重返社區之路：會所模式中的過渡性就業

Abstract

會所相信不論精障者的病況如何，都有貢獻社群的能力，因此這些加入會所的精障者，被稱為「會員」，而非「學員」。會員在工作日中，與工作人員協力完成會務工作，因此他們既是受助者，也是助人者，得以逐步擺脫「病人」的單一角色。我則好奇在工作日之外，會所如何協助他/她們能在社區中以就業者的身分取代病人的失能角色。 過渡性就業是會所獨有的就業服務形式，就此服務方案我提出三個研究問題：（1）過渡性就業的內涵為何？（2）會員的使用經驗如何？（3）過渡性就業對會所的意涵？我採取質性研究典範，使用參與式觀察法與深度訪談法蒐集資料。我以伊甸真福之家為田野，從2012年開始參與他們的工作日、就業晚餐以及醫院傳送過渡性就業職場，前後達15個月；訪談之有效樣本包含2位主管、1位外聘督導、5位工作人員、及8位曾在過渡性就業正式上線的會員。 我以「彈性擺盪：過渡性就業的內涵」、「嘗試就是成功：會員的使用經驗」、「建立精障社群：過渡性就業對會所的意涵」三章回應研究提問。研究結果發現，過渡性就業的確能為會員帶來正向的經驗，但受限於外部資源不利於會所模式發展，過渡性就業亦未能得到充分支持，因此建立精障社群的意涵目前無法發揮。接著我進一步討論就業服務能否回到精障者的主體需要上，避免僅成為再製合格公民的工具，這也是現階段會所運動需要持續反思的議題。最後我就實務面提出幾點建議，包含「重組醫院傳送內容」、「拉近職場距離」、「專職負責開發」、「過渡性就業與工作日並行」、「尋求母機構支持」，政策面我則認為三政協力的服務體系，才可能支持會所模式落實完整連貫的服務。

Clubhouse model believes that no matter how severe their symptom is, people challenged with mental health concerns all have capacity to contribute. That’s why who joined the clubhouse would be called 'members' rather than 'students'. On the work-ordered day, members collaborate with staffs to accomplish tasks, they are not only services users, but also providers. Thus, members gradually get rid of the “sick role” through participating work-ordered day. Beside work-ordered day, I was curious about how clubhouse helped their members get free from the “sick role” to become employees in the community. Transitional Employment is an unique form of employment services for clubhouse, thus, three research questions were proposed as follows: First, what is transitional employment? Second, how is it like for members to experience in the transitional employment? Third, for the clubhouse community, what is the implication of transitional employment? I adopted the qualitative research paradigm, and used participant observation as well as in-depth interview to collect data. I have participated in the Eden clubhouse’s work-ordered day, employment dinners, and the transitional employment workplace in the hospital for 15 months since 2012. Beside two supervisors, one guest supervisor, and five staffs, there are eight members who had used transitional employment as effective samples are obtained. Three research findings emerged as follows: “Flexible entrance and exit: the content of transitional employment”, “ Try success: experience of the members”, and “Establish community for people challenged with mental health concerns: the implication of transitional employment for clubhouse”. It was found that transitional employment indeed granted members with positive experiences. However, being confined by external resources disfavoring the development of clubhouse model, transitional employment has not been adequately supported. Therefore, the community for people challenged with mental health concerns could not be well established. I further discussed how employment services might respond to the need of their members. To avoid being as a tool to reproduce qualified citizens, which clubhouse as a social movement should always reflect on this issue. Finally, a few recommendations were made: “restructure hospital delivery working content”, “shorten the distance from the workplace”, “assume a full-time position responsible for the employment service development”, “transitional employment should go side by side with work-ordered day”, “seek supports from the head-quarter”. It was concluded, from the policy perspective, that only closed collaboration among three government departments can bring clubhouse model into a full play.