成功就業的慢性精神病患者之社會支持探討

本研究旨在探討成功就業之慢性精神病患者在就業前、求職中、初就業，及長期就業後的社會支持情形。透過質性研究蒐集四位慢性精神病患者在就業歷程中所接受的社會支持情形，輔以研究者的札記及相關文件資料，運用NVivo第十版質性軟體進行分析，研究結果如下：一、經過分析，成功就業歷程中包含各種類型社會支持：（一）就業前的社會支持主要係來自家人提供涵蓋情感、實質與訊息等各面向的支持；（二）求職中的社會支持情形，由家人擴及服務單位工作人員、親朋好友，所提供社會支持的內容，以訊息型支持為主；（三）在初就業時期主管和同事提供實質型與訊息型等社會支持的色彩頗為鮮明；（四）就長期就業而言，家人、同事、工作人員、教會等持續的給予支持是重要的。綜言之，社會支持會因不同階段而有所變化；不同的階段會有不同的社會支持來源，支持的內容也會根據研究參與者在該階段的需要而有所不同；另外，有些社會支持是跨階段與跨類型的。二、探討社會支持的過程中亦發現三項重要議題值得關注：（一）研究參與者接受職業重建服務的較少、認知也較缺乏；支持性就業服務轉銜至穩定就業服務的制度較不明確，顯示職業重建服務仍有進步的空間；（二）污名化普遍存於社會，當其角色為雇主或同事時，更會深刻影響慢性精神病患者的求職與就業；（三）自我支持扮演相當重要的角色，和社會支持有相輔相成的作用。

關鍵字

精神疾病；成功就業；社會支持；污名化；職業重建

並列摘要

The purpose of this research was to investigate the social support for the chronic mental illness who were employed successfully at different phases of their careers. This research divided it into four phases, pre-employment period, job search period, initial employment period, and stable employment period. The research was conducted through qualitative method. Data collected, researcher’s notes, and other related information were aggregated and analyzed by NVivo10. Results are as follows: 1. The resources and contents of social support were deferent from phase to phrase, and there were some social supports crossed phases and types. （1）Pre-employment period: Family provided social support of emotion, assistance and message.（2）Job search period: Family, professional staff, friends provided message type (social supports) the most.（3）The initial employment period: Supervisors and colleagues provided social supports of the assistance and message type.（4）The stable employment period: Family, colleagues, professional staff and church’s ongoing supports were important. 2.（1）Vocational Rehabilitation transitional services were not enough: A few research participants received vocational rehabilitation services, they also didn’t know vocational rehabilitation services.（2）Stigma affected employment: The community existed stigma on patients with chronic mental illness. It affected employment of the mental illness.（3）Self-support is important: Even having external resources and social supports, if patients with chronic mental illness had no employment motivation and self-support, the successful employment was still impossible.