Training courses which aim to prepare the mentally disabled for work take place in job training centres and in rehabilitation institutions for the mentally ill and disabled. They provide important opportunities for job preparation near the participant's home. While rehabilitation institutions carry out medical treatment and initial preparation for working life, the job training centres, as special institutions for professional rehabilitation, offer practical occupational qualifications as well as psychosocial support. They impart or update professional knowledge and skills and give participants the opportunity to practice or acquire generally expected modes of social behaviour in the workplace or at the training or retraining location. They do this by:

* Strengthening physical, mental and social stability,

* Encouraging motivation,

* Creating the necessary view of reality,

* Preparing for and implementing a realistic choice of job or profession,

* Getting to know and dealing with the disability in the real world of work.

"The courses offered in the job training centres generally last between 12 and 15 months, but three-month courses are also offered. The aim is to find a realistic job perspective, to reintegrate the participants into the general employment market or to make them sufficiently stable to undertake subsequent retraining or training. In some cases the course may lead to the judgement that an individual is not fit for work."⁶ Men and women who are generally at least 18 years old and who have a mental health problem can be accepted into job training centres.

REHABILITATION

Key components of rehabilitation for mental health disabilities (as with all disabilities) are vocational assessment, training, and follow-up support. This process must be handled flexibly and without rigid time limits. It should always be possible to extend or shorten the measures and to switch between medical and occupational rehabilitation.

"To avoid relapses, waiting times must be minimised and utilised as meaningfully as possible. For mentally disabled persons frequent changes of measures with different reference persons and geographical situations must be avoided. Training measures to prepare for an occupation should pass as smoothly as possibly into vocational training."⁷

Vocational training of people with mental health disabilities is based on the concept of keeping people "as close to the community and the company as possible". But studies show "that 40% of adolescents suffering from schizophrenia cannot immediately resume their educational and occupational activity or return to their home environment after inpatient treatment because of the chronic nature of their disorder or marked disturbances within their family."⁸ Training is also based on the principle that one should proceed to a higher level of occupational qualification only after the lower level has been consolidated. "The premature commencement of occupational rehabilitation measures based on unreal wishes without understanding of the illness mostly results in failure."⁹ The purpose of rehabilitation is not only to integrate people with disabilities into the economic and social mainstream of society, but also to prevent further disability. Prevention is integral to any rehabilitative approach. The substance of prevention must be aimed at mitigating risk factors which worsen illness and the ensuing disability.

The choice of occupation for the individual with a mental health disability is determined by the specific dynamics of the illness. Preparation for occu-