CPG for Psychosocial Interventions in Severe Mental ... - GuíaSalud

The main focus of rehabilitation is the functioning of people in their normal environments,
improving their personal and social skills, giving support for them to undertake the different roles
of social and community life and, in short, to improve the quality of life of the persons affected
and of their families, as well as support for their social participation in the community in the
most active, normalised and independent way possible in each case. In other words, the aim of
psychosocial rehabilitation is to help people with severe and persistent mental illnesses develop
intellectual, social and emotional skills that they need to live, learn and work in the community
with the least possible professional support 15 .
In this CPG, the importance of the psychosocial rehabilitation concepts is based on defining
its field as a series of psychosocial interventions aimed at improving the autonomy and functioning
of people in their environment and support to their normalised social integration and participation,
and their role in the framework of a community service system that cares for this population.
Thus, the term refers to a spectrum of psychosocial and social intervention programmes for
people who continuously suffer from Severe Mental Illnesses.
Psychosocial rehabilitation, therefore, is an instrument made available to help people recover
and its integration into the whole Mental Health Community Service System is necessary.
4.3. The concept of recovery
The SMI recovery concept has become a dominating concept in the health care system, but it
lacks a consistent definition 16 . This refers more to the process of overcoming the illnesses than the
mere control of symptoms, and going beyond the actual illness, it pursues a significant and satisfactory
life. Recovery has been conceptualised as a process, as a result and as both at the same
time. It involves the development of a new meaning and purpose in one’s life as one surpasses the
catastrophic effects of mental illness, and it does not just refer to the alleviation of symptoms, but
also to social and personal competence in areas that the person defines as important 17 .
The recovery concept has been defined as “the process where people are capable of living,
working, learning and participating fully in their community” 18 . Anthony et al 19 indicate that
practices aimed at recovery recognise that people with mental illness have the same wishes and
needs for work, accommodation, relationships and leisure as any other person who does not suffer
from a mental illness.
Mental illness represents important changes that break with life expectations both on a personal
level and in the environment, especially the family environment. The recovery concept
shows the need to renew these life expectations, overcoming these changes through the different
techniques that the services must provide. Any intervention based on the recovery model, increases
its efficiency as it is aimed at recovering the person’s meaning in life. It is, therefore, an integral
conception of the interventions, which bears in mind people’s lives, interests and motivation, and
not just the efficiency of partial interventions.
Reintegration into society is a result that can be reached through the use of therapeutic mental
health services, such as community psychiatry and rehabilitation, among others, as well as a
political and community initiative, to promote solidarity and openness with respect to individuals
who suffer from several mental illnesses. Recovery is neither a service nor a unitary result of the
services; it is a personal status 20 . This term must be referred to in this CPG because it is an objective
of psychosocial interventions, although it is difficult to find an operative universal definition
of the term that is agreed by consensus.
CLINICAL PRACTICE GUIDELINES FOR PSICHOSOCIAL INTERVENTIONS IN SEVERE MENTAL ILLNESS 33