"Why I stay in community psychiatric rehabilitation": a semi-structured survey in persons with schizophrenia

Abstract

Aims Although community psychiatric rehabilitation plays an important role in returning persons with schizophrenia to the society, many patients in China stay in rehabilitation centers for longer periods of time and subsequently fail to integrate. This study is aimed to explore the underlying causes of this trend and identify possible solutions. Methods This study used a qualitative descriptive design to examine the persons with schizophrenia who stay in rehabilitation centers for longer periods of time. The researchers conducted semi-structured telephone interviews with the patients recruited through purposeful sampling. The audio-recorded interviews were transcribed in transcripts in Chinese. Thematic analysis was performed using Colaizzi's 7-step method. Results Most patients believe that they have gained knowledge, improved skills, friendship and social circles through community mental rehabilitation, with the sense of belonging and enriched life strongly attracting them to the rehabilitation centers. They felt that the difficulty of further integration into society is mainly because of social prejudice and rejection. In addition, the activities of community mental rehabilitation meet the needs of social communication, which also hinder patients from further entering the society. Conclusions Persons with schizophrenia with long-term stay in community mental rehabilitation centers meet their friendship, sense of belonging and social needs by participating in rehabilitation activities. Providing special social opportunity for these patients can get them out of the rehabilitation center. Overall, it is possible for patients to gradually return to society in a collective form.

Association between social support and the severity of positive symptoms in rural community-dwelling patients with schizophrenia during the COVID-19 pandemic

“…Stigma can hinder a schizophrenia patient from making contact with others [ 32 ], and schizophrenia patients with internalized stigma have lower relational satisfaction, lower relational esteem and higher fears of relationships or relational anxiety than schizophrenia patients without internalized stigma [ 34 ]; additionally, stigma is more common among patients living in rural areas than among those in urban areas [ 4 ]. Furthermore, patients gain friendships and the subjective support of a sense of belonging, respect and satisfaction through community rehabilitative activities, yet such activities might stop during a pandemic [ 13 ]. During the COVID-19 pandemic, remote options such as wearable devices or online services have been adopted as alternative measures to monitor vital signs and treat common mental-health disorders [ 15 , 35 ].…”

“…Rural patients fail to collect free medication when they are reluctant to take medicine or are unsupervised or live far from locations designated for drug distribution, leading to poor medication adherence [ 11 ]. The stigma of schizophrenia is more severe in rural areas than in urban areas [ 4 ] and can affect health-seeking behaviors [ 12 , 13 ]. A subjective perception of schizophrenia patients, such as a sense of belonging and satisfaction, is important to the patients and can be obtained through community rehabilitative activities [ 8 , 13 , 14 ].…”

“…The stigma of schizophrenia is more severe in rural areas than in urban areas [ 4 ] and can affect health-seeking behaviors [ 12 , 13 ]. A subjective perception of schizophrenia patients, such as a sense of belonging and satisfaction, is important to the patients and can be obtained through community rehabilitative activities [ 8 , 13 , 14 ]. Social support might reduce stigma and create opportunities for patients to gain such subjective perception [ 4 ].…”