Analysis On Factors Influencing Rehabilitation Services And Research On Countermeasures For Persons With Psychiatric Disabilities

ObjectsMental disability refers to cognition, emotion and behavior defaults mainlyresulted from mental disorders lasting more than1year. Schizophrenia, depression,dementia, epilepsy and drug abuse are the main mental disorders related to mentaldisability. With the continuous transformation of the society, the development ofurbanization and the rapid pace of modern life, various mental disorders are on therise and the problem of mental health is becoming a social problem which willinfluence economic and social development in our country. Different from the otherforms of physical disability, mental disability will not only affects citizens’ physicaland social functions, but also bring physical and financial burden to society andfamilies. This will pose a huge challenge to our social security and medical system.As such, the mental disability attracts great attention from both the government andthe society. The purposes of this study are to provide some theoretical and practicalbasis for the government to make rehabilitation policies, based on the analysis onfactors influencing rehabilitation service for mental disables.MethodsThe Second National Survey for Mental Disorders (SNSMD) in2006adoptedsampling method of divide layered, multi-step and whole group. The study wasconducted in5,964study areas of734county-level units in31provinces. Based onthis, the national disabled situation monitoring was conducted in2007.This studymainly relied on the data collected by the national disabled situation monitoring in2010. The national disabled situation monitoring in2010was conducted in1,467 locations, with two study areas randomly selected from each one of734unitsmentioned above.3,255individuals with mental or multiple disability (1,501men,1,754women) are included in the survey. The average age is50.04±15.16. The maincontents of Survey Questionnaires cover the basic information, social security,education, occupation, rehabilitation and treatment, community service, etc. Softwareof SPSS (Version16) is used, and statistics description, variation test and Logisticregression are applied analyzing the factors that affect mental disabled in theirreceiving rehabilitation service.Results1. The monitoring results in2010show the following problems:(1) The ratio ofsimple mental disability and with the cases of multiple disability is4to1. As formultiple disabilities, intellectual disability accounts for44.8%of multiple disabilities.Their average month household electricity consumption and the annual income andspending are all low, especially for those living in the countryside. Even compared tonon-agricultural disabilities, the difference in medians are of statistical significance（P<0.05）(2)The proportion of self management is75.3%, on-the-job being82.6%,with the latter mainly supported by their families.(3)33.2%of disables are inrehabilitation and55.5%are in treatment, those in both rehabilitation and treatmentaccount for33.2%.13.2%in all accepts the rehabilitation service of community.Nearly39.6%are willing to receive rehabilitation service, but they give up due toexpense. Still33.8%of them have no any willingness. The first two kinds of demandsfor social help are living relief and medical relief, and rehabilitation is in the thirdplace.(4) In terms of social security,50%in all families are accepting the LowestLiving Security below RMB70.0per month.91.2%or95%of all disables participatein the Basic Medical Insurance or the new rural cooperative medical scheme(NRCMS). However, only14.7%resort to NRCMS and the pension coverage ofagricultural disabled is merely11.1%.2. Factors affecting rehabilitation and treatment. Among the models based on theanalysis of comparison, non-conditional Logistic regression of simple or multiple factors, the factors are ordered according the OR value. In the descending order, thefactors are the willingness of rehabilitation and treatment, quality of communityservice, social security, education, basic living status, gender, disability type anddomicile, all having statistical significance（P<0.05）. They are divided into individualgroup (disability type, education, willingness of rehabilitation and treatment, andgender), living security group (basic living status and social security) and communitygroup (domicile and community service). The analysis shows that, favorable factorsare high-level willingness of rehabilitation and treatment, community service, socialsecurity, basic living status and education, non-agricultural (urban) domicile, femaleand simple disability.Conclusion1.Factors influencing rehabilitation services for persons with mental disabilityare the willingness of rehabilitation and treatment, quality of community service,social security, education, basic living status, gender, disability type and domicile,them being significantly different（P<0.05）. This means those mentally disabled withstrong willingness or higher level of education are more likely to accept rehabilitation;those who are female, featured with simple disability or in working ages are morelikely to accept rehabilitation, compared to those who are male, featured with multipledisabilities or in old ages; those living in urban areas and enjoying higher level ofcommunity service are more likely to accept rehabilitation than those living in ruralareas or enjoying lower level of community service; and those with sound basic livingstatus and higher level of social security, are more likely to accept rehabilitation.2. Policies and suggestions: establishing the community-centered rehabilitation&treatment system for mentally disabled; speed up mental health legislation to ensurethe rights for mentally disabled; and the government should play a larger role inproviding rehabilitation&treatment service. Encourage and support localgovernments and non-governmental organizations to make further effort in enhancing the level of social security, and paving the way for those mentally disabled to returnthe society, especially creating job opportunities. Give more support to mentallydisabled living in rural areas. With the community being the major influencing factor,improve community rehabilitation facilities and conditions, and offer such services aseducation, occupational training and rehabilitation via resources in the community.Enhance publicity to increase the willingness for rehabilitation.