The place of vocational rehabilitation for consumers with mental health issues residing in hospital

Abstract

Introduction: For many people living with psychiatric disabilities, participation in work is a pressing goal. The journey to recovery often includes vocational rehabilitation. Yet, little is known about the vocational characteristics and needs of people with psychiatric disabilities residing in hospital and their experience of vocational rehabilitation in this setting. Objective: The main aims of this thesis were (i) to identify specific vocational characteristics and needs of people with psychiatric disabilities residing in hospital to gain a better understanding of the service user group; and (ii) to explore service users’ accounts of their personal experience attending a hospital vocational rehabilitation service. Methods: The thesis used a mixed methods design across two separate studies. The first study used a cross-sectional self-report survey to capture information about the characteristics and needs of the consumer group (n=30) and their perceptions about participating in work. Descriptive data from the survey was analysed using SPSS. Then a second study was conducted using semi-structured interviews to gather qualitative data from five individual consumers, to explore their experience of participating in a hospital based vocational rehabilitation program. The interview data was transcribed verbatim and analysed thematically. Finally the outcomes of both the studies were brought together in the conclusion chapter of the thesis. Findings: According to the quantitative survey results, having a job was important for the majority of respondents. Despite high levels of motivation to work, only about half of the survey respondents felt ready to work. The qualitative interviews provided more information about individual experiences of their journeys in returning to work occupations. Three main themes were identified: fulfilling recovery, benefits of occupational participation, and perceptions of the vocational rehabilitation experience Conclusion: Identifying the vocational characteristics, needs and perspective of the participants provides a basis for developing a conceptual framework to guide the design of effective hospital-based vocational rehabilitation services; to support the potential for people with psychiatric disabilities in hospital to attain positive vocational outcomes. Future research in this area would benefit from an extensive, longitudinal study across various sites and involving various vocational rehabilitation approaches, which explores employment and non-employment outcomes for people with psychiatric disabilities residing in hospital. People with psychiatric disabilities do think about work whilst in hospital and mental health professionals and occupational therapists need to consider the value of work, and offer opportunities for people to work towards their vocational goals.