[Perspectives in the vocational rehabilitation of the mentally ill and disabled--an overview of the current status and problems in the region of Westphalia].

The number of persons suffering from chronic mental disease but living outside the psychiatric hospital in the community, is rising, resulting in an increasing demand for facilities for occupation, occupational therapy and rehabilitation and for paid employment. The past few years have seen a distinct increase in the number of sheltered workplaces for the mentally ill. This development has also led to qualitative differentiation in the offers. In the region of Westphalia there are currently some 940 work places in special departments for the mentally handicapped at workshops for the disabled. Self-help enterprises and those offering opportunities for persons living on social benefits or pensions to supplement their income currently offer some 470 workplaces for the mentally ill, ten psychiatric hospitals are giving their former patients an opportunity to take part in occupational therapy as outpatients. Considerable differences are to be registered with regard to the offers of work, the forms of organization, the tasks involved and the types of supervision. Finally, a specialized psychosocial service has been established within the past four years by the head welfare office of the Landschaftsverband Westfalen-Lippe; this service is designed for the care of the mentally ill at their work place. Like many developments in social psychiatry, the differentiation of occupational rehabilitation has resulted from practical experience. Empirical findings on the indication for and efficiency of individual measures are virtually non-existent. A prospective five-year study is planned to investigate further results.