Vocational
Rehabilitation is a fine idea.
Of course, as with all fine ideas, it
has its "one true way" proponents.
Which isn't fine. And this is, in my opinion, why:
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Vocational rehabilitation to the exclusion of other
rehabilitation possibilities is mean spirited. It takes a variety of
rehabilitation efforts -- including affording persons with psychiatric
disabilities the opportunity to make real choices -- to aid in the recovery
process.
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An over-emphasis on vocational rehabilitation is not as
enlightened as we would like to think: persons with psychiatric disabilities
were pulling up turnips in the garden at Bedlam. The "work cure"
for mental illness has been with us for a long, long time.
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The "burden of work" is like a nine hundred
pound gorilla on the back of a disabled person. We know we are consuming taxpayer dollars in
addition to services, we know we should be productive citizens and
"make a contribution", we know that our "disabled" status
doesn't reflect well on us in the "unit of production" mentality
that pervades our culture... if you ask us "do
we want a job?" we'll
say "yes!".
How could we morally say "no!"? (Not to mention that
"yes" is what you want to hear, or that it qualifies us for
services... another aspect of the burden of disability).
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Money does not equate to meaning. To assist with the
recovery process, people need assistance with finding meaning in addition to
other, more concrete, problems. Tell me, how am I to find meaning if:
- my energy is spent
passing for normal in the workplace
- that this is
"good" is reinforced daily
- my employment
options are so limited I am not likely to find meaning -- beyond money
-- in the work that I can do
- that this is "good" is
reinforced daily
- that there is a
dearth of other programs that could assist with the
"meaning" problem, that lack of "meaning" isn't a real problem
- that this is
"normal" is reinforced daily?
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We need to question our basic assumptions about what persons
with mental illness want. Most providers, policy makers, and academics come
from a "power over" position in this endeavor. The basic assumption
that recovery involves restoring a person to a life that mirrors closely someone else's life is absurd. The basic assumption
that the linear path to autonomy is the one
true way to have a
"good" life is absurd.
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People with psychiatric disabilities find reinforcement
for the idea that we have failed on the linear path in just about every area
of life, and yet, the linear markers of success continue to be held out to us
as some sort of brass ring that can be achieved "with enough
supports". The approach is backwards. "With enough supports",
persons with psychiatric disabilities may find ourselves in a safe enough
context to have the courage to choose our
own path, define our own
meaning, and decide for ourselves what it is we really want to do... not based on the idea that
a return to "normal" is the best
outcome, but based, rather, on choices that we, as individuals, make
about what we really want for ourselves.
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