1. Noncompliance with psychotropic medications is a primary reason for recidivism to inpatient hospitalization. It is a great contributor to the "Revolving door syndrome." 2. Psychosocial rehabilitation clubhouses can decrease inpatient hospitalization in patients with chronic mental illness. Their supportive, vocational, and educational functions are worth the investment in terms of improving quality of life and functioning skills. 3. Patients on oral psychotropic medications were more compliant in this study than those on injectable neuroleptic regimens if they attended the clubhouse program. It is presumed that the clubhouse atmosphere "normalizes" the routine of taking psychotropic medications and enhances compliance.

Reducing Recidivism: Medication Versus Psychosocial Rehabilitation

Occupational therapists have been conducting functional assessments since World War I, and this accumulated experience has taught us several critical lessons. First, a comprehensive profile of a patient's functioning requires multiple assessment methods. Second, assessment content and measurement constructs must change with the times. Third, technology can enhance and extend functional assessment. Fourth, performance-based assessments of everyday activities can also be used to measure body functions/impairments. However, while deconstructing activities into body functions/impairments is possible, the results do not reflect patients' abilities to integrate the cognitive, motor, sensory and affective functions necessary to complete a complex activity. Finally, the differential complexity of everyday activities that a patient can master or successfully complete can also provide a ruler with which to measure progress.

Functional assessment in mental health: lessons from occupational therapy.

SUMMARY Delivery of mental health care is changing dramatically at the state and county levels in Wisconsin. These new trends are affecting psychiatric institutions and rehabilitation personnel in reference to staffing patterns, the roles of occupational therapists, certified occupational therapy assistants, patient population and level of acute care and the type and site of intervention. Therapists are moving to more community-based and innovative programming and are leading state and local advocacy initiatives. Many occupational therapists in Wisconsin have become pioneers pursuing nontraditional occupational therapy roles in response to changes in philosophy, funding, population demographics and evolving needs.

Responsive Changes in Mental Health Practice in Wisconsin

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Anne DeLuca

Papers

Milwaukee Evaluation of Daily Living Skills

Neuroleptic Reduction Helps Prevent RELAPSE