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Fallanalyse zur beruflichen Integration von Personen mit psychischen Störungen
Bericht im Rahmen des mehrjährigen Forschungsprogramms zu Invalidität und Behinderung - FoP-IV
Sammelwerk / Reihe:
Beiträge zur Sozialen Sicherheit, Band 5/10
Bern: Eigenverlag, 2010, 147 Seiten: PDF
From the 1990s to 2004 the steep rise in invalidity insurance pension receipt on the grounds of mental disability was a major cause for concern in several countries, including Switzerland. Several research projects carried out as part of the FSIO Invalidity Insurance Research Programme (FoP-IV) have examined the causes behind this upward trend. For example, the IV case file analysis by Baer, Frick and Fasel (2009) identified a number of factors that place individuals at risk of IV pension receipt on mental
The authors noted that during the 1992-2006 observation period the medical profession carried out too few occupational examinations or insurance medicine assessments of IV applicants' functional abilities and their fitness for work. Consequently, suggestions for the swift rehabilitation of the insured were frequently lacking.
The 5th IVG Revision once again prioritised the existing fundamental principle of the IV system, namely 'integration before a pension. Given that experience to date has shown that it is much more difficult to get individuals with a mental disability back into work than it is for individuals with a physical disability, better and more comprehensive knowledge about this issue is needed. The present study by the University Psychiatric Clinic Basle (UPK) builds on the findings of the above mentioned quantitative analysis with a qualitative survey and assessment.
The present study was based on a series of interviews with people who had received inpatient psychiatric treatment, in which they were asked questions about their fitness to work. The researchers were interested in the needs that these former patients had in this regard and examined collaboration between employers and the specialists working either for the clinic or elsewhere.
The report outlines the current situation regarding the occupational integration of people with mental health problems and exposes the difficulties arising from this process, some of which were already identified in the above mentioned IV case file analysis. The authors found that occupational integration measures were too seldom taken and when they were, such intervention often came too late, i.e. once the patient had been discharged. The beneficiaries themselves were frequently overwhelmed by the work needed to organise themselves or to ask others for assistance.
The research team recommends that the medical care providers (psychiatrists, clinics, family doctor) should offer employers more professional information, tools and assistance. In certain cases, they also recommend the involvement of an independent intermediary (job coach). The IV has already taken on board the importance of providing employers with advice and support. For example, since the 4th and 5th revisions of federal invalidity insurance legislation, cantonal IV offices have fostered greater contact with employers by means of a variety of measures. Revision 6a will also bear this point in mind.
Further recommendations concern improvements in diagnoses and predictive values, together with clear guidelines that can be following during the psychiatric care phase.
Finally the report suggests that GPs should be better informed about the existing IV instruments of early detection and intervention, and should be better qualified to use them. Following the 5th IV revision, contact between the Regional Medical Services and GPs has already been stepped up.
Overall, communication problems persist. For example, the researchers observed complications in relation to communication and cooperation between the employers/line managers, the integration specialists, the attending physicians and the insured. Resolving this problem remains a matter of priority.
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