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Vocational Rehabilitation

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:

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.

 

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.

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).

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:

  1. my energy is spent passing for normal in the workplace
  2. that this is "good" is reinforced daily
  3. my employment options are so limited I am not likely to find meaning -- beyond money -- in the work that I can do
  4. that this is "good" is reinforced daily
  5. that there is a dearth of other programs that could assist with the "meaning" problem, that lack of "meaning" isn't a real problem
  6. that this is "normal" is reinforced daily?

 

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.

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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