PEPS (Patient Empowerment Programme for Schizophrenia)

What is PEPS ?

PEPS is designed to provide modern information about all aspects of the illness to people with schizophrenia and their families.  This program aims to empower patients, through knowledge, to have the confidence and desire to be equal partners in the management of the illness.  PEPS has been divided into five sections as follows:  1) Introduction modules  2) Mind matters – modules specifically looking at mental health  3) Care plan – modules that discuss treatment and therapy options 4) Personal development – modules that offer information and advice on family and social matters  5) Health matters – modules that address physical health concerns

Development and Implementation of PEPS

Many people including patients, family members, and doctors in European countries have worked together on the development of original PEPS.  In Korea, Yongin mental hospital WHO collaborating center(Yongin WHO CC) has translated PEPS English version into Korean and has developed the Korean PEPS since 2005.   The center has worked together with Korean Academy of Schizophrenia. Since its inception PEPS has been supported by Ministry of Health and Welfare(MOHW), Korean Neuropsychiatric Association(KNPA), Korean Family Association for Mental Health(KFAMH), and Sanofi aventis   .In 2005, the first Korean version of PEPS was introduced by Yongin WHO CC. After symposium and workshop, 36 mental health facilities including community mental health centers, hospitals and clinics, and social recovery facilities adopted the program .  Thanks to the successful implementation of the first year program, the center released the second edition of PEPS in 2006.  The second year PEPS project started with translation and revision of the new PEPS manual.60 mental health facilities are performing PEPS this year.  PEPS is expected to bea model education program for people with schizophrenia

Family Link Korea Project

Family Link is the psychoeducation program for families of the people with severe mental illness, which was developed in Hong Kong and spread widely in Asia. Family Link provides people who suffered from mental illness and their family members with a series of 8 lessons, covering the topic area of : understanding serious mental illnesses, recognizing signs and symptoms of mental illness, handling crisis, effective communication skills, handling emotions like shame and guilt, knowing one’s own rights etc.It is geared to train families to be trainers and to empower them. The program is similar to the family-to-family education of NAMI(National Alliance for the Mentally Ill) in the US.

Yongin WHO collaborating center launched Family Link Korea in 2004.After translating the English version of Family Link package into Korean, the center organized steering committee for the program and held demonstration sessions for Korean families in 2004.For the last 2 years, 2005-2006, the center has provided family psychoeducation services to more than 600 families.11 regional education centers have run Family Link with support from Yongin WHO CC.

Each education group consists of around 20 members.Usually two hours are needed for each lesson.All 16 hours can be divided into 4 hours a day per week. Concrete time schedule can be modified according to the condition of the regional education centers.Trainers are mainly psychiatrists, but other mental health professionals may participate.In 2006, some family members who completed Family Link conducted education lessons.

Family Link uses workbook for participants and trainer’s guidebook.The contents of them are as follows :

Chapter 1: Understanding Mental Illness
Chapter 2: Who can understand me?
Chapter 3: Medications for mental illness
Chapter 4: Handling Crisis
Chapter 5: Be nice to yourself
Chapter 6: Recovery
Chapter 7: Rights and Advocacy
Chapter 8: Moving forward


Introduction of SEBoD Korea

The economic burden of depression is measured by direct and indirect costs associated with treatment and non-treatment of the disease. Direct costs are fees associated with treatment including medication and patient care. Indirect costs account for the financial repercussions of untreated depression such as lost of work days, unemployment, and care-givers' loss of productivity, Several international studies have demonstrated that indirect cost of untreated depression is actually three-to-four times greater than the actual cost of depression.

SEBoD is an abbreviation of "Social and Economic Burden of Depression", and in 2003, The SEBoD initiative was established following an international call to action for individuals, governments, and the medical community to join forces to eliminate the comprehensive suffering caused by depression in Asia. SEBoD Korea is an local center of SEBoD Asia, and cooperate with other Asian countries, but also we have promoted our own works sponsored by Wyeth Korea.

Purpose of SEBoD Korea is
1. Increase early detection and diagnosis rate of depression
2. Reduce stigma of depression
3. Improve public awareness of depression
4. Approach to the issues of social and economic burden of depression

Our actions during last 2 years to accomplish these purpose is like below;

1. Regular public awareness program
We assigned 6 sites as the center for regular public education on depression throughout the year 2005, and developed educational material for the depression on special population - old age, young age, children, housewives, employees by collaboration within chapters of SEBoD Korea. We also developed Depression Fact Sheet of Korea and spread to general people.

2. Public campaign
On October, around World Mental Health Day, we opened public campaign throughout the country. 19 mental health facilities such as hospital, mental health center, and public health center joined our campaign and they invited psychiatrists as a lecturer and gave information on depression, and depression screening and individual counselling. Over 24 people attended this campaign nationwide.

3. Depression recovery story contest
To draw interests and understanding of public about successful recovery from depression, we invite public to join contest for 'Depression Recovery Story'. SEBoD Korea and Daily Newspaper co-hosted this contest, and over 40 stories were applied for the Prize. Consultants and chapters of SEBoD Korea selected 5 stories, and awarded. We opened whole awarded stories on Web under agreement of applicants.
Qualitative study on help-seeking behavior among depressed people are going on using 40 real stories recovering from depression. Symptoms, causes, help-seeking and coping strategy were analyzed, and we expect this study will be basic data for early detection of depressed patients.

4. Study on the cost of lost productive time among workers with depression in Korea
Specific hypotheses behind this research are work productivity loss would be greater in workers with depression than normal healthy workers and the treatments of depression cost-effective. For measuring the health status and work performance, we used WHO Health and Work Performance Questionnaire(HPQ) and we estimated lost productive time. Within this year the result of this study will be published.

Introduction about “Alliance program”

The Alliance Program is a resource developed to facilitate and support the implementation of psycho-educational programs in patients with schizophrenia across different care settings. Most current treatment guidelines recommend psycho-education as an essential part of schizophrenia management, due to its favorable effect on the relationship between the affected patient, his or her caregivers and the care team and improvement in medication compliance and overall adherence to the treatment plan.

The Alliance Program consists of two workbooks: the mental health professionals' and the patients' and their caregivers' workbook, each comprising 11 sections. The sections address a spectrum of topics relevant for patients with schizophrenia, ranging from signs and symptoms of the disease, via treatment-related issues, to relationships and sexuality. Within each section, a number of key points are singled out, and the identical narrative is provided in both workbooks.

The modular organization of the material allows for maximum flexibility in the provision of psycho-education. Thus, a customized program can be developed to suit the needs and capabilities of patients, care team members and mental health care organization. The program can be delivered in a group session or, alternatively, the topics can be addressed in individual sessions with patients.

Moreover, the patients' workbook can also be used independently as an information source on schizophrenia. Although it is primarily aimed at patients, it is written in such a way that it can be provided as an information source to caregivers if care team members consider this appropriate. The information within the Alliance Program is provided in a way that allows it to be used by all care team members.