VOCATIONAL-REHABILITATION OF CHRONICALLY MENTALLY-ILL PATIENTS - RESULTS OF A PROSPECTIVE 3-YEAR STUDY

Vocational rehabilitation of mentally ill patients is now focused outs ide the psychiatric hospital. Three types of programmes play a major r ole: outpatient work therapy programmes at psychiatric hospitals, jobs in (partly) sheltered employment facilities as in companies specially adapted for employing mentally ill persons, and workshops for the men tally disabled. In the north-western German region of Westphalia-Lippe (population: 9 million) we carried out a three-year prospective study on a regionally representative sample from such rehabilitation instit utions to assess the course and outcome of vocational rehabilitation. The sample comprised 295 men and 176 women with a mean age of 36.1 yea r (+/- 9.6). The majority were chronically ill patients with a history of frequent long-term hospitalisation. 61% of all probands were suffe ring from schizophrenic disorders. The outcome of vocational rehabilit ation differs substantially among the three programme types, primarily due to varying baseline conditions, subjective expectations or goals, and courses of illness. The programmes are not alternatives but shoul d be seen as supplementary components of a care system which has to me et a wide range of patient requirements. Vocational integration into t he open labour market is a desirable and realistic objective for only some of those concerned.