Developments in the field of science and technology have revolutionized human life at so many

levels but in actuality this progress seems only superficial: underneath are men and women
living in conditions of great mental and emotional stress. People from all over the world
irrespective of culture and economic background suffer from mental illness. In today’s world,
stress is increasing everyday. The individualistic way of life and the lack adequate support
system makes people fall prey to mental illness. The insecurity and inferiority felt by these
people might make them withdrawn. Sometimes their problems remain unseen by the society
which leads lack of support and facilities. These unfortunate people require not only
medication and counseling but also a robust rehabilitation programme to bring them back into
the mainstream society.

From the 1960s and 1970s, the process of de-institutionalization meant that many more
individuals with mental health problems were able to live in their communities rather than
being confined to mental institutions. Medication and psychotherapy were the two major
treatment approaches, with little attention given to supporting and facilitating daily functioning
and social interaction. Therapeutic interventions often had little impact on daily living,
socialization and work opportunities. There were often barriers to social inclusion in the form of
stigma and prejudice. People with psychiatric disabilities tend to have the same life aspirations
as people without disabilities in their society or culture. They want to be respected as
autonomous individuals and lead a life as normal as possible. Psychiatric rehabilitation, also
known as psychsocial rehabilitation, is the process of restoration of community functioning and
well-being of an individual diagnosed of having a mental or emotional disorder and who may be
considered to have a psychiatric disability. These services often combine pharmacologic
treatment, independent living and social skills training, psychological support to clients and
their families, housing, vocational rehabilitation and employment, social support and network
enhancement and access to leisure activities. There is a focus on
challenging stigma and prejudice to enable social inclusion and working collaboratively in order
to empower clients. The goal of psychiatric rehabilitation is to help individuals with persistent
and serious mental illness to develop the emotional, social and intellectual skills needed to live,
learn and work in the community with the least amount of professional support.

Although psychiatric rehabilitation does not deny the existence or the impact of mental illness,
rehabilitation practice has changed the perception of this illness. Enabling persons with
persistent and serious mental illness to live a normal life in the community causes a shift away
from a focus on an illness model towards a model of functional disability. The overall
philosophy of psychiatric rehabilitation in mental disorders comprises two intervention
strategies. The first strategy is individual-centred and aims at developing the patient’s skills in
interacting with a stressful environment. The second strategy is ecological and directed towards
developing environmental resources to reduce potential stressors. Most disabled persons need
a combination of both approaches.

The rehabilitation program should start right from the first time the patient has come into
contact with a mental health professional. The aim is to teach patients the skills they need to
cope outside hospital and then gradually reintroduce them to life in the community. The
principles of rehabilitation are also applied to the care of patients outside hospital who are
coping poorly in the community and those who are functioning well in supported
accommodation and want to move on.

Effective rehabilitation services not only provide a better future for the patients but they also
help the society immensely by reducing hospital readmission rates in psychiatric patients as
well as economic burden on the society. However it becomes difficult when developing
countries like India are facing shortage of Psychiatric rehabilitation consultants and other
mental health practitioners with adequate training in psychiatric rehabilitation. Often
rehabilitation services are viewed as unimportant or as charity services which affect the
attitude of the patients to participate in rehabilitation programs. Very few settings are available
with appropriate psychosocial interventions. Majority of the centers do have only little or no
professional guidance. Although there are sporadic humble and voluntary efforts in the field,
the alarming demands outweigh the services offered and resources available. In this context,
there is a felt need to train health personnel in psychiatric rehabilitation. Utilization of the
trained personnel will help in the smooth functioning of the existing services which in turn will
develop interest to initiate more innovative strategies of rehabilitation that suit our culture.
Perspective about Rehabilitation Psychiatry can be channelized to a great extent with psycho
education, group meetings and by involving the care givers in the treatment program. Skill
development programs need to be provided during hospitalization.

The government as well as medical professionals have woken up to these challenges. The
expansion of psychiatric services coverage in the country in recent times will bring about
awareness and improve utilization of the resources. Establishment of National Institute of
Mental Health Rehabilitation, the first of its kind in the country in the area of mental health
seems to be a promising step for the future. We as a society should also acknowledge the
problems faced by the mentally ill and provide them with an unbiased environment to live and
work with respect and pride.