Day Care

“Occupation, Recreation and Socialization’

Psychiatric Day Care Service provides Occupational Therapy (OT) programme for patients admitted in the psychiatry ward and those referred from outpatient services with the complete intervention of Psychiatric Social Work and Psychological facilities. Outside referrals are also accepted. OT rehabilitates the patient for a better adjustment in his/her family and for making him/her a functional and productive member of society. The patient’s participation is directed through selected tasks to restore, reinforce and enhance his/her performance. It facilitates the skills and functions essential for adaptation and productivity, and for promoting and maintaining health.

The fundamental aim is…

“To develop the capacity to perform with satisfaction the tasks and roles essential to productive living and mastery of self and one’s environment.”

The objectives of OT, as a part of psychiatric rehabilitation, are to provide opportunities to patients to have meaningful contacts with persons and groups in the community; develop acceptable work habits, skills and work tolerance; explore and experience interaction with authority figures and develop collaborative working relationships with peers; assess the capacity to accept instructions, criticism, failure and success; help patients become aware of both their strengths and limitations; help patients develop a vocational interest that may facilitate social relationships and improve self-image.
Day care for psychiatric patients can be effective in returning the patient to a normal life in the community, or for relieving the strain on a family. Objectives should be clearly defined, with the therapeutic team working closely together. Programs should cater to the individual’s needs wherever possible and should be able to deal with a broad range of symptomatology.
Psychiatric day care attempts to provide adequate psychiatric care for patients in settings which do not break up a patient’s valuable and essential links with the community. Psychiatric day care is now an accepted program in all areas in the country and indeed of most other countries. Its value has become so well accepted in modern psychiatry

Significance of Psychiatric Day Care

1. The promotion of more independent social activity inpatients who may have lost this facility due to illness.
2. To allow the psychiatric care team to maintain contact with patients’ families, and in many cases to allow them to work with the family. In this respect, the family doctor’s special knowledge and skills can be made available to the psychiatric care team.
3. In maintaining patients’ contact with their normal social background, they can be encouraged not to avoid problems whose origins lie in the family constellation or work situation. Such denial occurs easily when patients acquire full inpatient status and often leads to recurrence of symptoms when the patient is discharged if these problems have not been recognized and dealt with. Day care, by bringing the patient continually into contact with these problems, while at the same time mediating and diluting the daily exposure, can often allow the working through of such situations to the benefit of patients and families.
4. The typical work day timing of day care programs, resembling as it does the normal work week for the average person, makes attendance at day care of value in retraining psychiatric patients to normal work week routine.

Our Day Care Team includes

• Psychiatric Social Workers
• Occupational Therapist
• Psychologists and
• Health Care Workers

Program Features

While details may of course vary from place to place, psychiatric day care should generally represent a treatment situation in which the day is fully programmed for the patients both individually and in groups, perhaps with a variety of programs for different clinical conditions. Inmost cases treatment is organized by a team of treatment personnel working together. Nurses and occupational therapists, often assisted by volunteers, usually form the basic team working directly with patients during the day, but appropriate input from Psychiatric social workers and psychologists is also essential in most cases. Psychiatrists should be involved either as direct team personnel or as consultants. In many cases the team leader is not necessarily a psychiatrist, although the contribution of a physician is normally desirable in some capacity. The staff, each contributing their special skills and expertise, should program the day for the patients in day care. Thus occupation, recreation and socialization throughout the time the patient spends at the day care centre are therapeutically organized by the staff in such a way that the patient obtains the maximum benefit from his or her time in the day care setting. While therapeutic philosophies vary in psychiatry as elsewhere in medicine, each psychiatric day care program should define what it is attempting to provide for the patients, both in groups and individually.

Scheduling of Day Care

Our typical day care programmes are as follows:
• 9 a.m. Patients check in and their attendance is recorded for administrative purposes.
• 9:15 a.m. Daily exercises or other appropriate fitness programme, followed by a break for conversation and general organizational discussion.
• 10 a.m. Patients meet in a large group to discuss day to day organizational matters and to work with the staff in planning activities for the day and future. Opportunity may arise here for discussing various real life situations, commenting on local and world events. The large group is an important area for placing patients in contact with the real world.
• 10:45 a.m. Break for refreshments.
• 11 a.m. To small group settings; in some cases to individual work with team members and psychiatrists.
• 12 noon. Lunch break. The lunch may be provided in various ways but it is desirable for patients to work on providing and preparing their own lunches whenever possible.
• 1-2 p.m. Rest period. Possibly with some organized recreational activity and another opportunity for individual work where necessary.
• 2-4 p.m. Occupational therapy of all types. Group outings, investigation of work situations and so on.
• 9) 4-4:30 p.m. A wrap p large group meeting to review day’s activities, future plans and special problems which have arisen both in the group and individually.
• 10) Leave for home while staff hold their own review and wrap up meeting to 5 p.m.
This is a typical program for Manashasthra Day Care.