The Benito Menni Psychosocial Rehabilitation Center aims at the rehabilitation and social reintegration of people suffering from severe mental disorders resulting from prolonged hospital stays. A comprehensive approach is carried out, starting from the construction of an individual care guideline, which allows us to begin to identify personal interests, oriented to socio-labor inclusion.
Within the framework of the coexistence program that is developed, we begin to work on aspects aimed at the re-education and reacquisition of instrumental skills for daily life, such as: personal hygiene, cleaning the house, relearning money management, psychoeducation in the acceptance of pharmacological treatment and its compliance, medical controls and acquisition of awareness of illness.
Reintegration into the social environment is worked on: location and geographical orientation, carrying out simple procedures, inclusion in occupational activities such as: day centers, resuming academic studies, labor reintegration, sports clubs, etc.
The aim is to develop the greatest possible autonomy that each person can achieve, to the insertion in external occupational activities, to appropriate the existing community resources, to expand the network and to rebuild socio-family ties.
The objectives and goals of most of the people who enter the service are collected in the construction of the individual guideline. They have to do with the recovery of a dignified and inclusive life in all aspects.
The programs developed at the Rehabilitation Center are:
SHELTERED HOME
This project was born as an alternative care service between the traditional hospital system (inpatient) and the community, for patients suffering from severe mental disorders.
It aims to cover different needs: permanent housing, food and coexistence within the framework of a psychosocial rehabilitation program (sheltered home) that acts as a bridge between hospitalization and life within a family structure or the beginning of an independent living project.
The treatment is aimed at complementing pharmacological therapy, placing special emphasis on the stimulation of the healthiest aspects of the personality, taking into account the capacities for autonomy and social integration. We consider family, social and community support and commitment necessary, especially from social support networks, mental rehabilitation centers, sports clubs, workshops, etc.
Its general objective is to contribute to improving the quality of life of people suffering from PMD, betting on their habilitation, rehabilitation and social insertion.
The focus of the project is oriented towards mental health work from a psychosocial and community approach. With a double component of intramural and extramural work; and strong emphasis on the re-education and reacquisition of the development of Social Skills.
True reintegration takes place in the community, so a large part of the programme takes place in the community; stimulating participation and inclusion in external activities. And promoting articulation with other teams, within the framework of the appropriation of existing community resources.
The idea is for users to be able to establish stable links with other institutions and build new social networks, as well as places of reference.
Our care program is based on a work methodology, which is structured in different stages: admission, permanence, pre-discharge, and discharge; framed in everyday coexistence. The delimitation of the intervention in different stages is directly related to the progressive evolution of the users within the project.
ASSISTED LIVING
Based on the experience of our work in psychosocial rehabilitation, with the Sheltered Home, we began to look for dignified alternative solutions for discharge. Faced with the absence of external devices that would give continuity to the work carried out, we have developed and generated a new step in psychosocial rehabilitation. Building our own model that encompasses different levels of intervention and care and that guarantees hospitality and quality. Thus, in 2012 our Assisted Living program began to operate.
These are devices that are fully integrated into the community, which allow an autonomous life in a regime of group coexistence, but with support and supervision. “We are talking about an intermediate device, that is, ‘between and between’: between the psychiatric hospital, Casa de Medio Camino and life within the family or completely autonomous.” We currently have 3 Assisted Living Facilities in operation.
Psychiatric care in “Assisted Residences” aims to achieve higher degrees of deinstitutionalization, to minimize the process of deterioration and to better social reintegration.
Their general objective is: To contribute to the improvement of personal autonomy, the recovery of social and instrumental functioning of people suffering from MPST, enabling social reintegration and the empowerment of their own lives.
It is worth highlighting the prior knowledge that users have for the formation of each group that graduates, which simplifies coexistence and the technical task of approaching.
It is a sine qua non condition that the users have completed the process in the Protected Home project. This makes it possible to put the skills and achievements acquired into practice on the new device.
Care programs enable the user to have a daily routine, generate a sense of belonging, and reacquire habits. The most valued activities are paid work internships. They allow the development of the greatest possible autonomy, on the path to the recovery of a new life.
The greatest challenges that Uruguay faces in social reintegration is the construction of social policies that take into account psychological suffering.
It is necessary to create programs and generate adequate resources to meet the different needs, life stages and degree of deterioration of the target population.
Although work is beginning with the recovery model in Mental Health, there is a great task ahead due to the health status of users who have and are still going through the old asylum model.
The work of reintegration will be a progressive task. Keeping pace with the recovery times that people need will be necessary to build a bond that provides security. It is observed that users who are incorporated into community devices often need to return to that old structure, presenting psychic instability, in the face of the possible and gradual reconstruction of a life in society. Due to the strong incidence of isolation in which they have lived.
Clear examples of successful social reintegration are the users who live in the Assisted Living Program, who have developed a level of autonomy that allows them to sustain their lives and fulfill daily responsibilities such as: housework, shopping, maintaining external activities such as work, studies, etc. E.g. A user of one of the residences works as a receptionist at the Geriatric Home of Sisters Hospitallers, achieving work effectiveness due to her good performance.
Another example is a user who has been working in an effective position in the departmental government of our city for two years. Several users also started a group work enterprise, carrying out maintenance work and cleaning of gardens, which they have been sustaining for about two years.
The Mental Health Law is aligned with the model of community care provided by the National Integrated Health System (SNIS) based on the paradigm of people’s recovery, for which it requires the opening, development and diversification of alternative structures that definitively replace monovalent structures.
The current Government has developed and presented a National Plan to Address Mental Health, strengthening existing institutional plans and responses and creating new ones. Emphasis is placed on prevention and promotion, treatment and rehabilitation.
Within this framework, the Casa de Medio Camino devices for people with mental health problems are part of the Comprehensive Care System for the community inclusion of people with mental health problems within the framework of the aforementioned Law.
These devices are specifically aimed at the discharge of people admitted to monovalent hospitals in Uruguay and the closure of such hospitals, in a process of transformation of care.
This path of transition, while encouraging, makes visible the lack of social policies with respect to chronic mental pathologies; in which the “total institution” has imposed on the patient the quality of “chronic”, producing the appearance of new psychopathological conditions, which are called hospitalism, characterized by social evasion. intransigence, colonization, apathy, inactivity, isolation, etc.
They experience it as a form of learning that allows them to integrate into society and relate to other people. Influencing the way they act and behave. Acquiring a certain degree of awareness, responsibility for their actions, and generating the ability to live in solidarity, respect and service to others.