In making his case for a flexible, long-term sheltered workshop, the author presents seven propositions that he supports with reviews of outcome studies in psychiatric treatment and rehabilitation. He submits that it is unrealistic to expect a lasting cure for many psychiatric patients; that despite rehospitalizations, many patients spend most of their lives in the community, where their vocational performance is poor; that total vocational rehabilitation is an unrealistic goal for many of the patients but that in our culture employment is essential to self-respect; and that hospital patients can and will work in hospital work-shops and in community workshops after discharge. In addition, he describes a work-for-pay program affiliated with a psychiatric day hospital.
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