Vocational rehabilitation of chronically mentally ill patients - A synopsis of the current position

Vocational rehabilitation has long been of central importance in the compre hensive treatment of the psychiatrically disabled. This is reflected by the creation of a broad spectrum of vocational rehabilitation programs, rangin g from inpatient and outpatient work therapy and sheltered employment to su pported employment programs within the competitive labour market. Evaluatio n studies have shown that although sheltered vocational rehabilitation prog rams effect a significant rise in the work activity, rate of employment, jo b tenure and income of people with chronic mental illness in the alternativ e labour market, these programms do not substantially increase job placemen t in the competitive labour market. By contrast, supported employment progr ams have proven more successful in achieving a higher integration rate in t he competitive labour market for the chronically mentally ill. As opposed t o the well-developed alternative labour market, supported employment progra ms are not broadly disseminated in German-speaking countries. Furthermore, vocational rehabilitation in general suffers from a lack of systematic eval uation and thus from inadequate scientific foundation.