakers presented papers from three different perspectives, i.e. biological, psychological and social. The presentations would then be supplemented with workshops and symposia.
In addition, partnership activities and public addresses would be held in the evening sessions. On the other hand, exhibition and poster sessions were on display in the Exhibition Hall, together with video library and slide preview.
In this section, the focus would be placed on the papers and research findings presented from the social perspective in the treatment and rehabilitation of people with schizophrenia.
Any discussion on social rehabilitation for mentally ill persons should touch on the concept of deinstitutionalization. According to L.L. Bachrach from the University of Maryland, USA, the movement of deinstitutionalization in the United States could be traced back to 1955. The assumptions of deinstitutionalization are threefold
1) community care is more humane;
2) it is more therapeutic; and
3) it is less expensive and more effective.
However, she emphasized that community care is not a benign treatment for all mentally ill patients, some still require hospital care.
In the service planning for the mentally ill, she presented six principles for consideration. They are :-
1. services for persons suffering from schizophrenia must be individually tailored, mass planning" must be avoided;
2. for those individuals who require it, hospital care must be readily accessible;
3. services must be planned with the context of prevailing cultural norms;
4. outcome measures muss be relevant and realistic;
5. persons suffering from schizophrenia must be themselves involved in service planning to die fullest extent possible;
6. continuity of services is essential; time-limited service provision must be avoided.
The movement of deinstitutionalization has led to the emergence of community treatment for the mentally ill. Community treatment has indeed become both the dominating concept and approach in the treatment and rehabilitation of psychiatrically disabled persons in the United States and Canada. According to M.A. Test from the University of Wisconsin, USA, the adoption of community treatment could be traced back to 1972 in the United States. There are three service guidelines for community treatment. First, the primary focus of treatment is in the community, not hospital. Second, comprehensive services should be rendered, i.e. illness management and coping skills training, with a supportive environment. Third, services should be organized and delivered to reach clients.
The Training in Community Living (TCL) [also known as the Program of Assertive Community Treatment, or PACT] has become a national model of community care in the United States. …