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

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Programmes directed to leisure and spare time
Leisure and free time programmes in people with SMI and with deficiencies perceived
in their social relations help improve the general satisfaction with their lives, it reduces
the perception of solitude, fosters self-esteem, improves satisfaction with social relations,
with leisure activities and improves social functioning 158 .
Recommendations
D
D
Daily living skills training programmes could be offered to people with SMI in order to
improve their personal independence and their quality of life.
For people with SMI who require support to remain in their accommodation it is advisable
that the community residential offers include more extensive psychosocial programmes.
People with SMI and deficiencies perceived in their social relations should follow community
leisure and spare time programmes.
During the monitoring of the individualised therapeutic programme, it is advisable to
systematically assess the need to use the spare time programmes and offer them to people
with SMI who require them.
5.2.4. Programmes aimed at employment
Over the last decades in all Mental Health programmes, the employment-oriented programmes
and devices for people with SMI are considered to be strategic and form part of the basic rehabilitation
objectives.
Labour insertion is an instrument to achieve full social integration in conditions of personal
autonomy and participation in the community. It also responds to a right, and to an ethical question
derived from the permanent exclusion from the work market. The need for labour insertion
programmes to include health and social care aspects in their methods, and not just occupational
training aspects, is admitted.
Work, in the recovery process, is not just an activity that develops generalizable competences
and improves personal functioning, but it is also an element for social exchange and economic
independence. Remuneration and salaries are considered a key motivational element for a person
to stay in a job. In any case, due to the different experiences, it is common to place emphasis on
motivation and personal choice and take into consideration, from the onset, personal interests and
objectives.
Despite the obvious need for these resources, there is no generalised or approved practice.
Labour insertion resources have a different typology and experience varies from one country to
another. This is due to the differences between the health and social services systems, the different
regulations that govern access to employment, social-cultural differences and the actual labour
market.
By way of analysis, there are two approaches to address a labour rehabilitation intervention.
One is the train-then-place or supported employment, which places emphasis on the stability and
recovery of skills in prior programmes that permit subsequent generalisation. The other, placethen-train,
which places emphasis on immediate occupation of a job, activating the learning and
monitoring programmes in the job 161 .
CLINICAL PRACTICE GUIDELINES FOR PSICHOSOCIAL INTERVENTIONS IN SEVERE MENTAL ILLNESS 81