{"id":339138,"date":"2026-03-20T12:38:17","date_gmt":"2026-03-20T12:38:17","guid":{"rendered":"https:\/\/www.newsbeep.com\/nz\/339138\/"},"modified":"2026-03-20T12:38:17","modified_gmt":"2026-03-20T12:38:17","slug":"whats-the-equivalent-of-a-wheelchair-for-a-person-with-schizophrenia-how-psychiatric-rehabilitation-brings-community-into-care","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/nz\/339138\/","title":{"rendered":"What\u2019s the equivalent of a wheelchair for a person with schizophrenia? How psychiatric rehabilitation brings community into care"},"content":{"rendered":"

Imagine your dream is to get a job at the local library. You have a love for people and for books. You also have schizophrenia, a psychiatric disability<\/a> that makes life in the community more challenging. <\/p>\n

You often have extreme psychological experiences. When you leave your apartment, you hear voices that tell you it\u2019s not safe, and you feel scared. People seem to keep their distance from you. You feel lonely sometimes. <\/p>\n

Most of the people you spend time with are mental health staff members, who provide medications and psychological therapies to make the voices and paranoia less intense. Their treatment philosophy is based on the belief that by reducing the symptoms, working at the library might be possible for you someday.<\/p>\n

But what if they have it backward? What if waiting for your symptoms to get better means waiting too long, or even forever? <\/p>\n

That\u2019s where the concept of psychiatric rehabilitation, or PSR<\/a>, turns traditional mental health treatment on its head. While PSR does not minimize the significance of psychiatric symptoms, reducing those symptoms is seen as neither necessary nor sufficient for improving quality of life. Instead of asking \u201cWhat are your symptoms?\u201d and \u201cHow can we make them better?\u201d providers instead ask, \u201cWhat do you want to do?\u201d and \u201cWhat\u2019s getting in the way?\u201d <\/p>\n

These questions might lead to interventions that are not traditionally considered mental health services: practicing job interviews, scheduling wake-up calls, learning unfamiliar bus routes or making environmental changes like negotiating accommodations. Irrespective of symptoms, such interventions can support people diagnosed with psychiatric disabilities like schizophrenia, major depression and bipolar disorder.<\/p>\n

We are<\/a> psychologists and<\/a> researchers who<\/a> have worked in these settings and who study ways to support people with psychiatric disabilities like schizophrenia. And we believe rehabilitative approaches to psychiatric disabilities can help people engage in activities they value, including work, relationships, passions and public service.<\/p>\n

Origins of psychiatric rehabilitation<\/p>\n

Psychiatric rehabilitation originated at a time of upheaval and hope. In 1963, President John F. Kennedy signed the Community Mental Health Act<\/a> into law, establishing mental health centers in the community with the goal of decreasing the number of people living in long-term psychiatric institutions. By 1975, the number of patients in state and county mental hospitals had rapidly declined by 62%<\/a>. <\/p>\n

However, the law never really fulfilled its promise. Even when connected to outpatient care, people with psychiatric disabilities had unmet needs related to community living, including educational attainment<\/a>, employment<\/a>, housing<\/a> and community participation<\/a>, leading to a lower quality of life.<\/p>\n

But what if building a meaningful and self-directed life in the community really was possible, if people were given the right support? <\/p>\n

Psychiatric rehabilitation emerged during the 1970s and 1980s in part as a response to the deinstitutionalization movement<\/a>, where more and more people with psychiatric disabilities lived in the community. Psychologist William Anthony, a pioneer of psychiatric rehabilitation, described the purpose and values of this approach as analogous to physical rehabilitation. Both are centered on improving patients\u2019 ability to live within their chosen environment<\/a>. <\/p>\n

For example, in physical rehabilitation, a person with a serious mobility impairment would not only receive treatment that improves their ability to walk on their own, but also supervised practice using a wheelchair. Modifying their environment, such as adding curb cuts to public sidewalks, is also critical.<\/p>\n

