Abstract
Abstract The developmentofcommunity mentalhealth care forpeople with severe disorders mightbenefitfrom a reconsideration of the role of work in psychiatric treatment and rehabilitation. effectiveness of work in psychiatry in the UK is limited to studies conducted a generation ago, when mental health care was still hospital-based, and the level of unemployment in the general population was lower than today. Employment is scarcely considered directly in mental health policy, while purchasers have few guidelines on which to base their strategies. Here, five perspectives on work in psychiatry are offered: ideological principles; macro-economic considerations; demand on the part of service users themselves; the changing context of mental health care, with its effects on the public presentation of mental illness; and evidence of clinical benefits from constructive occupation. Each of these cases is presented, with particular attention paid to the clinical benefits which are relevant to evidence-based health care. Evidence of the