Transitional Care
In Canada and Scotland, the transitional discharge model (Forchuk,
Reynolds, Sharkey, Martin, & Jensen, 2007) has proved successful. Patients
who were discharged to the community after long hospitalizations received
intensive services to facilitate their transition to successful commu-nity
living and functioning. Two essential components of this model are peer support
and bridging staff. Peer sup-port is provided by a consumer now living
successfully in the community. Bridging staff refers to an overlap between
hospital and community care—hospital staff do not termi-nate their therapeutic
relationship with the client until a therapeutic relationship has been
established with the community care provider. This model requires collabora-tion,
administrative support, and adequate funding to effectively promote the
patient’s health and well-being and prevent relapse and rehospitalization.
Poverty among people with mental illness is a signifi-cant barrier
to maintaining housing. Residents often rely on government entitlements, such
as Social Security Insur-ance or Social Security Disability Insurance, for
their income, which averages $400 to $450 per month. Although many clients
express the desire to work, many cannot do so consistently. Even with
vocational services, the jobs available tend to be unskilled and part-time,
resulting in income that is inadequate to maintain independent living. In
addition, the Social Security Insurance system is often a disincentive to
making the transition to paid employment: the client would have to trade a
reliable source of income and much-needed health insurance for a poorly paying,
relatively insecure job that is unlikely to include fringe benefits. Both
psychiatric rehabilitation programs and society must address poverty among
people with mental illness to remove this barrier to independent living and
self-sufficiency (Perese, 2007).
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