Psychosocial Rehabilitation in Mental Health Care for Older Adults

  • Carlos Augusto de Mendonça Lima
  • Nicolas Kuhne


Psychosocial rehabilitation (PR) in old age psychiatry is the set of direct and indirect processes, mobilizing individuals and their environment, in order to allow adults at retirement age presenting a disability, a capacity limitation, or a difficulty of performance related to a mental health problem to recover an optimal functioning. PR for older adults doesn’t differ from that of younger adults. But their specific needs require special skills of professionals and specific resources too. In older adults, the social reintegration and rehabilitation aspects are more valued than vocational ones. Solutions are required for the participation of retirees in all kind of activities within the community. Two complementary dimensions must be taken into account: the psychological well-being and individual resilience. The reduction of stigma and discrimination is central. By acting on social determinants of health, it is possible to improve a better subjective mental health and well-being, to build the capacity of communities to manage adversity, and to reduce the burden and consequences of mental health problems. Primary care teams should be included in all PR program as a cost-effective valuable resource able to deliver and manage important steps of such programs in the respect of local cultural rules.


Psychosocial rehabilitation Well-being Resilience Stigma Discrimination Social determinants of health 


  1. 1.
    World Health Organization. Atlas: mental health resources in the world. Geneva: WHO; 2014.Google Scholar
  2. 2.
    Organisation Mondiale De La Santé. Rapport Mondial sur le Vieillissement et la Santé. Genève: WHO; 2015.Google Scholar
  3. 3.
    de Mendonca Lima CA, Camus V. Aging and mental health: epidemiological considerations. Psiquiatr Biológica. 1996;4(4):193–8.Google Scholar
  4. 4.
    de Mendonca Lima CA, Camus V. Envelhecimento das populações e saúde mental. Informação Psiquiátr. 1995;14(3):97–9.Google Scholar
  5. 5.
    Brundtland GH. Director-General, World Health Organization. Second World Assembly on Ageing-Main Assembly Statement. Madrid, 9 avril 2002.Google Scholar
  6. 6.
    World Health Organization. World health report 2001. Geneva: WHO; 2001.Google Scholar
  7. 7.
    World Health Organization/World Psychiatric Association. Reducing stigma and discrimination against old persons with mental disorders. Geneva: WHO; 2002 (WHO/MSD/MBD/02.3).Google Scholar
  8. 8.
    de Mendonca Lima CA, Kühne N, Bertolote JM, Camus V. Psychose, réadaptation psychosociale, psychiatrie de la personne âgée: concepts et principes généraux. L’Année Gérontol. 2003;1:347–68.Google Scholar
  9. 9.
    Camus V, de Mendonca Lima CA. Psychosocial rehabilitation of the elderly with early- or late-onset schizophrenia: general principles. In: Hasset A, Ames D, Chiu E, editors. Psychosis in the elderly. London: Taylor and Francis; 2005. p. 85–96.Google Scholar
  10. 10.
    World Health Organization/World Psychiatric Association. Psychiatry of the elderly: a consensus statement. Geneva: WHO; 1996 (WHO/MNH/MND/96.7).Google Scholar
  11. 11.
    Jones R. Rehabilitation. In: Copeland JRM, Abu-Saleh MT, Blazer DG, editors. Principles and practice of geriatric psychiatry. Chichester: Wiley; 1994. p. 889–994.Google Scholar
  12. 12.
    Morin L, Franck N. Historique et fondamentaux. In: Franck N, editor. Outils de la réhabilitation psychosociale. Issy-les-Moulineaux: Elsevier Masson; 2016. p. 1–18.Google Scholar
  13. 13.
    World Health Organization/World Psychiatric Association. Organisation of care in psychiatry of the elderly: a technical consensus statement. Geneva: WHO; 1997 (WHO/MSA/MNH/MND/97.3).Google Scholar
  14. 14.
    Vidon G. La réhabilitation psychosociale en psychiatrie. Paris: Éditions Frison-Roche; 1995.Google Scholar
  15. 15.
    Pratt CW, Gill KJ, Barrett NM, Roberts MM. Psychiatric rehabilitation. San Diego: Academic Press; 1999.Google Scholar
  16. 16.
    Tessier L, Clément M. La réadaptation psychosociale en psychiatrie. Québec: Gaëtan Morin Éditeur; 1992.Google Scholar
  17. 17.
    de Mendonça Lima CA, Ivbijaro G. Editorial: mental health and wellbeing of older people: opportunities and challenges. Ment Health Fam Med. 2013;10(3):125–7.PubMedPubMedCentralGoogle Scholar
  18. 18.
