Trends in Psychosocial Rehabilitation: a Comparison Study of Two Decade-Long Cohorts

Introduction. Psychosocial rehabilitation became a pressing need within community care settings with the fall of asylums and subsequent deinstitutionalization of psychiatric patients. Unders- tanding the different interventions and measuring outcomes is es- sential to provide clear, robust data for cost-benefit deliberation of psychosocial services, to ensure sustainability of ongoing programs and political advocacy. The authors present a description of the population attending the Psychosocial Rehabilitation Service (PRS) of Magalhães Le- mos Hospital, comparing two different decades: 1997-2006 and 2007-2016. Methods. The authors performed a retrospective cohort study, including all patients admitted to the PRS from 2007 to 2016. Socio- demographic and relevant clinical data was collected and analyzed in regard both to population description and outcome measure- ment (number of admissions per year and length of stay of such admissions per 100, before and after inclusion in the program). IBM® SPSS® Statistics software was used. Data regarding the prior decade (1997 to 2006) was provided by a previous research group, and the same protocol was used by the two groups. The results of both studies were compared. Results. Sociodemographic analyses showed that the typical population that frequents Magalhães Lemos’ PRS is similar over the twenty year period, with an increase in the number of patients that are referred, which reflects easier access, more referrals by health professionals, and greater human resources. Mental Health Services should not be centered only in acute care management, and the reduction in both acute inpatient admissions and length of stay after PRS intervention in both cohorts highlights the benefit of these interventions. Patients with schizophrenia spectrum disorders seem to be those who benefit most out of these interventions, which may ameliorate negative, social and cognitive symptoms. Conclusions. Overall, the results substantiate the argument for early psychosocial investment, while empirically validating the sig- nificance of rehabilitation services in a paradigm of empowering, pa- tient-centered, recovery-oriented practices. This study presents only correlation, and not causation. Further studies are expected to delve further into outcome measurements and have a prospective design.