Introducing of psychiatric patients in work world

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Introducing of psychiatric patients in work world

• Department of Psychiatry
• Residential Psychiatric rehabilitation Centre
  ASL LAquila - Italy

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In 1978 in Italy was issued the law (n 180),
that established the closing of mental hospitals
and the creation of alternative structures. It
meant the beginning of a rehabilitative process
and the psychiatric patients right to enter the
working world.
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• Job environment is one of the situations that
  most affects the psychological well-being and the
  mental health of workers.
• Harnois e Gabriel, 2000

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Worker shows a lower level of mental disease
than the unemployed and the students do.(Graez,
1993)
Golconda
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the changing from unemployment to employment
status showed impressive effects regarding the
psychological symptoms. (Liem e Liem, 1998)
La vittoria
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LEGISLATIVE HISTORY
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Law No 68 of march 1999 regardingthe right of
disabled people to work
Law No. 68 clearly indicates the cases and
procedures companies must follow to employ
disabled people.Employers, public and private,
who have more than 14 employees are obligated to
hire disabled people in the following amounts
(either obligation or reserve quotas)The Law
allow tax exemptions for hiring disabled people
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• ARMONY PROJECT Law n 662/1996
• Project of psycho-social rehabilitation for
  psychiatric patients.
• Improving of the quality of life through
• Social competence and skills attainment
• Development of an environment fit to promote
  the social and the job integration.
• Economic aid for working Law 94/2000
• It is granted by the department of Psychiatric to
  psychiatric patients able to work.
• It allows to introduce psychiatric patients in a
  working environment, following a personalized
  program.

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Job whats for?

• To get a wage
• To improve autonomy
• Participating to community life
• Getting a new role and a better social status
• Improving ones esteem
• Promoting the professional growth

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Problems

• Lack of continuity in carrying out tasks and
  multiple tasks
• Working according to predefined timetables
• Relationship problems
• Accepting critics and supervision
• Short flexibility and difficulty in changing

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Main models of introducing psychiatric patients
in the work world in Italy

• In any department of psychiatric exists a model
  for introducing psychiatric patients in the work
  world
• The general trend is using either normal
  working structure or specifically targeted to
  psychiatric patients (and not structure for
  disabled people in general)
• In some cases the Department itself carries on
  this procedure, other times the social services
  do it.
• Sometimes, at a local level, job and solidarity
  cooperatives have been created fitted to
  psychiatric patients

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The principals models job insertion in Italy

• The typology of patient for whom a program of
  entering to the working group is more frequently
  realized is as follows
• male, young or young-adult age, affected by
  psychotic trouble, single, followed by the
  psychiatric public services more than three years

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INTERVENTION AND PROGRAMS

• Stage and job insertion in B type COOPERATIVES
• The firms that conjugate the economic
  requirements with a social purpose and the
  disabled integration
• Patient works together ordinary , not disabled
  member and educational support operators
• provides a initial period of stage with available
  worker ship
• result average 25 of patients will be work
  member at the end of the period of stage or will
  be engaged in some firms general improving of
  working abilities reduction of hospitalization
  till the 80

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Mental health and working The
working introduction program for heavy mental
patients and persistent in MENTAL HEALTH
DIPARTIMENTO OF LAQUILA
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DIPARTIMENTO DI SALUTE MENTALE
DIREZIONE
DIREZIONE
Infantile Psychiatry ward
Mental health Centre
Managers Assistant
S.P.U.D.C.
C.S.M.
S.R.P.R.
N.P.I.
Academic psychiatric service for diagnosis and
care
Struttura di riabilitazione
7 Case famiglia
Centro diurno
Agenzia Lavoro
Il buon esempio
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Rehabilitation psychiatric center of di LAquila
Camera dascolto
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• At the end of rehabilitative project ,after of
  the Ex post valutation result, people get
  knowledge of a preparation programmefor working
  world insertion based on the following variables
• Knowledge job learnning
• -Duty knowing/function
• Doing know professional autonomy and personal
• -working Capacity
• - Work autonomy
• Personal autonomy
• To be knowledge relazional area and social
• -Consciousness
• -Relation with others
• -Respect of rules

La Vittoria
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The main models of rehabilitation psychosocial by
the job insertion programmes in Italy

• The model train and place seems to be the most
  largely widespread
• The programmes utility and stage pre-working
  characterizes the more developed working
  insertion
• Presence of the professional figures as tutor
  with internal support activity and external to
  DSM considered significant qualitative

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• PROTECTED LABORATORY
• after basic rihabilitation and before getting a
  job competitive
• specific habitats, separate from the normal
  production context, where works only handicaps,
  supported by operator
• Very simple working, minimum payment
• Brief days work, little pressure
• To productivity and to quality
• results 3-5 of patients progress and find a
  competitive job
• suits as a long term solution for the serious
  patients and handicaps

• Supported instructionzion (supported education)
  for how interruped the school

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STATEMENTS AND PROGRAMS

• IMPIEGO DI TRANSIZIONE (Transitional
  employment)
• Parallel develop of rehabilitative programme or
  of auto-help (Clubhouses)
• Begin with internal work (cleaning, small
  maintenance), continuation of internal firm work
  not registered position, used to rotation,
  limited duration (max 6 months), less payment
  than competitive job
• results from 20 to 35 of patients find out a
  competitive job, with maintaining job problems

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• SUPPORTO LAVORATIVO
• (Supported employment)
• Underpay employment, favourite from legislation,
  booked for handicaps, developed near the
  not-handicap worker
• supported from necessary statements of patients
  need training, supervision, transportation...
• Based on the INTEGRATION principles, of payment,
  of individualization and of continuative support
• results by 34 of patients find a competitive
  job, percentage can be varied up to 50 for wider
  programs, complete and long

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INTERVENTION AND PROGRAMS

• (Supported employment)
• of SIL employment insertion in local sanitary
  Service
• Request identification of handicap gt45 and the
  check of handicap by the law L. 68/99
• provide an initial stage with available grant
• results average 25 of patients will be engaged
  in the same firm
• The supported employment is integrated among the
  effective psycho-social treatment of schizofrenia

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The partners are Verdeaqua Nuovi Orizzonti
(leadership) Asl 4 dellAquila Telecom Italia
Learning Centre Cnos Fap, LAquila Industrial
development society of LAquila
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TRAINING ACTIVITYobject creation glass, wood,
pottery articols

• hours 600
• Trainees 16
• Duration sett.2005 - nov 2006
• CNOS FAP

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MANUFACTORING FIRMSTARTINGFIELD glass, wood,
pottery articols.

• hours 600
• Trainees 13
• Duration ott.2006 - giugno 2006
• CNOS FAP

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Experimental training activity using ICT

• hours 160
• Duration nov.2005 gen.2006
• Trainees 16
• Tils LAquila

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• WORKSHOP

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THE REALIZED PRODUCTS FROM THE STUDENTS OF
OFFICINA DELLE ARTI
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• CREATIVITY