Restoring Self-Adequacy: Vocational Rehabilitation of Mentally Ill Patient

In Pakistan, the contribution of mental disorders to the overall disease burden is about 11.9%. Mentally ill patients are often viewed as those unable to fulfill their personal and occupational responsibilities, and therefore considered a burden on family and society. Unemployment rate for these individuals is estimated to be around 85% to 92%, much higher than for other disabled individuals. This directly or indirectly leads to increased dependency of these patients on the families which often results in social avoidance and discrimination by society. About 70% of psychiatric individuals completely depend on families for economic support. Vocational rehabilitation being one significant aspect of psychosocial rehabilitation, is given to individuals with health-related limitation or impairment, and is focused on maximizing work involvement and potential. It is both patient-focused and evidence-based, and involves multi-professional intervention. It is considered as pivotal since the confidence gained from employment helps patients in recovery, enhance their self-esteem and increase self-reliance by empowering them. In this regard, Individual Placement and Support model (IPS) a variant of Supported Employment, is widely used and involves placing the individuals in competitive employment and then supporting them. It has been found that it plays important role in sustaining the employment for the patients and motivating individuals to maintain their psychological health by the use of its seven principles. The principles work as core elements in dealing with the challenges associated with the work and employment of mentally ill patients. The present article is intended to bring this concept to light by discussing a case study of a client suffering from schizoaffective disorder.

Vocational rehabilitation is an important aspect of recovery and rehabilitation. Healthcare professionals can play a considerable role in giving patients self-adequacy by supporting, preparing and advocating them in rehabilitation. Further work is needed at different levels to understand the concept of vocational rehabilitation in the context of resource constraint environment and practice it at full potential by involving healthcare professionals, policymakers, and different Non-Governmental Organizations.