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The abstract and excerpt below are from an article published in the journal Administration and Policy in Mental Health. The article describes the model rehabilitation program featured in the recent Mental Illness Education Project videotape, Catching up with the World: Participation and Autonomy in Recovery from Mental Illness.

PRISM: A Public Psychiatric Hospital Model for the 1990's
By David Starkey, Ph.D., Clinical Director, Medfield State Hospital and Barbara Leadholm, Green Spring Health Services, Boston, Mass.
Published by Administration and Policy in Mental Health, Vol. 24, No 6, July 1997, p. 497 © Human Sciences Press, Inc. (excerpted with permission) Please contact the publisher for information on obtaining a copy of the article at Human Science Press: 800-221-9369. Contact: Georgia Prince, Manager, Rights and Permissions. email:


The Massachusetts Department of Mental Health in the Metro Suburban Area developed an inpatient psychiatric rehabilitation model called PRISM. PRISM takes into account the latest thinking about skill development and patient participation and works with state mental hospital patients of all functional levels. This article will describe the transformation of a state hospital into a rehabilitation treatment facility providing longer term treatment, when necessary, while attempting to limit the effects of institutionalization through skill development and patient participation in treatment. Psychosocial interventions as a systematic hospital practice, in addition to state of the art pharmacotherapy, provide the state hospital patient with a modern treatment approach that has the potential to improve quality of life, decrease relapse, and increase the efficiency and responsiveness to patient needs of public sector hospitals.


The Psychiatric Rehabilitation Integrated Service Model, PRISM, described here differs from other rehabilitation models by addressing the effects of institutionalization in addition to the problems created by mental illness itself. For the hospital to play a meaningful role in the longer term treatment of schizophrenia, its function must be, in part, to avoid institutionalization. To be efficient and optimally effective in its methods, its treatment must focus on recovery of function and skill development. The model must engage all staff in developing a new identity and philosophy in their work with patients, transforming the organization in its approach toward assisting patients in coping with their illness.

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