Abstract The aim in this dissertation is to investigate into the working of the rehabilitation process as to actors involved. A specific focus has been set on the component “Work introduction”. The study shows that the road back to work is a complex matter. Individuals involved have different backgrounds and living situations, which influence this rehabilitation. The empirical basis of the study is built on interviews of four employees and two earlier unemployed persons. The statements of the informants were analyzed through the two concepts: Activation and empowerment. The interviews revealed that the authorities were not entirely content with program “Work introduction”, since the cooperation lacked a coherent view on the common tasks. In some cases the result is that clients fall between the authorities. A main problem of their cooperation nails down to that the authorities apply different definitions. An insight of this study is that 50% get a job and 50% goes back to social insurance office after they had been passing through the program “Work introduction”. This asks for a more differentiated view on clients.     Key words: unemployed, sick insurance, rehabilitation, work introduction

1 juli 2008 trädde en förändrad sjukförsäkring i kraft där syftet är att effektivisera sjukskrivningsprocessen och därmed öka möjligheterna för sjukskrivna att återgå i arbete. Kritik har riktats mot lagen och dess kommande konsekvenser angående individers arbetsförmåga. Individer som bedöms ha viss arbetsförmåga men inte tillräcklig för att få ett arbete kan komma att hänvisas till kommunernas försörjningsstöd. De flesta individer som råkar i ekonomiska svårigheter kan få psykiska problem bland annat i form av ökad stress. Individer som redan har psykiska problem och dessutom får ekonomiska svårigheter råkar då dubbelt illa ut. Syftet med uppsatsen är att beskriva hur personer med psykiskt funktionshinder påverkas av en förändrad ekonomisk situation. I uppsatsen får läsaren möta Sara, Per och Paula som samtliga på ett eller annat sätt påverkats eller kommer att påverkas av de nya bestämmelserna. Sara och Paula lever under ett hot om att deras sjuk- respektive aktivitetsersättning kan komma att dras in. Per har redan upplevt konsekvenserna av en indragen aktivitetsersättning. Frågorna vi ställer oss i uppsatsen är om hot om en förändrad ekonomi får följder för individens återhämtningsprocess, hur den förändrade lagen påverkar individens ekonomi samt vilka copingstrategier individen använder sig av för att hantera sin situation. Vi har använt oss av en kvalitativ metod i form av intervjuer med individer samt verksamhetsföreträdare inom psykiatrin. I tolkningen av vårt material har vi använt oss av ett copingperspektiv samt begreppen återhämtning och ekonomiska konsekvenser. Vi har använt oss av en hermeneutisk tolkning som innebär att tolka materialets delar och helhet parallellt. Uppsatsens resultat är att personer med psykiskt funktionshinder kan komma att drabbas hårt av en förändrad sjukförsäkring. Då en indragen sjuk- eller aktivitetsersättning innebär att individen måste söka sig ett arbete. Om individen inte kan arbeta men ändå inte bedöms av Försäkringskassan ha tillräckligt nedsatt arbetsförmåga så får individen ansöka om försörjningsstöd från kommunen. De ekonomiska konsekvenser som detta innebär påverkar i sin tur individens återhämtningsprocess.

<p>At the turn of the year 2009/2010 there was a change in the regulations on sickness impact. This led to 328 persons in County of Kronoberg had an expired period of sickness benefit from the Social Insurance Office (Försäkringskassan) when they reached the maximum time for sickness or temporary disability compensation. These individuals were offered introductory programs with the employment services. The purpose of this study is to investigate how the population with expired period of sickness benefit from the Regional Social Insurance Office in the County of Kronoberg (Försäkringskassan Kronoberg) is described in the initial stage, and to explore how individuals who achieved expired period of sickness benefit from the Social Insurance Office (Försäkringskassan) talks about the meaning to get an expired period of sickness benefit regarding economic and social issues. The study was inspired by Grounded theory. The method has consisted of both quantitative and qualitative interviews. In total, six persons participated in the surveys. Narrative method was used in the interview with a person with experience of an expired period of sickness benefit from the Social Insurance Office (Försäkringskassan). The interviews indicate that the authorities have different focus on the concept of rehabilitation. This means that what is to be regarded as rehabilitation and the efforts which may benefit the individual depends on which authority has the power of definition. This study is made before preparing administrators for either statistics or working methods were established by the relevant authorities. Longer experience in the field is still missing about what the change means for both individuals who have experience of the expired period of sickness benefit and professionals. This points out; further research in this area is needed.</p>

