Support from Family and Employers Key to Successful Social Reintegration of Psychiatric Patients, Study Finds
Mental illness affects millions of people every year and, in certain cases, it is necessary for the patient to undergo a period of rehabilitation in psychiatric clinics. After the period of hospitalization, returning to social life is often difficult and marked by new challenges and problems of readaptation. Psychiatrist Renato Del Sant, director of the Adult Day Hospital (HDA) of the Institute of Psychiatry (IPq) of the Hospital das Clínicas (HC) of the School of Medicine (FM) of USP, analyzes the particularities of mental illnesses and the challenges faced by those who suffer from this condition.
According to the specialist, mental illness has a different specificity than somatic diseases, such as cardiac, neurological and gynecological diseases. While a patient with this type of condition suffers from dysfunction, but can continue working and socializing, the symptoms of mental illness penetrate the individual’s personal life and compromise their social, academic, professional and sexual relationships.
Rehabilitation
According to Del Sant, this particular characteristic explains the importance of rehabilitation in the lives of these patients, since mental illness compromises their ability to live their lives. He says that mental illnesses also have impoverishing characteristics, since when they need to be hospitalized, patients are often unable to keep their jobs and lose their income.
“Because of this, mental illness is a type of impoverishing disease. Many patients with cancer, heart problems or those in need of a transplant continue to work and earn their own money. Mental illness impoverishes, there is a loss of life repertoire and as a result the person becomes stigmatized, the population sees them as someone who is outside of society,” he observes.
Follow-up
For the specialist, the financial subsidy offered by the federal government through psychosocial assistance to patients who return to social life is extremely important, but improvements are needed in the monitoring network. He explains that the acute treatment of the disease in the country offered in wards and outpatient clinics is first-world, but much of the quality is lost when the individual leaves the hospital to be welcomed by the monitoring networks.
According to the psychiatrist, the Brazilian public monitoring network has an instrument called the Psychosocial Care Center (Caps), which needs to be constantly improved and driven by the technical-scientific side so that it can help former patients in the process of social coexistence. Del Sant also explains that a quality monitoring network helps the government save money, as rehabilitation is cheaper and helps to avoid new hospitalizations.
“It is also important to say that, no matter how complex a mental health system is for the patient, in which there are psychiatrists, psychologists, occupational therapists and nurses, the entire multidisciplinary team, it still cannot treat the patient completely. Because of this, the individual also needs the help of lay people who are outside the clinics, mainly from the family and business community”, he explains.
Job market
According to Ana Laura Alcântara Alves, director of Occupational Therapy at the Adult Day Hospital, people with mental illness often recover and are prepared to return to the job market, but they encounter difficulties in doing so. She says that recently, people with some type of disability have been increasingly gaining their rights, but when it comes to people with psychosocial disabilities, there is still a lack of support from many public policies.
“We often treat patients and their symptoms subside, they adhere to their medications, and they are ready to return to work, but from then on there are no job openings for them. We even have meetings with NGOs that offer job openings for people with psychosocial disabilities. We prepare their resumes and train them for interviews and dynamics, but sometimes they go through the selection process and end up on a waiting list that takes years,” he explains.
Stigma
For the therapist, the biggest challenge that former patients face is the issue of stigma, which comes not only from the employer, but also from coworkers themselves when they learn that a particular individual has a disability. In addition, she explains that former patients often need a longer period of adaptation to work tasks because of the sudden change in routine, and this is often viewed with suspicion by many professionals in companies.
“We all have difficulties when we are about to start a new job. It is scary, we feel anxious and confused. But for these patients, it is even more scary and they become even more anxious. So it is necessary to be more prepared not only for this individual, but also for their family, the health professionals who are accompanying them, but, most importantly, for the staff who will welcome them into the company,” he says.
According to Renato Del Sant, one possible cause of this stigmatization is the attention given to extremely isolated cases of people with psychosocial disabilities who end up committing crimes. He explains that, although these occurrences represent a portion of the total number of psychiatric patients, they still generate fear and distrust in the general population.
“Over the past 20 years, the media has played an excellent role in demystifying a number of mental illnesses, but when a person with a psychiatric disorder commits an atrocity, it is all over the newspapers, even though this type of patient is rare. Most cases, in which the patient recovers and returns to work, to relationships, to having children, end up not being reported because they do not attract an audience. From then on, this prejudice of people who do not really know the patients is spread,” explains the psychiatrist.
Experts point out that psychiatric clinics are very different from those portrayed in films and, in reality, are a great opportunity for volunteer groups, who feel fulfilled by helping patients. They also explain that the Adult Day Hospital carries out many group visits to cultural and entertainment institutions and, most of the time, the staff at these places are pleasantly surprised by the good behavior of the patients.