Vocational Rehabilitation for Persons with Schizophrenia: Recent Advances in Japan

摘要

In Japan vocational rehabilitation for persons with mental illness has made gradual advances in social resources and clinical practices for the past decade. In the 1980s, social participation of people with mental illness started to be promoted eagerly, with significant revisions of the related laws. In 1996, a seven-year-plan for normalization was begun, with much emphasis on vocational rehabilitation of persons with mental illness. Social resources are increasing, though not enough. We report the effectiveness of an integrated program support with group activities, individualized care, maintenance medication, and cognitive-behavioral therapy for job finding. At the psychiatric day treatment unit of Tokyo University Hospital, 27 patients with schizophrenia received skills training in job finding from 1991 to 1995. They developed employment readiness through group activity. Most of them acquired targeted skills, reported increased self-efficacy, and generalized in real job interviews. Individual care and peer support of the group seemed effective in overcoming stressful situations. The supportive relationship enabled them to comply with medication. Twenty-two were employed with disclosure of their illness and maintained employment for more than three months. Development of social resources combined with effective support may help persons with schizophrenia work according to their abilities and improve their quality of life.