精神科デイケア利用後に一般雇用での就労を継続している当事者の経験の語り—ナチュラルサポートを得て就労継続に至るまでのプロセス

Narrative of experiences of individuals with mental illness who continue working in general employment after visiting mental health rehabilitation day hospitals: The process for continuing working with natural support

要旨：本研究の目的は，若年層にあたる時期に精神科デイケアを利用し，その後に一般雇用での就労を継続している当事者の語りから，精神科デイケア等での就労支援における効果的な介入のあり方を明らかにすることである．12名の対象者の語りを修正版グラウンデッド・セオリー・アプローチ（M-GTA）を参考に分析した結果，20の概念と8のカテゴリ，【デイケア内での就労能力の基礎固め】と【社会におけるナチュラルサポートの自己獲得】の2つのコアカテゴリが生成された．就労場面においては「他者との信頼構築や居場所の確保」「自己理解」が重要であることが見出され，これらが就労継続に有用な影響を与える可能性が示唆された．

　Many users of mental health rehabilitation day hospitals aim to continue working. However, several studies have focused on welfare employment and employment training for individuals with mental illness, while there is little research on those who are able to continue working in general employment. The aim of this study is to explore the ideal form of effective intervention in employment support based on the narrative of experiences of individuals who use mental health rehabilitation day hospitals. In this study, semi-structured interviews were conducted with 12 participants who continue to work in general employment after using the services of mental health rehabilitation day hospitals. Participants described their experiences in the mental health rehabilitation day hospitals and later life that were useful for continuing to work. The Modified Grounded Theory Approach (M-GTA) was used as the analysis method. As a result of analyzing the narratives of 12 participants, 20 concepts, 8 categories, and two core categories [foundation of work ability in mental health rehabilitation day hospitals; natural support in society] were identified. In the work environment, it is important for individuals to have the diplomatic aspect that is open to society such as “building trust with others and securing the place to belong” and the inner aspect such as “self-understanding.” This study determined that both factors are closely intertwined, based on the narratives of participants. It is suggested that these factors may have a useful effect on the wish to continue working among individuals with mental illness.