1. Rehabilitation in Psychosis: Rebuilding & Transforming Lives Dr Sridevi Kalidindi PhD, FRCPsych Chair, Faculty of Rehabilitation & Social Psychiatry; Co-Chair, Joint Commissioning Panel –Mental Health; Consultant Psychiatrist in Rehabilitation & Recovery; Visiting Lecturer IOPPN Trust Clinical Liaison Lead for Contracts Sridevi.kalidindi@slam.nhs.uk http://www.rcpsych.ac.uk/workinpsychiatry/faculties/rehabilitationandsocial.a spx

2. Rehabilitation in Psychosis – Co-producing Transformed Lives. “Thank you for giving me my life back” Real life stories: Clinical and service user innovation – the long(er) view Severe personality disorder and psychosis Autistic spectrum disorder and psychosis Substance misuse and psychosis BME, substance misuse and psychosis

4. People with complex psychosis and complex needs  Psychosis  Treatment resistance  Negative symptoms  Comorbidities – mental and physical health  Functional impairments  Challenging behaviour  Difficult to engage  Risk  10-14% of EIP require rehabilitation  10-20% of secondary care; Account for 25%-50% of the annual UK mental health budget (MH Strategies 2012)

5. Specialist skills of rehabilitation services http://www.rcpsych.ac.uk/workinpsychiatry/faculties/rehabilitationandsocial.aspx

6. Skills of a Community Rehabilitation Team (see guidance) Leadership; the long(er) view ‘Pull through’ to less restrictive, more independent, socially inclusive and meaningful lives Public Relations Internal to the team Patients & carers Working with other teams Provider facing Managing transition Commissioner facing Census, performance management; systemic blocks, challenge discrimination - educate placements/care packages/ funding panel OATs local service development cost of unmet need (Campion 2012)

7. Whole system approach to mental health rehabilitation services

8. A National Strategy National commissioning Guidance (Waxing and waning rehabilitation services nationally) www.jcpmh.info

9. Out-of-Area Treatment In Sight, In Mind – Toolkit for OATs

10. Setting National Standards AIMS – Rehab; CQC Community Rehab standards underway NICE guidance eg. i) Transition from Hospital to Care Home ii) New – NICE guidance service specification (2016!)

11. A Pathway Approach Many local examples of good innovative pathways, both in-patient and community National pathway: High level within the commissioning guidance Detailed - under construction. Careful not to stifle local innovation, based on local needs Earlier intervention is key. Criteria – 2 acute admissions in one year, > 30 day admission

12. Faculty of Rehabilitation & Social Psychiatry National review of Rehabilitation (all types) National review for Mental Health Supported Housing National Survey of Rehabilitation Services Employment –DWP, Expert Review; Training for assessing Doctors Recruitment, Education and Training International Rehabilitation

13. International Rehabilitation Psychiatry #FundaMentalSDG United Nations Sustainable Development Goals 2015 Development Agenda www.fundamentalsdg.org

14. Rehabilitation in Psychosis – Co-producing Transformed Lives