Academic journal article The Journal of Rehabilitation

Computer Training for the Young Adult Patient with Chronic Mental Illness

Academic journal article The Journal of Rehabilitation

Computer Training for the Young Adult Patient with Chronic Mental Illness

Article excerpt

Patients in state-operated psychiatric hospitals today are generally the most chronic of the mentally ill population. Vocational rehabilitation staff rely on such activities as sheltered workshops and facility maintenance tasks as primary arenas for job training. Through a pilot vocational training program in computers, some patients have shown an aptitude for this challenging work despite their psychiatric impairments.

Vocational rehabilitation is considered by many mental health professionals to be one of the most important aspects of treatment. Lamb (1982) asserts that "work therapy geared to the capability of the individual patient should be the cornerstone of community treatment" (p. 176). Bennett (1983) found that employer exposure to the employee with a mental illness changed the attitudes of citizens and professionals about the employability of the mentally ill. Anthony and Liberman (1986), after a review of the literature suggest that persons who are severely psychiatrically disabled have skills that are positively related to measures of rehabilitation outcome and that these persons can also learn other skills. Furthermore, they state that rehabilitation outcome is improved by skill development, intervention and environmental resource development.

It is indicated that vocational rehabilitation should begin as early as possible after admission since prolonged periods without rehabilitation can lead to loss of vocational functioning. For example, Farkas, Rodgers, and Thurer (1987) found that in a group of deinstitutionalized persons with mental illness (n=43, mean age=40) who had not received inpatient vocational training, none improved significantly in vocational functioning over a period of 5 years after discharge. This suggests the importance of vocational training during the hospitalization period and after discharge. Despite this indication, proper vocational rehabilitation may not always be available in either inpatient or outpatient mental health systems. A list of four serious impediments to the integration of vocational rehabilitation strategies into the mental health system was compiled by Harding, Strauss, Hafez, and Lieberman (1986): rigidity, isolation, compensatory ad hoc operations, and narrow frames of reference of mental health service providers. However, the findings of Anthony and Jansen (1984) in a review of the literature are encouraging. They determined that psychiatric symptomatology, diagnostic category, intelligence, aptitude and personality tests are poor predictors of future work performance. This determination is important for the vocational rehabilitation counselor to consider when designing work programs for persons suffering from schizophrenia or other severe chronic mental illnesses.

The onset of schizophrenia, the most chronic and debilitating mental illness, occurs at a crucial stage in life, namely the transition into adulthood. During this period (age 18-25) most young adults are in the process of determining their career goals or testing various jobs or occupations. Schizophrenia disrupts this entire process and often the victims face difficult problems in developing vocational skills or interests. Both the positive symptoms (hallucinations, delusions) and negative symptoms (alogia, anhedonia) of schizophrenia, as described by Andreason, 1982 and Andreason and Olsen, 1982, intensify this debilitation, making it difficult for the victim to function with other people in either a living or work environment. It is the extent of this debilitation which contributes greatly to the 70% unemployment of those with chronic mental illness (Goldstrom and Manderscheid, 1982).

Generally, vocational rehabilitation for the person suffering from schizophrenia is encouraged when symptoms begin to stabilize. However, Anthony and Liberman (1986) state that "even if symptoms persist, rehabilitation can proceed within the limits of the individual's capability to respond to training and supportive interventions" (pp. …

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