Psychiatric rehabilitation challenges mental health professionals to consider questions like \u201cWhat is the equivalent of a wheelchair or curb cut for a person with schizophrenia?\u201d<\/p>\n

\"Close-up<\/a><\/p>\n

Psychiatric rehabilitation is based on the belief that recovery is possible with the right support.
\n Halfpoint Images\/Moment via Getty Images<\/a><\/p>\n

One key example of this approach is a form of supported employment called individual placement and support<\/a>. In this model, employment specialists learn from patients about their goals and preferences; help them search for jobs and identify potential employers; and assist with applications, resumes and interview preparation. Staff will systematically visit businesses in the community to learn about their needs and hiring preferences. Research has shown that this model effectively increases competitive employment<\/a> for people with psychiatric disabilities, and that most who become employed have a better quality of life.<\/p>\n

In addition to gaining employment, psychiatric rehabilitation can help people with severe psychiatric disabilities reduce hospital admissions<\/a>, obtain housing<\/a>, improve cognitive function<\/a> and reduce stigma<\/a>. Each of these interventions is designed to improve a person\u2019s functioning in the community, either by modifying their skills or their environment. <\/p>\n

Because many of these services can be delivered by people without advanced degrees, psychiatric rehabilitation also opens careers in mental health services<\/a> to a broader swath of the community.<\/p>\n

The future of psychiatric rehabilitation<\/p>\n

Despite its effectiveness, many factors limit access to psychiatric rehabilitation<\/a>, including underfunding, lack of appropriate Medicaid reimbursement, an unprepared workforce and an overemphasis on pharmaceutical treatment. <\/p>\n

Psychiatric rehabilitation practices could improve the extent to which they are culturally tailored and centered on serving the most vulnerable and disenfranchised populations. For example, research has found that having a low income is correlated with worse outcomes<\/a> in these services, and that not enough programs consider cultural diversity<\/a>.<\/p>\n

Progress in treating mental illness has been elusive, and it\u2019s not because researchers don\u2019t know which treatments are effective. Rather, it\u2019s because care quality varies greatly and the best services are often inaccessible<\/a>. Psychiatric rehabilitation relies primarily on financing through state mental health agencies and Medicaid<\/a>, and its future depends on sustainable financing. <\/p>\n

Until investments match need, disparities in the health and quality of life of people living with psychiatric disabilities will continue.<\/p>\n

In community, with support<\/p>\n

Just like those recovering from a physical illness, we believe people recovering from psychiatric disabilities are deserving of comprehensive rehabilitation services that enable their full participation in community life.<\/p>\n

So imagine once more that you love books, love the library and live with schizophrenia. You got confirmation from your employment specialist that she found a library in the community seeking a part-time worker. She mentioned you to them, and they\u2019re willing to give you a chance. <\/p>\n

You and your peer support specialist<\/a> take the bus back and forth to the library one more time to make sure you\u2019re confident about the route. To prepare for your interview, you sit in your community mental health center\u2019s computer lab and use a virtual reality program<\/a> to practice your job interview skills. Later that afternoon, you share your excitement and fears with peers in a Hearing Voices Network<\/a> support group. <\/p>\n

Tomorrow\u2019s your interview. With your support network at your back, you believe your dream could come true.<\/p>\n","protected":false},"excerpt":{"rendered":"Imagine your dream is to get a job at the local library. You have a love for people…\n","protected":false},"author":2,"featured_media":339139,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[134,554,555,111,139,69],"class_list":["post-339138","post","type-post","status-publish","format-standard","has-post-thumbnail","category-mental-health","tag-health","tag-mental-health","tag-mentalhealth","tag-new-zealand","tag-newzealand","tag-nz"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/339138","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/comments?post=339138"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/339138\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media\/339139"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media?parent=339138"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/categories?post=339138"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/tags?post=339138"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}