    de Mendonça Lima CA, Mintzer J. World Mental Health Day 2013: a day to reflect on the mental health and well-being of older people around the world. WPA News, September 2013.Google Scholar
  19. 19.
    Saraceno B. Préface. In: Vidon G, editor. La réhabilitation psychosociale en psychiatrie. Paris: Édition Frison-Roche; 1995. p. 13–5.Google Scholar
  20. 20.
    Orley J, Kuyken WQ. Quality of life assessment: international perspectives. Berlin: Springer-Verlag; 1994.CrossRefGoogle Scholar
  21. 21.
    Guerlan B, Katz S. Quality of life and mental disorders of elders. In: Katschnig K, Freeman H, Sartorius S, editors. Quality of life in mental disorders. Chichester: Wiley; 1997.Google Scholar
  22. 22.
    World Federation for Mental Health. Dignity in mental health. WMHD Report 2015. In: Leplège A, editor. Les mesures de qualité de vie. Paris: PUF; 1999.Google Scholar
  23. 23.
    Nakagawa T. Psychological well-being in older adults. Angew Gerontol Appl. 2017;2(17):9–10.Google Scholar
  24. 24.
    Perrin T, May H. Assessing occupational capacity and wellbeing. In: Perrin T, May H, editors. Wellbeing in dementia. An occupational approach for therapists and carers. Edinburgh: Churchill Livingstone; 2000. p. 123–44.Google Scholar
  25. 25.
    Fava G. Well-being therapy. Treatment manual and clinical applications. Basel: Karger; 2016.CrossRefGoogle Scholar
  26. 26.
    Richardson JC, Chew-Graham CA. Resilience and well-being. In: Chew-Graham CA, Tay M, editors. Mental health and older people: a guide for primary care practitioners. Switzerland: Springer; 2016. p. 9–17.Google Scholar
  27. 27.
    Hurst S. Vulnérabilité et résilience dans le grand âge. Angew Gerontol Appl. 2017;2(17):39–40.Google Scholar
  28. 28.
    Gaebel W, Rössler W, Sartorius N. The stigma of mental illness – end of the story? Switzerland: Springer; 2017.CrossRefGoogle Scholar
  29. 29.
    World Health Organization, Commission on Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva: WHO; 2008.Google Scholar
  30. 30.
    World Health Organization and Fundacao Calouste Gulbenkian. Social determinants of mental health. Geneva: WHO; 2014.Google Scholar
  31. 31.
    O’Sullivan C. Social determinants of mental health. In: European Communities. Background document for the thematic conference: “Promoting Social Inclusion and Combating Stigma for better Mental Health and Well-being”. Luxembourg: European Communities; 2010. p. 9–14.Google Scholar
  32. 32.
    de Mendonça Lima CA. Lifespan perspective: social determinants of health and promotion of mental health in old age. In: Bährer-Kholer S, editor. Social determinants and mental health. New York: NOVA; 2012. p. 203–13.Google Scholar
  33. 33.
    World Health Organization. Investing in mental health: evidence for action. Geneva: WHO; 2013.Google Scholar
  34. 34.
    World Health Organization. Psychosocial rehabilitation: a consensus statement. Geneva: WHO; 1996 (WHO/MNH/MND/96.2).Google Scholar
  35. 35.
    Organisation Mondiale De La Santé. Classification internationale du fonctionnement, du handicap et de la santé. Genève: OMS; 2001 (WHO/EIP/GPE/CAS/ICIDH-2 F1/01.1).Google Scholar
  36. 36.
    World Health Organization/World Psychiatric Association. Education in psychiatry of the elderly: a technical consensus statement. Geneva: WHO; 1998 (WHO/MNH/MND/98.4).Google Scholar
  37. 37.
    World Health Organization. Quality assurance in mental health care. In: Check-lists and glossaries, vol. 1. Geneva: WHO; 1994 (WHO/MNH/MND/94.17).Google Scholar
  38. 38.
    World Health Organization. Quality assurance in mental health care. In: Check-lists and glossaries, vol. 1. Geneva: WHO; 1997.Google Scholar
  39. 39.
    Stengard E. Key principles for mental health promotion and mental disorder prevention in older people: ProMenPol and DataPrev projects. In: European Communities, editor. Mental health and well-being in older people–making it happen. Conclusions from the thematic conference. WHO/MSA/MNH/MND/97.2. Luxembourg: European Communities; 2010. p. 5–6.Google Scholar
  40. 40.
    United Nations. Principles for the protection of persons with mental illness and for the improvement of mental health care. Résolution 46/119 de décembre 1991 adoptée par l’Assemblée Générale des Nations Unies.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Carlos Augusto de Mendonça Lima
    • 1
  • Nicolas Kuhne
    • 2
  1. 1.Unity of Old Age PsychiatryCentre Les ToisesLausanneSwitzerland
  2. 2.University of Applied Sciences Western SwitzerlandLausanneSwitzerland

Personalised recommendations