A structured review of psychiatric rehabilitation for individuals living with severe mental illness within three regions of the Asia‐Pacific: Implications for practice and policy

• Published in: Asia-Pacific psychiatry 2019-06, Vol.11 (2), p.e12349-n/a
• Main Authors: Hill, Harry, Killaspy, Helen, Ramachandran, Padmavati, Ng, Roger Man Kin, Bulman, Nicole, Harvey, Carol
• Format: Article
• Language: English
• Subjects: Asia; Capital budgeting; Clinical medicine; Evidence-Based Practice; evidenced‐based practice; Health Policy; Humans; implementation; Mental disorders; Mental Disorders - psychology; Mental Disorders - rehabilitation; Pacific Islands; Psychiatric Rehabilitation; Rehabilitation; schizophrenia; severe mental illness
• ISSN: 1758-5864; 1758-5872
• DOI: 10.1111/appy.12349

Introduction Psychiatric rehabilitation can provide and support recovery‐oriented care by assisting individuals living with severe mental illness to lead full lives. Despite a well‐established evidence‐base, implementation and access to these interventions in clinical practice for people with severe mental illness in the Asia‐Pacific region is low. We therefore aimed to evaluate prominent themes impacting on clinical practice, policy, and the implementation of psychiatric rehabilitation across the Asia‐Pacific region. Methods A comprehensive review of relevant literature on psychiatric rehabilitation of three regions within the Asia‐Pacific was conducted using a structured search of PubMed and other databases. Eligible articles were selected which focussed on how psychiatric rehabilitation is defined and implemented across the Asia‐Pacific region, as well as the associated successes and challenges. Common themes were generated. Results Six themes emerged: the impact of policy, legislation, and human rights; access difficulties; the important role of family; the significance of culture, religion, and spiritual beliefs; the widespread impact of stigma; and the indigenous models of excellence being developed. Discussion Consideration of the six themes and their implications should help raise awareness of the issues involved in the provision of psychiatric rehabilitation in the Asia‐Pacific region and may improve outcomes for people living with severe mental illness. Suggested strategies include: developing a shared understanding of psychiatric rehabilitation; establishing quality legislation that's well implemented; adapting evidence‐based models to develop culturally appropriate services; implementing stigma reduction and empowerment‐based interventions; and, ensuring coordinated action among all stakeholders, combined with effective leadership.