Clinical Expertise

The Clinical Service is one of the most significant aspect of the services at PRC. A multidisciplinary team approach is utilised to provide holistic care guided by the biopsychosocial model. The team is responsible for overseeing the provision of clinical services and ensures the delivery of high-quality therapeutic care. The multidisciplinary team consists of medical practitioners, nursing and allied healthcare workers.

Referral Process

The initiation of treatment in most instances is through a referral process. Except for those returning from overseas, all other persons must be transferred to the facility utilizing agreed referral forms or correspondence. This should be accompanied by an assessment of the resident’s past, current health status and risk level.

Admission

Although a referral is required, admission to PRC is not mandatory. Based on the residential status of PRC and services that will be provided, PRC will not be able to accommodate all persons who are diagnosed with a mental health disorder. The facility is not a hospital and its primary focus is on rehabilitation and will function as a continuation of care.

Admission Criteria

Inclusion criteria:

1. Must be at least 18 years old.
2. Must be willing and motivated to participate in the treatment programme offered by the facility. (Ideally, participation should be voluntary).
3. Ideally should be able to meet their ADL with minimal assistance.
4. Should not require acute medical care.
5. Have had previous psychiatric treatment and in need of further maintenance and stabilisation.
6. Requires structured therapeutic rehabilitative support.

Exclusion criteria:

1. Individual who is at immediate high risk for violence and/or suicide.
2. Individual who requires acute medical care and are highly dependent.
3. Individual who is a substance user that needs to go through a withdrawal/detoxification programme.

Types of Admission

1. Voluntary/Self Admission – an individual recognises the need for treatment and seeks admission on his/her own.  A referral would however be needed.
2. Involuntary Admission – treatment that is mandated or initiated by a mental health professional, law enforcement, or court order.
3. Continuity of Care – individual who is discharged from a hospital and is a part of an outpatient treatment programme but requires additional support to facilitate the recovery process.

Assessment and Treatment Process

Assessment will be an ongoing process. Conducting a full assessment for the incoming residents is necessary even though they will be coming from another treatment programme. This is necessary to ensure the accuracy of the admitting diagnosis, or to conceptualise new and or additional diagnoses, and to formulate treatment plans for the best possible outcome. The clinical team will employ keen observation, interview, examination, and critical thinking skills to formulate a diagnosis and treatment plan utilising the Biopsychosocial Model and Case Formulation.

The treatment plan will incorporate the holistic approach and will include the necessary referrals for psychosocial interventions and nutritional interventions.

Review of Residents

All residents will be reviewed by the psychiatrist as necessary weekly After the initial; assessment, all residents will be reviewed by the psychiatrist weekly, as necessary reviews will also be done in cases of emergency or as the need arises. Reviews and updated treatment plans should be documented in the resident’s Electronic Health Record. Reviews by the physician and nutritionist will be done as needed.

Diagnostics Investigations

Medication used to treat psychiatric conditions can impact the physical health of individuals. It is important for all residents to have diagnostic investigations performed on admission as a baseline to determine their physical status and to monitor underlying health conditions.

Psychotherapeutic Interventions

Psychotherapy will be done primarily by the psychologist. Each resident will be individually assessed and a treatment plan tailored to meet the identified need (s). Interventions may be in the form of individual, family and group sessions and include any of the following amongst others:

1. Cognitive behavioral therapy (CBT)
2. Dialectical Behavior Therapy (DBT)
3. Solution-Focused Brief Therapy (SFBT)
4. Mindfulness-Based Therapy
5. Interpersonal Therapy (IPT)
6. Acceptance and Commitment Therapy (ACT)
7. Eclectic therapy.

Social Interventions

Social interventions are necessary to provide social benefits, help to build human capital, and provide socioeconomic benefits for vulnerable groups. Programmes will be designed
to help raise the standard of living and earning capacity for the residents at PRC. The Programmes will include helping residents get financial assistance, family and community investigations, and resources necessary to facilitate their reintegration and help to live independently. Social workers will be responsible for conducting the initial assessment for each resident to determine their needs and the level of support needed. They will also be responsible for doing follow-up visits following discharge, to ensure that residents are effectively reintegrated.

Discharge

Collaborated discharge planning will commence upon admission and will be completed prior to the discharge of each resident. This will include any social investigations and networking that are necessary to help residents re-integrate with families and communities. It will also include the necessary education on medication management and the importance of keeping appointment for follow-up care.

Follow-up

Follow-up reviews may be facilitated through PRC’s Community Intervention Programme and collaboration with the Community Treatment Team at HSA Behavioural Unit. Members of the clinical team will be responsible to ensure that residents receive follow-up care interventions as necessary when discharged. A detailed follow-up plan outlining the current diagnosis, medications and other needed intervention(s), will be provided by the treatment provider or caregiver.

Medication and Pharmacy Supplies

All prescriptions for the residents will be filled, packaged and collected from the HSA. These will then be distributed through the internal dispensary by the Registered Psychiatric Nurse, or the Pharmacy Technician.

Stock medications such as over-the-counter analgesics, anti-allergic medications, and first aid medications; as well as other medical supplies such as bandages, needles, syringes, will be stocked in the dispensary. These will be dispensed on request to the relevant cottages.

Telehealth Services

This is the delivery of distance mental health care through telecommunications technology using videoconferencing, telephone audio or recorded messages. Services include assessment and interventions such as therapy (individual, group, family), resident and caregiver education and medication management. The aim is to provide additional access to care. Telehealth will follow similar format as the face to face care and will involve various members of the multidisciplinary team.