從杜鵑窩到職場就業─慢性精神疾病患者就業困境探討

From the cuckoo's nest to the job market:Employment plight of patients with chronic mental illness

劉沛均(Pei-Chun Liu)

指導教授 ： 馬財專

國立中正大學/社會科學院/勞工關係學研究所/碩士(2013年)

摘要

在台灣，慢性精神疾病患者中，有超過九成的患者屬於勞動人口的年齡，卻只有14.8%的患者在職場中成功就業。不論是因為社會汙名化或是慢性精神疾病患者本身病況的特殊性，都造成患者在職場中就業相較於一般身心障礙者更加不利。工作使人得以在社會中自立生存，對於慢性精神疾病患者，就業同樣是他們應有的權利。

本文以質化研究訪談就業中和待業中的慢性精神疾病受訪者，並輔以訪談協助慢性精神疾病患者就業的專業服務人員。當中，慢性精神疾病患者疾病類型主要為精神分裂症以及躁鬱症，而專業服務人員則包括精障庇護工場社工、精障社區就業服務員、精障社區復健中心、公立就業服務站職業重建個管員，以及一位臨床心理師。希冀藉由訪談不同領域的受訪者以及患者本身，更全面的了解慢性精神疾病患者在職場中就業的困境。

訪談結果發現，成功就業的慢性精神疾病患者以及待業中的慢性精神疾病患者，在自我認知、工作能力以及勞動現況都有許多不同的特質，但同樣有工作持續力低、工作穩定度低、工作技能接受病症影響（但程度及自我認知不一）以及對於人際關係處理能力低，容易出現人際衝突的現象。而專業人員的觀點對於慢性精神疾病患者就業看法相近，同樣認為患者主要問題為低持續性、低穩定性，以及病況或藥物副作用影響就業。

依訪談結果，了解慢性精神疾病患者的特殊性不同於其他身心障礙者，因此不適用於一般就業方案。為鼓勵患者就業，並提高患者就業動機以及患者就業的持續性以及就業穩定性，於本文提出相關政策建議。

關鍵字

職務再設計 ； 就業 ； 精神疾病患者 ； 庇護性就業 ； 支持性就業

並列摘要

In Taiwan there are over 90% patients with chronic mental problems who also are labor force, but only 14.8% can get their job successfully. Not only social stigmatization but their specialty would cause the more difficulty than handicapped. Work makes people live independently in this society, and it’s their rights, too.

In this article, we did a qualitative research to interview mental illness patients are employed or unemployed, and the staffs of helping patients get a job. The chronic mental illness interviewers were schizophrenia and bipolar disorder; the staffs included welfare workers, employed assistants, rehabilitations clinic, and a clinical psychologist. Hoping to fully clarify the difficulties of mental illness patients got jobs by interviewing patients and all kinds of interviewers.

The interview results found there were many different characteristics from employed and unemployed mental illness patients, like self-perception, working ability, and labor situation, but the working sustainability, working stability, working skill effected by illness (but degree and self-perception were different), and low abilities of solving interpersonal relationships easily caused interpersonal conflicts. Similarly, the viewpoints of specialists were the same as the patients. They also thought the problem of mental illness patients’ employments were low sustainability, low stability, and condition or medical side-effects.

We knew the specialty of chronic mental illness patients differ from other handicapped patients, so they were not appropriate for general employment programs. To stimulate patients the employing motivation, employing sustainability and employing stability, we gave some relative policies and recommendations in this article.

並列關鍵字

Shelter ； Job Redesign ； Employment ； Mental Illness ； Supported

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