This paper describes the journey and process of conducting Illness Management and Recovery (IMR) programs in Brunei Darussalam to the current date. In the last decade, Occupational Therapy has focused on activities of daily living as a non-standardised form of assessment and treatment approach for clients with mental illness in Brunei Darussalam. Most of the treatment models used are conservative and are effective in reducing the symptoms but they do not prevent relapses and assist in empowerment of clients. This awareness led to the search for evidence-based practices to improve outcomes. IMR program was initially implemented in RIPAS Hospital, Brunei by Occupational Therapist for clients from Psychiatric Day Hospital.
The original modules were translated into Malay Language and Islamic spiritual aspects were included to provide for congruence with local cultural beliefs. The modules contents were not standardised and not audited by any assessors. After the completion of IMR, no follow-up was done on clients’ chosen goals. Towards the end of 2014, we were involved with the Community Psychiatric Rehabilitation Centre who piloted this recovery program for a selected group of clients with Schizophrenia for 3 months. Two weeks training and practical exposure were delivered to the Rehabilitation Centre staffs. Conclusion Involvement of other staff from the Mental Health setting has facilitated the evaluation of the effectiveness of the program.
However, assessment of the pilot showed lack of communication, insufficient training, usage of “too technical” and non standardised modules, poor follow-up on consumers’ goals and lack of relapse prevention plans. Our program scored reasonably well in the IMR fidelity scale (41/65) although it scored poorly on the General Organisational Index (15/60). Implementation of Illness Management and Recovery in Brunei can be further improved through strong leadership, effective training and committed staff to ensure sustainability of an effective evidence-based recovery program.
