Utilization of Psychiatric Rehabilitation Services among People Coping with Severe Mental Illnesses

Introduction

People coping with severe mental illness (SMI) experience serious debilitation, decrease in quality of life and a significant decline in daily life functioning. The Israeli health system provides psychiatric rehabilitation services, named Sal Shikum services (SSS), aimed at integrating people with SMI into the community, with the goal of enhancing their quality of life and functioning. Yet only 30% of eligible individuals utilize these services. This study examined factors contributing to the utilization of SSS.

methods

In this cross-sectional study 227 people with SMI who were entitled to SSS filled out an online survey distributed through social media and within a psychiatric department. The survey included questionnaires assessing utilization of SSS, level of knowledge regarding rehabilitation services, attitudes toward seeking mental health treatment, quality of mental health provider-client relationship and degree of provider-client shared decision-making.

Results

Users of SSS exhibited a higher level of knowledge and more positive attitudes towards seeking mental health treatment compared to non-users. In the path analysis, quality of provider-client relationship and attitudes significantly explained the likelihood of using SSS. Furthermore, attitudes mediated the relationship between quality of provider-client relationship and utilization of SSS. 

Discussion-conclusion

Quality of provider-client relationship and attitudes towards seeking mental health treatment seem to be the most important factors in explaining the likelihood of SSS utilization. Programs aimed at reducing negative attitudes towards seeking mental health treatment and at improving provider-client relationship should be developed. Improving provider-client relationship can be achieved by promoting professional development of mental health providers through targeted training and by increasing manpower within health systems in order to enhance service availability and reduce staff workload. Additionally, campaigns and programs to reduce stigma towards mental health services can contribute to more positive attitudes towards such services and to the utilization of mental health rehabilitation services.