Academic journal article Indian Social Science Journal

Quality of Life of Persons with Mental Illness Staying in a Psychiatric Rehabilitation Centre and Home: A Comparative Study

Academic journal article Indian Social Science Journal

Quality of Life of Persons with Mental Illness Staying in a Psychiatric Rehabilitation Centre and Home: A Comparative Study

Article excerpt

ABSTRACT

Background: Institutionalization of individuals with disabilities is viewed negatively as it does not enjoy societal sanctions. Such discourse was further strengthened in India along with the de-institutioncdization movement and associated developments in the west. But Young in 2004 initiated a discourse on the need to define quality of life and effects of chronic mental illness on persons. Evidence suggests that people affected by mental illness with prolonged treatment experience considerable deficits in terms of negative symptoms, cognitive impairments and inadequate social support disposing them severely disabled to function in the community. Using an explanatory research design, the quality of life data were obtained by using both quantitative and qualitative measurements such as a semi structured interviews and Lehmann's quality of life scale. In-depth interviews were analyzed using narrative thematic analysis while descriptive statistics along with t' test for independent samples, chi-square for associations were used for quantitative data analysis. The PRC group reported the better performance on daily activities and functioning, life satisfaction, health, personal safety and global life satisfaction than those who were living in home care. Besides, qualitative analysis revealed that PRC group perceived overall life conditions as positive and had better life than those who were at homes. The home care was characterized by unstructured activities and less monitoring by the family members in terms of medications and follow-ups. Hospitalization followed by psychiatric home placement significantly benefits the persons with chronic mental illness since it facilitates a transition from hospitalization to community life.

Key words: Psychiatric rehabilitation centre, mental illness, quality of life

INTRODUCTION

Institutionalization of individuals with disability and aging is viewed negatively as it does not enjoy the sanctions from Indian value systems and socio-cultural morale. It is often associated with giving away from the family responsibilities towards its ill member (Jose et al, 2012; in press; Thomas and Nagaraju, 2012; Sridhanya, 2012; in press; & Department of Economics and Statistics, 2009). Consistently, influenced both by the socio-cultural morale or value systems and the philosophy behind the de-institutionalization movement in Europe and other western countries, most mental health professionals in India subscribe negative views about institutionalization (Barton, 1959; Goff man, 1961; Knuze, 1985). As a result, in India also, we have observed many models of community care programmes for people with mental illness, including therapeutic community, day care centers and short and long term rehabilitation services, as evidenced in western countries {WHO, 1995).

Before the development of anti-psychotic medicines, in-patient care facilities such as nursing homes, remand homes and rehabilitation centers were heavily criticized as being "institutional like" (Knuze, 1985). Such discourses was further strengthened when {Linn & et. al, 1977), in a randomized control study on the effect of nursing home care for persons with psychiatric illness, found a significant deterioration in self care, worsening of behavioural problems, mental confusion and depression.

However, on the other side of the story, (Young, 2004) initiated a discourse on the need to define quality of life and need to understand the effects of long term psychiatric illness on persons with mental illness. This was in the background that his study evidenced that people affected by mental illness with prolonged treatment do have considerable deficits in terms of negative symptoms, cognitive impairments and lack family and social support disposing them severely disabled to function in the community. Furthermore, (Timko & et.al, 1993) in a randomized control study of nursing home care, found that as compared to the hospital in-patients, nursing home residents had better choice, control in policies, more social and recreational activities while their subjective life satisfaction remained positive and unchanged. …

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