The feasibility of vocational rehabilitation in subjects with severe mental illness.

Vocational rehabilitation represents an important element within the mental health care system. To ensure the success of rehabilitation, programs of varying degrees of complexity are needed in order to meet patients abilities and needs. Rehabilitation success must be examined multidimensionally and not be reduced to the mere integration into competitive employment. Success is also represented by progress in the level of vocational integration, strengthening of work capabilities, the improvement of the functional level, and in a better quality of life. The patients need for rehabilitation has to be recognized as early as possible to shorten the duration of the patients disintegration and to avoid stagnation periods. Rehabilitation needs to start in the clinic; with psychiatric help sustained during the rehabilitation process to prevent illness exacerbation and premature program termination. The patients development regarding his or her functional level, work capability, and subjective wellbeing needs to be evaluated throughout the program to consistently monitor the patients individual needs and abilities and to ensure appropriate support. Training for cognition and social skills should be integrated into rehabilitation programs to compensate individual deficits.