At the turn of the year 2009/2010 there was a change in the regulations on sickness impact. This led to 328 persons in County of Kronoberg had an expired period of sickness benefit from the Social Insurance Office (Försäkringskassan) when they reached the maximum time for sickness or temporary disability compensation. These individuals were offered introductory programs with the employment services. The purpose of this study is to investigate how the population with expired period of sickness benefit from the Regional Social Insurance Office in the County of Kronoberg (Försäkringskassan Kronoberg) is described in the initial stage, and to explore how individuals who achieved expired period of sickness benefit from the Social Insurance Office (Försäkringskassan) talks about the meaning to get an expired period of sickness benefit regarding economic and social issues. The study was inspired by Grounded theory. The method has consisted of both quantitative and qualitative interviews. In total, six persons participated in the surveys. Narrative method was used in the interview with a person with experience of an expired period of sickness benefit from the Social Insurance Office (Försäkringskassan). The interviews indicate that the authorities have different focus on the concept of rehabilitation. This means that what is to be regarded as rehabilitation and the efforts which may benefit the individual depends on which authority has the power of definition. This study is made before preparing administrators for either statistics or working methods were established by the relevant authorities. Longer experience in the field is still missing about what the change means for both individuals who have experience of the expired period of sickness benefit and professionals. This points out; further research in this area is needed.

Sammanfattning Regeringens intention med den nya lagen om sjukförsäkring som infördes i juli 2008 och kompletterades i januari 2010, var att gå från en passiv långtidssjukskrivning till ökad rehabilitering och en möjlighet till återgång till arbetsmarknaden samt ett minskat utanförskap.  Den mediala debatten i samklang med våra praktikplatser gjorde oss nyfikna på hur förändringen har påverkat livet för den enskilde individen. Vårt syfte är således att undersöka vilka konsekvenserna blir för enskilda individer i samband med och efter beskedet om utförsäkring från sjukförsäkringen. Vi ville utan att ha några förutfattade meningar lyfta fram intervjupersonernas berättelse så vi valde att ha en explorativ ansats, men tog stöd av en semistrukturerad intervjuguide baserad på tre teman som vi ville veta mer om. Temana är; ekonomisk situation, upplevelser av relationer med berörda myndigheter och upplevelser av samhällets syn och deras syn på sin självbild.   Resultaten är komplexa och visar att de teman vi valt ut påverkar varandra, med det menar vi att det ena inverkar på det andra. De teorier vi valt att använda i analys av materialet är Ekonomi- skam modellen, Kasamteori samt teori om social uteslutning. Vi kan se en väg som leder från ekonomisk uteslutning vidare till social uteslutning för personer som utförsäkrats samt att den ekonomiska stress de utsätt för i kombination med skamgörande erfarenheter ger hög risk för psykisk ohälsa. I vår avslutande diskussion reflekterar vi om lagstiftarens intention med reformerna har haft den avsedda effekten för de utförsäkrade. / Abstract The governments intentions with the new law in sickness benefits that was introduced in July 2008 and was supplemented in January 2010, was to go from a passive long-term sick leave to increased rehabilitation and a possibility to return to the labor market, along with reduced exclusion. The media debate in unison with our trainee jobs made us curious about how this change has affected the individual. Our purpose is accordingly to make researches into the consequences for the individuals in connection with and after expiration of sickness benefits. We wanted without preconceived opinions emphasize the interviewee’s stories so we chose to have an explorative inception. But we took support in a semi- structured interviewguide based on three topics we wanted to know more about. The topics are; economic situation, experiences of the relation with concerned public authorities and experiences of societies view on them and their own view on themselves. The results are complex and show that one factor affects another, which means that one thing, leads to another. The theories we have used are a model for Economics- shame, Kasam and social exclusion theories. We can see a road that leads from economic exclusion to social exclusion for the persons whose period of sickness benefits has expired. And also that the economic stress combined with shameful experiences gives a high risk of psychic illness. In our concluding discussion we reflect about if the government’s intentions with the new laws have had the intended effect for these persons.

When analysing what the concept of work has meant historically in Sweden, acomplex image of shifting meanings emerge. Labour has been given meaning andvalue to the individual as a tool of empowerment and self-reliance and to society asa way of financing the welfare state. There has also been a conflict in how to besthandle those who fall outside of the norm of labour. The history of the SwedishNew Work Strategy is a history of conflict regarding whose responsibility it is toensure the wealth and wellbeing of the persons in unemployment or on sick leave:the state, or the individual. In this study, we use Carol Bacchi’s (2009) method fordiscourse analysis to critically analyse how labour, unemployment and sick leaveis represented in documents from two governmental agencies with close ties to boththe state, the labour market, and the individual. We conclude that the currentdiscourse surrounding labour, unemployment and sick leave is centred around theNew Work Strategy and the norm of labour. The individual is categorised as apassive recipient of the governmental agencies’ programmes. The individual isrepresented as needing to be disciplined and controlled, shaped, and conformed tothe ideal of being employable and having the ability to work full time. The goals ofthe governmental agencies are represented to be minimising the usage of sick leavebenefits or unemployment benefits. Labour is also portrayed in the documents asthe only way of financing the welfare state, and as the foremost solution to socialexclusion. Analysing how problems with unemployment and sick leave isrepresented leads to realising that the language we use may construct and constrictthe way we as individuals and as social workers understand social problems. Thiscreates possibilities of thinking differently about what social problems arerepresented to be and how best to handle them.