Practice and services for psychoscial rehabilitation of people with schizophrenia in Belgium

Schizophrenia has long been regarded as a chronic disabling disorder with an almost inevitable negative outcome. However, recently, several long-term studies suggested that recovery might be possible for first-episode as well as chronic schizophrenic patients. Although the importance of rehabilitation interventions, aiming at reintegrating schizophrenic patients in society, is increasingly recognised, a substantial proportion of these patients still does not have access to rehabilitation services. Objectives: The aim of the present study was to study the practice and offer of rehabilitation interventions and services in Belgium. Methods: A standardized questionnaire was sent out to all Belgian individual psychiatrists and to those working in general hospital psychiatric wards, in psychiatric hospitals and in community mental heath centres whose patients are affected by schizophrenia In a significant proportion (> 10%). Results: Although rehabilitation was generally regarded as an important concept of care, systematic screening and training of relevant skills was far from generally available. The assessments of abilities necessary for rehabilitation were assessed by only slightly more than half of the respondents. The availability of training in rehabilitation skills was even more limited: less than half of the respondents mentioned giving training in one of the four rehabilitation domains questioned, and only 32% provided training in Activities of Daily Living (ADL) as well as in vocational, social and independent living skills. Conclusions: We can therefore conclude that although the importance of rehabilitation is increasingly being recognised, the systematic assessment of patients' abilities and training in necessary skills have yet to develop on a larger scale.status: publishe