Stakeholders’ views on vocational rehabilitation programs: a call for collaboration with Occupational Health Physicians

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Giorgio Mattei
Valentina Sacchi
Salvatore Alfieri
Antonella Bisi
Niccolò Colombini
Silvia Ferrari
Giuseppe Giubbarelli
Fabriziomaria Gobba
Alberto Modenese
Luca Pingani
Marco Rigatelli
Marisa Rossetti
Giulia Venturi
Fabrizio Starace
Gian Maria Galeazzi


Great Recession, economic crisis, psychiatry, vocational rehabilitation programs, occupational health medicine


Background The triple-dip recession occurred in Italy in years 2008-2014 impacted negatively on people’s health, mainly by increasing the rate of unemployment. Such mechanism on one hand increased the prevalence of mental health disorders, e.g. depression, on the other impaired vocational rehabilitation programs (VRPs) delivered to psychiatric services’ users.

Objectives   To explore the different points of views of users and professionals involved in VRPs developed inside an Italian community mental health center (CMHC), in order to co-design a psychoeducational group intervention (PGI) for users included in such programs.

Methods   A purpose sample of users, psychiatrists, educators and nurses of the CMHC of Castelfranco Emilia (Modena, Italy) involved in psychiatric rehabilitation programs participated to a focus group. Content analysis was performed with MAXQDA 12, by developing a hierarchical code system a posteriori (derived from the data). The respondent validation phase was carried out by means of a multiple-choice questionnaire, delivered to all participants.

Results 86 interventions were coded, divided into two macro-areas:  Positive and Negative Reinforcements (48 interventions, 56%, and 38 interventions, 44%, respectively), further subdivided into three areas: professionals (service factors), personal factors (user’s related) and work environment (including relationships in the workplace).

Conclusions Some of the needs emerged during the focus group (e.g. lack of information, concerning duties and rights of the users-workers, as well as risks they are exposed at workplace) are specific of occupational health. Therefore, a PGI destined to users involved in VRPs should include an occupational health physician, at least in some specific sessions. This might help at further increasing the liaison between psychiatry and occupational health medicine within the clinical field.

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