Psychosocial Rehabilitation Services

Psychosocial Rehabilitation Services A. Psychosocial Rehabilitation Services (PSR) consist of a network of services designed to support, restore, and maintain community functioning and well-being of adults with a serious and persistent mental illness. The purpose of the service is to promote recovery, resiliency, and community integration by maintaining the person’s optimal level of functioning and preventing psychiatric decompensation, thereby decreasing the risk of unnecessary hospitalization and the need for higher level intensity services such as Program of Assertive Community Treatment (PACT) and Acute Partial Hospitalization. Service activities aim to alleviate current symptomatology and address the person’s underlying condition by reducing the negative effects of social isolation, promoting illness education, creating and monitoring wellness action plans, and the development of other coping and independent living skills. B. PSR must utilize systematic curriculum-based interventions for recovery skills development for participants. The curriculum-based interventions must be evidence-based or recognized best-practices in the field of mental health as recognized by the Substance Abuse and Mental Health Services Administration (SAMHSA). Curriculum-based interventions must address the following outcomes for the people participating in PSR: 1. Increased knowledge about mental illnesses; 2. Fewer relapses; 3. Fewer re-hospitalizations; 4. Reduced distress from symptoms; 5. Increased consistent use of medications; and 6. Increased recovery supports to promote community living. C. The PSR systematic and curriculum-based interventions must address the following core components: 1. Psychoeducation; 2. Relapse Prevention; 3. Coping Skills Training; and 4. Utilizing Resources and Supports (inclusive of crisis planning). D. The PSR systematic and curriculum-based interventions must, at a minimum, include the following topics: 1. Recovery strategies; 2. Facts about mental illnesses; 3. Building social supports; 4. Using medications effectively; 5. Drug and alcohol use; 6. Reducing relapse; 7. Coping with stress; 8. Coping with problems and symptoms of mental illnesses; and 9. Self-advocacy. E. All people are required to have a Recovery Support Plan. People must participate in setting goals and assessing their own skills and resources related to goal attainment. Goals are set by exploring strengths, knowledge, and needs in the person’s living, learning, social, and working environments. F. Each person must be provided assistance in the development and acquisition of needed skills and resources necessary to achieve stated recovery goals. G. Documentation of therapeutic activities must be provided in weekly progress notes. H. Providers must have the capacity to offer PSR in each location a minimum of three (3) days per week for a minimum of four (4) hours per day, excluding travel time. Having the capacity to offer in this context means that the provider must provide the required services for the population(s) the agency is serving for each location where the provider is certified by DMH to provide services. I. PSR locations must have sufficient space to accommodate the full range of therapeutic activities and must provide at least 50 square feet of space for each person. J. PSR must be community-based, located in their own physical space, separate from other mental health center activities or institutional settings, and impermeable to use by other services during hours-of-service operation. PSR (except for Senior PSR) cannot be provided in an institutional setting, as determined by DMH. K. PSR must include, at each service location, a full-time supervisor (refer to supervisor qualifications in Chapter 11). A director (refer to director qualifications in Chapter 11) with the responsibility of therapeutic oversight must be on-site a minimum of five (5) hours per week. The service director must plan, develop, and oversee the use of an Evidenced-Based Curriculum approved by SAMHSA implemented to address the needs of people receiving PSR. The chosen Evidence-Based Curriculum must be implemented to fidelity. In addition to the minimum of five (5) hours of on-site supervision, the director must also participate in clinical staffing and/or Treatment Plan review for the people in the service(s) they direct. L. PSR must maintain a minimum of one (1) qualified employee to each 12 or fewer people present in a PSR. The supervisor may be included in this ratio.