Chapter 1 12 In the Netherlands, there were no plans for the mass discharge of patients or closure of institutions. Initially, there was only a slight and gradual reduction in the number of beds in psychiatric hospitals (40). However, the number of beds has decreased significantly in recent years. Two requirements for innovations in community care: recovery and evidence-based Several well-designed community-based programs have been developed to improve the mental health care system. These proposals for improvement were based on two principles: (1) the use of a recovery paradigm to guide service delivery and (2) the implementation of services that have been shown to be effective in improving patient outcomes (41). These two principles are discussed briefly in this section. (1) What is recovery? In recent years, the concept of recovery has become increasingly important and has generated interest and optimism among various stakeholders, such as service users, providers, and insurance companies (42). Previously, the term rehabilitation was used (8). However, the relationship between consumers and practitioners has been fundamentally redefined. Rehabilitation refers to what clinicians do and recovery refers to what consumers do. Clinicians support consumer recovery on an equal basis (43). Therefore, treatment success in mental health care for people with SMI is increasingly perceived as progress in terms of recovery. However, recovery is a complex and multidimensional concept defined in various ways (44-46). Three types of recovery In the typology used throughout this study, three types of recovery can be differentiated, evolving from the definition of recovery by Anthony. These types of recovery should not be considered mutually exclusive but rather as complementary aspects of recovery (47). The first type is clinical or symptomatic recovery (47-49), meaning the level of psychiatric symptoms at one point in time or the course of symptoms over time. Broadly defined, this also includes the number and duration of relapses (44, 48, 5052). The second type is functional recovery, defined as the degree of vocational and social functioning, such as acting age-appropriately, performing daily living tasks without supervision, engaging in social interactions (53), and independence with regard to housing (46, 50).
RkJQdWJsaXNoZXIy MjY0ODMw