Community-based services is where support is delivered to persons who, because of mental disorders, are unable to cope with the activities of daily living and social interactions. Community-based services are provided at the commune (gmina) level, as one of social assistance tasks delegated by the central public administration, and are delivered through community self-help homes and specialist home care services.
Community self-help homes (community support centres)
Community self-help homes are established under the Mental Health Act, for persons with a mental condition or intellectual disability who experience difficulties with and require assistance in the activities of daily living, i.e. social interactions, education, employment, and sustenance. The role of community self-help homes is to:
● establish a fixed timetable of daily activities for the persons concerned,
● provide assistance in escaping isolation,
● provide assistance in establishing and nurturing relationships with other people,
● empowering and training to perform activities of daily living, adopt healthy eating habits, manage personal budget and belongings, engage in leisure activities, sports activities, as well as cultural and social activities,
● transition to independent living.
These goals are achieved through:
- development of a therapeutic community,
- occupational therapy,
- leisure and sports activities,
- music therapy,
- classes in fine arts,
- basic life-skills trainings (cooking, budget management, personal hygiene),
- social skills trainings (conversational skills, assertiveness, communication).
Beneficiaries of home care services are persons who require third-person assistance because of age, medical condition, disability, or the like. Care services delivered at home or, rarely, at community support centres may include:
assistance in the activities of daily living:
- shopping, cleaning, cooking,
- cleaning, bathing, dressing,
- attending to administrative matters;
assistance for persons with medical conditions:
- administration of medications,
- making bed,
- prevention of bedsores and burns,
- maintaining contact with family and the community, to the extent possible.
The following forms of specialist services can be provided as part of home care services:
- specialist medical home care services – a special type of home care services determined by the type of medical condition or disability of the person affected; delivered by healthcare professionals, i.e. nurses, rehabilitation specialists, physical therapists, psychologists, therapists, trainers and educators;
- specialist psychiatric home care services – for persons with mental disorders, delivered at home to individuals who, because of their mental condition, may find it difficult to handle the activities of daily living, especially in terms of social interactions, education, employment, and sustenance.
Specialist psychiatric home care services are mainly intended to sustain and develop skills necessary for active, independent living.
In essence, the persons are empowered and encouraged to live active and inclusive lives (instead of relying on other people) and are offered assistance in gaining access to medical services and rehabilitation. Specialist psychiatric home care services are delivered by nurses, social workers, rehabilitation specialists, physical therapists, psychologists, educators, speech therapists, occupational therapists, and other professionals of similar expertise. If required, a person can be offered several types of home care services, or home care services can be allocated to several members of a family. Home care services are coordinated by a social worker.
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To be eligible for home care services, you must first get a referral from a psychiatrist or a GP. A person concerned may also request specialist home care services from a social welfare centre.
Housing assistance – supervised apartments
According to the Mental Health Act, housing assistance is a form of community-based social care and is delivered to persons who, because of mental disorders, find it difficult to deal with the activities of daily living and social interactions.
Housing assistance can be provided as specialist home care services, or at community self-help homes.
Community self-help homes offer residence to people in need – they develop the resourcefulness and independence in living of the residents through various forms of trainings and activities. However, the duration of stay is up to 3 months, or up to 8 months in total per calendar year. Also, the Social Assistance Act stipulates that persons with mental disorders can be allocated to a supervised apartment.
Supervised apartment is a form of social care in which residents are trained – under the supervision of qualified specialists – to live independently, or as a substitute for a stay at residential care facilities.
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Supervised apartment provides conditions for independent living in a real-world setting, offering residents the chance to integrate themselves with the local community.
A supervised apartment can be operated by any social welfare centre or a not-for-profit organisation. A person can be offered a place at a supervised apartment based on prior arrangements made between a social worker representing the competent social welfare establishment in charge of the apartment, and the person in need (or their legal representative or legal guardian).
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Residing in a supervised apartment is governed by a civil law agreement concluded with the resident or their legal representative/guardian.
The agreement specifies, among others, the purpose and duration of stay, the scope and type of services, and the payment conditions. The type and scope of support services can be modified, taking into account the situation of the person residing in a supervised apartment, and is subject to reassessment at least every 3 months.