Mental illnesses are the most disabling diseases.Apart from the patient they also burden the care givers and the immediate family members.Gradual down spiral of chronic illnesses leave the patient dysfunctional and the caregivers helpless.
The stigma related to the mental illness , delay in medical help can further worsen the course of illness.
Patient denying illness or any abnormal behavior, unwillingness to accept help (absence of insight);harm to self or harm to others becomes the major hurdle in treatment.
Lack of skills to handle such critical situations, inadequate knowledge of the nature of illness ,lack of facilities in the vicinity to treat the illness are the concerns of the family.
Management of a patient with mental illness can be divided into
- Acute phase treatment
- Long term management
ACUTE PHASE TREATMENT
Major modality of treatment is medications, education of family members about illness and supportive care.
This is planned preferably in an inpatient setup.Requires continuous supervision
Continuing medications and working towards complete functional recovery.
Problems during this phase include relapse of symptoms, stopping medications, poor support and difficulty in daily activities.
Can be planned on an outpatient basis with adequate support or in a rehabilitation centre
LONG TERM MANAGEMENT:
Required in chronic conditions like
- Chronic schizophrenia
- Long standing bipolar affective disorder
- Chronic OCD
- Post head injury sequelae
- Comorbidities and dual diagnosis
Main challenges during this phase would include:
- Symptomatic management
- Monitoring side effects of long term medication
- Ensuring compliance
- Maintenance of daily routine
- Ensuring safety of patient and family members
- Psychological measures to improve functionality
- Reintegration into society
Rehabilitation services play a major role in this phase of treatment.
At AAS we help the patient by
- Ensuring medication intake
- Using evidence based pharmacotherapy for the target symptoms
- Decreasing care givers burden
- Improving functionality
- Enhancing/encouraging the available skill set and personal strengths
Providing psychological therapies like
- Cognitive retraining
- Social skills training
- Behavioral therapy
- Music therapy
- Art therapy