Mental Health Rehabilitation
Under Review April 2018
This leaflet is for patients, carers and anyone else who would
like to find out more about what rehabilitation is and how mental
health rehabilitation services work.
What is meant by rehabilitation?
To reskill (from the Roman Latin word habilitas), to
restore to a former capacity, to reinstate, to restore former
rights. It can also mean to prepare someone to resume normal life
after an illness, or to restore to their former status.
What is a mental health rehabilitation service?
It is a service to help people recover from the difficulties of
longer-term mental health problems. It will help and support people
who still find it difficult to cope with everyday life or get on
with other people. It will aim to help you deal with problems, to
get your confidence back, and to help you to live as independently
The difficulties with living with a longer-term mental
health problem can mean that you can't be discharged home, but
you may have to spend some time in a specialist rehabilitation
Many NHS regions in the UK have mental health
rehabilitation units. Just over half are based in the community and
the rest are based in hospital sites. Around half of NHS Trusts in
England also have community rehabilitation teams who work with
people after they have left hospital and moved to supported
The service will try to help you recover, while accepting that
you may still have serious difficulties which need continuing help
The rehabilitation team includes psychiatrists, nurses,
occupational therapists, psychologists and social workers.
Who might need a mental health rehabilitation service?
Usually if you have a diagnosis of schizophrenia,
schizoaffective disorder or bipolar disorder. However, only around
1 in every 100 people with a diagnosis of schizophrenia require
rehabilitation. Typical difficulties include:
- Problems with organising and planning your daily life - finding
it hard to plan and actually carry out what you mean to do.
- Symptoms of mental illness, such as hearing voices that are
distressing or make it difficult to communicate with other
- Being exploited or abused by others.
- Behaving in ways that other people find difficult or
threatening - this can lead to contact with the police or
- Harmful use of alcohol and non-prescribed ("street")
You may have difficulties because:
- Medication just doesn't work well enough for you. The illness
affects your concentration, motivation and ability to organise
- You also suffer from depression and anxiety.
- You may struggle to manage everyday activities - like
self-care, budgeting, shopping, cooking, managing your money.
The stigma of mental illness can be an added burden. It may be
particularly difficult to find work, have a reasonable income, or
to be included by other people. You may have to cope not only with
a difficult mental illness, but also with the attitudes of other
When are people referred to rehabilitation services?
- Usually after a few years of mental health problems - and a
number of hospital admissions. However, it can sometimes be helpful
if you are trying to get over a first episode of illness.
- If you can't be discharged from an acute ward, but are unlikely
to get any better there.
- If you are moving to a placement with less support and
supervision. This can happen if you are leaving a forensic or
secure service, or if you are moving from residential care to a
more independent home in the community.
- If you might benefit from the structured environment and
intensive therapeutic programmes that are available on
a rehabilitation unit.
What are the aims of mental health rehabilitation?
- To learn or re-learn life skills.
- To get your confidence back.
- To cope better without so much help.
- To achieve the things you want to, like living in your own
flat, getting a job or starting a family.
- To feel independent and comfortable with your life.
Professionals working in rehabilitation services support people
with their particular problems, but, as they get better, adjust
this support as needed.
Rehabilitation services will usually work for you for months or
years. They will support you as you feel more confident and improve
your skills. It can be hard to keep hopeful over these long periods
- and the staff will do their best to help you do this.
What treatments and support are provided?
- Talking therapies (e.g. cognitive behaviour therapy and
specific work with families and carers).
- Guidance on healthy living (e.g. diet, exercise and stopping
- Help to reduce or stop alcohol and street drug use.
- Support to manage everyday activities such as personal hygiene,
laundry and more complex living skills such as budgeting, shopping
- As you get better, you will spend more time in the community.
You might do some sport, go to the cinema, do a course, learn some
skills for work, or start to get a job.
- Help with accommodation and social security benefits.
- Sometimes legal advice.
Your rehabilitation service should be helping you to regain
your skills for community living, with the same opportunities
as anyone else. You need to be able to have useful and interesting
Rehabilitation units should provide a safe and homely space
where you can feel comfortable, safe and are able to have safe
relationships with other people.
What does a rehabilitation psychiatrist do?
He or she will have specialist expertise in the long-term
treatment and care of people with severe mental illness and complex
needs. They look at the long-term possibilities for the patient,
not just symptoms of the illness, and work closely within a team of
other professionals. They will provide:
- Thorough assessment and treatment.
- Advice to colleagues on the diagnosis and management of severe
and complex mental health problems for people who are not
helped quickly by standard treatments.
- Advice on residential and community support services.
- Advice to commissioners about what services should be
developed, and how to run high-cost placements.
- Management of patients in rehabilitation units.
- Supporting joint working with voluntary sector agencies that
provide supported housing and work opportunities for rehabilitation
patients as they recover.
When you are first admitted to a rehabilitation service,
you should have a detailed assessment which includes your views and
The staff will discuss a care plan with you. This should be
developed as far as possible with you - and sometimes
with a carer or your family.
As time goes on, you will spend more and more time doing things
in the community (see above), and less time in the unit.
A rehabilitation unit should help you to feel better about
yourself, more confident, more easy with your feelings and more
hopeful for the future. Your length of stay will depend on how you
get on - according to what you need.
Some regions in the UK, and around half the NHS Trusts in
England, have a community rehabilitation team. These services
support people who have made the move from a rehabilitation unit to
some form of supported accommodation, but who require ongoing
support with their day-to-day lives, both social and personal.
The community rehabilitation team can give more specialised
support than the more general community mental health teams.
The team will continue the work of the rehabilitation unit. They
will work with you to update your care plan and make sure that it
progresses. They will support you with managing your medication,
looking after your home, and doing any activities you may want to
get involved with,
The team will involve your carer(s) or family (if appropriate)
to help them give you the understanding and support you need.
In other parts of the United Kingdom, approaches to
rehabilitation and recovery may be different.
recovery for people with complex mental health needs - a template
for rehabilitation services. Published by the Royal College of
Psychiatrists' Faculty of Rehabilitation and Social Psychiatry,
edited by Drs Paul Wolfson, Frank Holloway and Helen Killaspy.
Ireland: a national voluntary
organisation which includes mental health professionals and lay
people who provide care, support and friendship.
advice and support to anyone experiencing a mental health problem
and campaigns to improve services, raise awareness and promote
understanding. Infoline: 0300 123 3393.
Illness: a national
mental health charity which provides information,
services and a voice for everyone affected by mental
illness. Helpline: 0300 5000 927.
Association for Mental Health: Scotland's leading
mental health charity which provides information and services for
people experiencing mental health problems, addictions,
homelessness and other forms of social exclusion.
Support in Mind
Scotland: works to improve the wellbeing and quality
of life of people affected by serious mental illness. This includes
those who are family members, carers and supporters.
This leaflet was produced by the Royal College of
Psychiatrists' Faculty of Rehabilitation and Social
Psychiatry and the Public Education Editorial Board.
Series editor: Dr Philip Timms.
Written by Maurice Arbuthnott and Dr Tom
Edwards, Dr Helen Killaspy, and Dr Shawn
This leaflet reflects the best available evidence at the time
Under Review April 2018 Royal College of
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