Vocational Rehabilitation and Employment
| Date | 01 June 1998 |
| Pages | 8-15 |
| DOI | https://doi.org/10.1108/13619322199700013 |
| Published date | 01 June 1998 |
| Author | Edward Peck,Peter Bates |
| Subject Matter | Health & social care |
8 The Mental Health Review 2:2 ©Pavilion Publishing (Brighton) 1997
Edward Peck, Director
CMHSD
Peter Bates, Directorate Manager,
Rehabilitation and Community Care Services
NOTTINGHAM HEALTHCARE (NHS) TRUST
T
he defining of self through work (paid or
unpaid) is an essential part of how we see
ourselves and is something that most of us
take for granted. It is usually only through the shock of
forced unemployment, redundancy, resignation through
illness or a badly-planned retirement that many of us
realise how vitally work, particularly paid work, affects
our lives. For most of us, it is the main source of income,
status, occupation, purpose and, particularly, social
relations. Employment cannot therefore be considered
as a discrete part of our lives since it bears on all other
aspects of life: the range of our life chances; whereand
how we live; how we structure our day-to-day lives;
what we can afford to do; experiences we can have; and
even the range and natureofour friendships and other
relationships. The value conferred on individuals
through work, in terms of money, a clear role, relation-
ships with others, self image, and a measure of control
over life, cannot be over-estimated. Although much the
same is true, to some extent, of leisure activities and
informal support, they do not usually bring in an
income, which is a prerequisite of undertaking many
other activities in society.Thus, the recognition of the
importance of occupation and employment to service
users is becoming increasingly apparent.
Expanding on this theme, an American psychiatrist
noted recently that:
‘ Most obviously work provides an income which
permits mentally ill people autonomy in gaining
goods and services; secondly,work provides these
individuals with the kind of time and space structure
that Lamb has described as being critical in the
treatment of chronic mental illness; thirdly, work
has the potential for broadening the social contacts
of mentally ill people; fourthly, work provides the
person with the readily recognisable societal role
and work forces individuals to active and involved.
Shepherd has written that work gives the individual
patient a sense of personal achievement and mastery
and that no other single activity is so rich and
complex in its psychological, social and material
significance’ (Bachrach, 1992).
Furthermore, when asked, most users of mental health
services specify that their needs include the needs to
work and undertake meaningful activity,and to optimise
income.
Shepherd (1997) summarised some of the key
research findings:
●
‘ underactivity and lack of meaningful social role
is associated with higher levels of symptoms;
●
access to structured day care and occupation is
associated with better short-term outcomes;
●
longer-termoutcomes arelargely determined
by broad social and economic conditions;
●
problems for mentally ill people are not just
obtaining work but keeping work;
●
range of models for providing work and
employment.’
It is tempting to launch into a taxonomy of these models,
but thereis a broader context to establish before giving
in to that temptation. Nonetheless, at this early stage in
the paper, it is important to make a distinction between
‘conventional’ employment and ‘unconventional’
employment. The term conventional employment is
used to mean a job with a contract of employment, living
wage, and work colleagues who come together at the
workplace, rather than in another role relationship. In
Vocational Rehabilitation
and Employment
FRAMEWORK FEATURE
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