Intervention axes of community mental health

Six axes of intervention are proposed, main actions that are carried out through home sessions of community occupational therapy, complemented by the intervention from neuropsychiatry in the outpatient clinic of our hospital:

1. Counseling, education and prevention in mental health and acquired brain injury: both to patients and to caregivers and referents (professional or non-professional).
2. Autonomy, quality of life and personal well-being: development of the possibilities of occupational participation in meaningful activities and roles, facilitating and optimizing preserved volitional (also called motivational) processes, improvement and/or maintenance of performance components, emotional support for the reconstruction of occupational identity, adaptation of the physical and social environment to favor participation (and optimize care processes).
3. Community participation: accompanying, informing and advising the patient in the establishment of links with community resources in their environment, in order to achieve better integration into the community.
4. Resource linkage: to promote the linkage of the patient with his or her referral mental health center and/or drug dependence care and follow-up center, whether it is a previous problem or a new case, in order to ensure continuous care.
5. Support to families: its objective is to reduce overload and facilitate an environment that favors occupational participation. The aim is also to take advantage of the space at home to build a space for communication and expression between patient and family. On the other hand, within the facilities of the Institut Guttman, meeting places are created among family members to favor the exchange of experiences and learning among equals.
6. Psychiatric approach to behavioral and emotional problems: from monitoring the evolution in each home session, telephone care, and support and coordination with neuropsychiatric outpatient visits.

What is the profile of people who can benefit from the program?

At present, the program serves people living in Catalonia who, after an ACD, are in any of the following situations:

• Having diagnosed a previous mental disorder.
• Having a diagnosed mental disorder after the ACD.
• Having undiagnosed/undiagnosable mental health problems/difficulties, but which produce occupational deprivation.
• Having difficulties that interfere with desired occupational participation, related to substance abuse, pathological gambling, suicidal ideation, etc.

Present and future of the Community Mental Health Program for patients with ACD and their families.

During 2019, the program has carried out a total of 240 home interventions and more than 130 interventions related to the cases attended (coordination with professionals, joint neuropsychiatry-TO visits, telephone coordination, etc.). The experience and resources of the network show that the number of people who can benefit from this type of services is significantly higher, so there is still much to be done. We hope to grow and bring direct benefit to individuals and their families, focused on their needs and intersectional, considering cultural, ethnic, social and gender peculiarities.

The aim, in line with the main mission of the Institut Guttmann, is to put all our efforts in facilitating that people with ACD and their families can move forward, taking advantage of their own strengths and those of their community, betting on a network of care based on occupational balance, full participation and optimization of resources. In other words, facilitating access to a meaningful life, autonomous, enjoyed in the company of others and, above all, lived with dignity.