Vocational rehabilitation in psychiatry: A re-evaluation

Objective: To highlight the vocational gap in the provision of psychiatric rehabilitation, to outline the goals and conceptual framework of psychiatric rehabilitation, and to discuss rehabilitation interventions with specific reference to vocational rehabilitation and the evidence base for supported employment. Conclusions and service implications: Vocational psychiatric rehabilitation has been a neglected area of practice in Australian psychiatry. Psychiatric treatment needs to adopt a more balanced approach in the provision of a range of services, including vocational rehabilitation, in order to improve long-term outcomes for people suffering from psychiatric disability. A vocational focus should be included in psychiatric rehabilitation and better integration between mental health services and vocational services needs to take place. Supported employment is an evidence-based practice that is designed to help people with psychiatric disabilities participate as much as possible in the competitive job market.

Psychiatrie [Psychiatry].

The novelties in clinical psychiatry are close to somatic medicine adaptation. The clinical staging concept in psychiatry (as in cancerology) is the result of an early intervention strategy in psychotic disorders. A differentiated mode of understanding of the phases of psychiatric disorders allows a prevention oriented approach. Individualized therapeutic programmes in accordance with specific problematics favors the orientation towards focalised follow-ups, for instance CBT programmes on Internet may be proposed to patients motivated and rather autonomous. Others, on the contrary, less accessible to health care should benefit of the support of a mobile team and specific coaching to return to vocational services. Systematic follow-up of the metabolic syndrome, often induced by atypical antipsychotics, belongs to those basic adjustment processes.

The employment of people with mental illness

People with a mental illness are among the most socially and economically marginalised members of the community. They experience high levels of unemployment and nonparticipation in the labour force. Unemployment has a number of negative effects including the loss of purpose, structure, roles and status and a sense of identity which employment brings. Employment enables social inclusion in the wider community and is an important way that people with a mental illness can meaningfully participate in the wider community. Australia has a mental health strategy, which guides the ongoing reform of mental health services. However, specific strategies to address the social and economic marginalisation of people with a mental illness have not been addressed. A recovery-oriented approach is recommended, which integrates the key sectors involved. To date there has been little intersectoral collaboration between the various sectors such as mental health services, housing, and vocational services. People require more role-specific assistance to enable them to participate in socially valued roles implicit with citizenship. There is a need to formulate improved pathways to assistance and more evidence-based forms of assistance to re-establish career pathways. This report aims to: 1) collect relevant overseas and Australian evidence about the employment of people with mental illness; 2) identify the potential benefits of employment; 3) describe patterns of labour force participation in Australia among people with mental illness; 4) identify how mental illness can cause barriers to employment; 5) outline the type of employment restrictions reported by people with mental illness; 6) identify the evidence-based ingredients of employment assistance; 7) identify relevant policy implications; and 8) suggest strategies to improve employment outcomes and career prospects for people with mental illness.

Self-reported health needs and use of primary health care services by adolescents enrolled in post-mandatory schools or vocational training programmes in Switzerland.

BACKGROUND: The second Swiss Multicenter Adolescent Survey on Health (SMASH02) was conducted among a representative sample (n = 7428) of students and apprentices aged 16 to 20 from the three language areas of Switzerland during the year 2002. This paper reports on health needs expressed by adolescents and their use of health care services over the 12 months preceding the survey. METHODS: Nineteen cantons representing 80% of the resident population agreed to participate. A complex iterative random cluster sample of 600 classes was drawn with classes as primary sampling unit. The participation rate was 97.7% for the classes and 99.8% for the youths in attendance. The self-administered questionnaire included 565 items. The median rate of item non-response was 1.8%. Ethical and legal requirements applying to surveys of adolescent populations were respected. RESULTS: Overall more than 90% of adolescents felt in good to excellent health. Suffering often or very often from different physical complaints or pain was also reported such as headache (boys: 15.9%, girls: 37.4%), stomach-ache (boys: 9.7%, girls: 30.0%), joint pain (boys: 24.7%, girls: 29.5%) or back pain (boys: 24.3%, girls: 34.7%). Many adolescents reported a need for help on psychosocial and lifestyle issues, such as stress (boys: 28.5%, girls: 47.7%) or depression (boys: 18.9%, girls: 34.4%). Although about 75% of adolescents reported having consulted a general practitioner and about one-third having seen another specialist, reported reasons for visits do not correspond to the expressed needs. Less than 10% of adolescents had visited a psychiatrist, a family planning centre or a social worker. CONCLUSIONS: The reported rates of health services utilisation by adolescents does not match the substantial reported needs for help in various areas. This may indicate that the corresponding problems are not adequately detected and/or addressed by professionals from the health and social sectors.

Report of recommendations to the Iowa Department of Education, Division of Vocational Rehabilitation Services, June 30, 2007

Report on the Iowa Department of Education, Division of Vocational Rehabilitation Services for the year ended June 30, 2007

Department of Education, Iowa Vocational Rehabilitation Services Performance Plan, FY 2009

Agency Performance Plan, Department of Education, Iowa Vocational Rehabilitation Services

Iowa Vocational Rehabilitation Services Strategic Plan, 2007-2010

This report outlines the strategic plan for Iowa Vocational Rehabilitation Services, goals and mission.

Report of recommendations to the Iowa Department of Education, Division of Vocational Rehabilitation Services, June 30, 2008

Report on the Iowa Department of Education, Division of Vocational Rehabilitation Services for the year ended June 30, 2008

Report of recommendations to the Iowa Department of Education, Division of Vocational Rehabilitation Services, June 30, 2009

Report on the Iowa Department of Education, Division of Vocational Rehabilitation Services for the year ended June 30, 2009

Report of recommendations to the Iowa Department of Education, Division of Vocational Rehabilitation Services, June 30, 2010

Report on the Iowa Department of Education, Division of Vocational Rehabilitation Services for the year ended June 30, 2010

Report of recommendations to the Iowa Department of Education, Division of Vocational Rehabilitation Services, June 30, 2011

Report on the Iowa Department of Education, Division of Vocational Rehabilitation Services for the year ended June 30, 2011

Report of recommendations to the Iowa Department of Education, Division of Vocational Rehabilitation Services, June 30, 2012

Report of recommendations to the Iowa Department of Education, Division of Vocational Rehabilitation Services for the year ended June 30, 2012

Report of recommendations to the Iowa Department of Education, Division of Vocational Rehabilitation Services, for the year ended June 30, 2004

Report of recommendations to the Iowa Department of Education, Division of Vocational Rehabilitation Services, for the year ended June 30, 2004

Report of recommendations to the Iowa Department of Education, Division of Vocational Rehabilitation Services, June 30, 2005

Report of recommendations to the Iowa Department of Education, Division of Vocational Rehabilitation Services, June 30

Iowa Division of Vocational Rehabilitation Services Performance Report, FY2004

Agency Performance Report