精神障礙者支持性就業的職場自然支持

Abstract

開發職場中的「自然支持」以提供持續的現場協助是我國支持性就業的重要任務。回顧精神障礙者於職場中的自然支持研究，多以病友本身的主觀經驗出發討論支持帶來的結果，缺乏自然支持者提供資源的過程與就業服務員在服務體系中角色的呈現。本研究期待透過支持性就業服務體系的脈絡，探究自然支持資源的開發過程與內容提供的樣貌。 本研究以配對研究的方式，深度訪談五位就業病友、六位自然支持者、以及四位就業服務員，以三角檢測的策略了解病友如何看待體系中自然支持資源、自然支持者提供的協助內容、以及就業服務員如何開發建立自然支持資源。 研究結果發現，建立自然支持者需要具備如共事機會或是職權等職場條件，就業服務員於職場辨識出具有潛在條件者，透過促進自然支持者與病友互動的策略，推動自然支持資源的發揮。自然支持者提供的支持資源包括工作指導、工時彈性與職務調整等工具性支持，以及促進人際互動、認同與歸屬感等情緒性支持。雇主階層的自然支持者因其職權與責任感，擔負示範者與協調者的角色；而同階層的同事則是透過經驗普遍化和職場外的社交活動，給予友伴般的支持。對病友而言，自然支持者減少其面對工作上的壓力，是維持病友就業穩定的關鍵力量。最後根據上述研究結論，提出現有策略探討、自然支持建制化可行性、以及職場作為倡導橋樑等意涵討論，以及研究者的學習與反思。

Keeping the track of providing on-site support through developing “natural supports” at workplace is the important task of supported employment service in Taiwan. In recent years, there are plenty of researches on natural supports which focus on the subjective experience of service users. However, the process of providing natural supports and the role of employment service worker and natural supporter need be presented in this research. It is expected that this research will discover the process and content of providing natural supports from supported employment service. This research is a match pair study which explores natural supports in supportive employment services for persons with mental disabilities from the perspectives of the service users, their colleagues/employers and employment service workers. In this research, five service users, six natural supporters and four employment service workers are being studied through the method of individual depth interview and the strategy of triangulation. As the research reveals, there are requirements including co-working opportunity and authority of office to develop natural supports. Employment service workers recognize potential natural supporters on job site, and they use strategies to facilitate the interaction between natural supporters and service users to promote natural supports. The contents of natural supports contain instrumental support(job training, flexible working hours and job accommodation) and emotional support(social interactions, identification and sense of belonging). Employers as natural supporters work as demonstrators and coordinators due to authority of office and responsibility. Colleagues as natural supporters provide friendship through social activities and generalizing the experience of service users. Natural supports are the crucial factor to maintain the employment stability of persons with mental illness. According to the above findings and conclusions, the following discussions are recent strategy of developing natural supports, the feasibility of institutionalizing natural supports, workplace as a bridge of advocacy and the introspection of researcher.