Thesis (M.M.) Florida State University, 2004. / Advisor: Jayne M. Standley, Florida State University, College of Music. Title and description from dissertation home page (viewed 7-11-07). Document formatted into pages; contains 69 pages. Includes biographical sketch. Includes bibliographical references.

Thesis (D.Clin.Psych.) - University of Queensland, 2006. / Includes bibliography.

Thesis (Ph. D.)--University of Texas at Austin, 2008. / Vita. Includes bibliographical references.

This thesis is concerned with the rehabilitation and employment of mentally ill people. It focusses on a Community Programme which offers a year's employment to people with a mental illness. Fifty -three people recruited to the Sprout project were interviewed at various stages during their career on the project. The study sets out to evaluate the project's impact on participants, both during their employment there and subsequently. Participants' views on employment in general and on Sprout were obtained, along with details of their employment and psychiatric histories and of their social circumstances. At a time of high general unemployment, there is much debate about the emphasis work should be given in rehabilitation. In the thesis, I rehearse some of the arguments and counterarguments and consider what light the views of service -users can throw on the issue. It emerges that many mentally ill people believe that they benefit from being in work. They want to work and, given a supportive setting, are capable of doing so. However, there were few opportunities for those leaving Sprout to take up either sheltered or open employment elsewhere. The outcomes for Sprout participants were highly diverse and it seems imperative that such diversity should be reflected in a range of provision which catered for variations in ability and interest. To polarise discussion and debate whether or not work has a place in rehabilitation seems unhelpful. The project had, on the whole, disappointingly little long -term effect on the abilities and quality of life of participants. However, when viewed in the context of other research findings, these results are not surprising as rehabilitation rarely succeeds in bringing about lasting improvements in ability. Moreover, it was evident that Sprout participants often faced substantial difficulties in their lives outside work and yet received little or no support from health or welfare services. This may have affected outcome. The thesis points up deficiencies in current services for mentally ill people and suggests ways in which the employment opportunities of this group might be enhanced. It is insufficient to look only at the employability of the individuals concerned, without also considering the wider social factors which influence access to and retention of employment.

The return of the patient to the community is the goal of institutional treatment programs for mentally ill persons. The attention and effort made in recent years toward improved care of mental patients in hospital has also included consideration of the material and emotional needs of the patient at the point of leaving the hospital. This study examines the discharge situations of male patients treated at the Crease Clinic of Psychological Medicine at Essondale; and describes the role of social workers in patients’ re-establishment in the community. The needs and problems revealed by the study are examined in the perspective of a comprehensive rehabilitation service for discharged mental patients. The method used in the study was to compile pertinent information from the case records of 100 male patients discharged in a recent year. The information was extracted from the case records by means of a schedule. From this information was tabulated some of the common needs of patients leaving Crease Clinic. An analysis was then made of resources within the Clinic and in the community at large whereby the recorded needs might be met. A selection of case summaries was made to illustrate some typical problems. The factual material illustrated the variety and frequency of rehabilitation needs. For the mental patient these included not only material needs for housing and a job, but also intangible needs for support and help with continuing emotional stress. The interrelationship of outer material needs and inner emotional problems was noted. It was found that needs for housing and a job were a problem for approximately one patient in five; and that the proportion of patients who required help with inner stresses was approximately one in three. An examination of the resources available for meeting needs revealed significant gaps and limitations in the provision of subsidized boarding care and in the financing of vocational training. An over-all deficiency was apparent in the numbers of professionally trained social workers. In the concluding chapter there is suggested an operational definition of rehabilitation: a process whereby needs are met which enable the patient to become re-established as a citizen. There is a discussion of ways and means of narrowing the gap between needs and resources, and of the role of the social worker in community action. The development of social welfare resources for discharged mental patients is related to a network of community facilities concerned both with civilian rehabilitation and with mental health maintenance. / Arts, Faculty of / Social Work, School of / Graduate

There has been a growing trend to discharge patients from mental hospitals after short periods of hospitalization. These discharged patients may have unresolved problems and need continuing service in the community if they are to maintain their level of social functioning. The After Care Clinic in Burnaby was formed to provide continuing service to the patient. However there is much concern about the high readmission rates to the hospital and the adequacy of the aftercare services. The present study is a pilot study to examine the services provided by the After Care Clinic. The researchers reviewed aftercare literature and utilized hospital records. Information was obtained from questionnaires to patients, clinic staff and other agency staff. Prom these sources the social, work, and home needs of patients and the treatment given were examined. Opinions about the aftercare services and possible improvements were also examined in an attempt to assess the adequacy of the services provided by the After Care Clinic. The findings showed a large number of patient needs and nominal service given. Treatment was medically oriented with brief supportive therapy. Only one person in the sample of 45 saw a social worker. The staff of the clinic and other agencies were aware of the lack of services for the discharged patient but differed in their perception of their roles and their expectations of an adequate service. The clinic staff thought that responsibility for aftercare services should be shared between hospital and community agencies. However community agencies felt that the hospital should assume responsibility. These findings indicate the present gaps in the aftercare services and the need, for responsibility and leadership. It seemed, apparent that it should be the role of the mental health branch to take responsibility for leadership in the development of a coordinated and comprehensive aftercare service. / Arts, Faculty of / Social Work, School of / Graduate

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