COMPLEX REHABILITATION CENTRE OF PH HORNÍ BEŘKOVICE

The Norway Grants have prepared a number of topics for the Czech Republic that have not been supported by European Union subsidies. In 2014, the Ministry of Health of the Czech Republic, as the mediating body, announced a grant call. Programme C11, Public Health Initiatives, was aimed at improvement of psychiatric care services. Norway Grants Grant No. NF-CZ11-OV-2-028-2015 was assigned to the Horní Beřkovice Psychiatric Hospital based on a well-prepared plan for the introduction of comprehensive psychiatric rehabilitation methods.

Norway Grants support

The total project cost of the construction of two rehabilitation centres and the support of activities amounts to CZK 32,801,158. The Horní Beřkovice Psychiatric Hospital obtained a financial subsidy from the Norway Grants financial mechanism in the amount of CZK 25,347,555 for the construction of the Horní Beřkovice Psychiatric Hospital Comprehensive Rehabilitation Centre. The psychiatric rehabilitation programme was co-financed by the hospital with the amount of CZK 7,453,603.

The construction of the psychiatric rehabilitation infrastructure was launched in May 2016, and buildings O and B were approved in March 2017. The implementation of the programme was carried out in cooperation with the project partners, namely organizations dealing with the development of non-state social services and a university. The comprehensive rehabilitation programme includes treatment in the hospital and follow-up social care.

The project was completed with a successful psychiatric rehabilitation programme carried out in the psychiatric hospital and at Fokus workplaces. A total of 80 long-term hospitalized patients were activated. At the same time, two buildings were reconstructed in the hospital complex.

Rehabilitation Planning Group

The Horní Beřkovice Psychiatric Hospital and Fokus Labe, Fokus Liberec and Fokus Praha-Mělník established the Rehabilitation Planning Group in April 2014, which prepared a methodology for joint work: a structured programme focused on work diagnostics, training of skills and therapeutic courses aimed at overcoming crisis situations. In 2015, the work team was significantly strengthened by a new partner (Jan Evangelista Purkyně University, Faculty of Health Studies, Department of Occupational Therapy and Physiotherapy), which prepared a social rehabilitation programme – application of new intervention and therapeutic means of occupational therapy and physiotherapy.

The aim of psychiatric rehabilitation in the conditions of the Horní Beřkovice Psychiatric Hospital is to help people with psychiatric disabilities to increase their ability to function in order to be successful and satisfied in the environment they have chosen to live in. The successful goal of comprehensive rehabilitation is to enable better integration of patients with serious mental illnesses into society outside the psychiatric hospital.

Psychiatric rehabilitation programme

The programme was started on 1 April 2015. During the programme in 2016 and 2017, Fokus Praha's Dolní Povltaví Team established cooperation with 13 clients, 5 of whom left the hospital to start their independent life. Fokus Liberec activated 15 patients, 6 of whom are actively working to develop their life priorities. Focus Labe initiated 35 patients for activity, 27 of whom were new patients who achieved the goal of integration into community care, and 8 of whom were patients of the existing community services provided by Fokus Labe whose necessary hospitalization time could be shortened thanks to the set system.

Based on the programme, a total of 46 of 80 hospitalized patients who participated in the psychiatric rehabilitation programme moved back to the natural environment with the subsequent support of community services. The programme will continue to operate in accordance with the set sustainability parameters until 2023. It will be covered by the funds provided by the Horní Beřkovice Psychiatric Hospital and assisting Fokus organizations.

The programme carried out by the Comprehensive Rehabilitation Centre is divided into 4 basic stages which are essentially chronological in sequence, but which also rotate cyclically:

1. Diagnostic and motivational stage
2. Planning stage
3. Rehabilitation stage
4. Evaluation stage

The activities are focused on three consecutive stages of recovery from illness, stabilization and, above all, re-orientation and re-integration. The number of rehabilitations was determined by the diagnosis according to the needs of individual clients, based on the check of the progress achieved. The duration of the comprehensive rehabilitation programme was 3 to 12 months, based on the established client progress. The number of clients in the group was 3 to 8. The clients were also visited at the specialized workplaces of the partners Fokus Labe, Fokus Liberec and Fokus Praha-Mělník in order to be able to participate in the subsequent social integration after their hospitalization.

The main therapeutic goals of the comprehensive rehabilitation method:

• minimizing or stabilizing illness symptoms
• preventing rehospitalisation
• supporting the ability to function independently
• supporting the ability to work and study

Horní Beřkovice Psychiatric Hospital Comprehensive Rehabilitation Centre

The project intention was to create the Horní Beřkovice Psychiatric Hospital Comprehensive Rehabilitation Centre, which enables the development of patients' abilities. The Fokus organizations obtained a conversation room for work with clients. Two new training workplaces were created in the hospital complex, the construction of which was supported by a Norway Grants grant amounting to 85% of the total investment, including interior equipment.

• Psychosocial Skills Training Centre – B – Monastery
• Manual Skills and Art Therapy Training Centre – O– Coal House

O – Coal House Manual Skills and Art Therapy Training Centre

The manual skills training centre was created by reconstructing former coal storage building O. The original one-storey building was transformed into a two-storey rehabilitation workplace. The following occupational therapy workshops and workplaces were created:

1) Gymnasium

2) Workshop A – pottery and basketry techniques

Workshop B – polymer material processing, wax and soap workshop

Workshop D – paper production, jewellery making, graphics and varnishing

Workshop C – textile processing, handicraft techniques, working with silk

B – Monastery Psychosocial Skills Training Centre

The social skills training centre was created by reconstructing the 2nd floor of building B in the former monastery in the psychiatric hospital complex. The new workplaces are connected to the rooms used within follow-up care to provide an interactive relationship between clients and non-profit organizations offering follow-up care. The following therapeutic activities were created:

1. Training laundry
2. Training kitchen
3. Therapeutic space for individual consultations, conversation room, 5 workplaces
4. Space for community meetings – therapy
5. Room for manual-educational training of cognitive functions