pational and social re-integration should take place in the hospital and should. begin as soon as the acute illness processes have receded. Collaboration between the general practitioner, the consultant, the hospital, the vocational adviser, the school, the parents and the rehabilitation facility is essential .

"Measures to prepare for an occupation therefore fulfill an important bridging function towards occupational and social reality. On this road the disabled person often needs special assistance to master the anxieties arising (medication, sound relationships, dosed demands, experience of success, recuperation breaks, possibilities of withdrawing)."¹⁰

WORK AND OCCUPATIONAL THERAPY

Lengthy periods of illness or hospital stays frequently lead to a loss of elementary mental and social skills. "Patterns of communication and interaction acquired in the illness process and typical for mentally disabled persons have to be broken down and new patterns of communication learned. It should also be considered, however, that for some patients the hospital with its very low-stimulus and low-demand living organisation is an attractive alternative to the anxiety-inducing demands of actual life."¹¹

The crucial consideration in occupational integration is to make vocational training available as soon as the appropriate training programme has been identified.

"The working time must be organised to be as flexible as possible (breaks, possibilities for withdrawing when overtaxed, work plans before and after crises). By means of adapted requirements overload and understretching must be avoided as far as possible."¹²

 

Financial support for companies integrating disabled employees into the workplace is available from the Employment Office. Benefits are also available under the Severely Disabled Persons Act.

CORPORATE OCCUPATIONAL TRAINING

A stable home and flexible training programme are the major prerequisites for the success of corporate occupational training for mentally disabled persons. Companies can access the support of skilled specialists, usually provided through local psychosocial services. Special provisions can be made for people with mental health disabilities for whom the standard examination situations are too emotionally stressful to allow peak performance. And there are special training regulations for disabled persons.

Workshops for disabled people cater primarily to people with intellectual disabilities who are not ready for the general employment market. Since the workshops are geared primarily to people with intellectual and physically disabilities, individuals with mental health disabilities often are not performing tasks which match their capabilities. Furthermore, they often feel stigmatized by being juxtapositioned with more visible disabilities

Transitional companies ease the transition from a workshop for disabled people to the general employment market. They often include companies operating as much as possible under market conditions. They seek to mitigate the processes of mental and social deterioration brought about by unemployment and long periods of hospitalisation and preparation for reintegration. A major element of these models is that they provide reasonable remuneration appropriate to the work performed.

Special forms of assistance are necessary to enable persons with mental health disabilities to enter the world of gainful employment. Socio-psychiatric services, which have been built up over the past few years, seek to involve patient organisations and family to prevent social withdrawal and to restore or maintain qualifications.