Criteria for assessing the need to support the work of disabled people with mental disorders

Authors:

Ishutina Inna Sergeevna — PhD in Medical sciences (Cand. Med. Sci), Director of the Institute of Rehabilitation and Habilitation of the Disabled, А1ЬгссЫ Federal Scientific and Educational Centre of Medkal and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: in.ishutina@yandex.ru; https://orcid.org/0000-0002-6640-904X.

Khodakovskii Matvei Dmitrievich — junior researcher of the Department of medical and social expertise and medical rehabilitation of disabled people of the Institute of Rehabilitation and Habilitation of Disabled, Abreoht Federal Scientific and Educational Centre of Medkal and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: hodak200@yandex.ru; https://orcid.org/0000-0001-6953-5191.

Starobina Elena Mikhailovna — Grand PhD in Pedagogical sciences (Dr. Ped. Sci.), chief scientist at the Department of professional and psychological rehabilitation of disabled of the Institute of Rehabilitation and Habilitation of the Disabled, А1Ьгес14 Federal Scientific and Educational Centre of Medkal and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: estarobina@yandex.ru; https://orcid.org/0000-0003-1820-9307.

Sokurov Andrei Vladimirovich — Grand PhD in Medical sciences (Dr. Med. Sci), Director of the Institute of Additional Professional Education, А1ЬгссЫ Federal Scientific and Educational Centre of Medkal and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: ansokurov@yandex.ru; https://orcid.org/0000-0002-3736-2895.

Shabanova Oksana Antonovna — PhD in Medical sciences (Cand. Med. Sci), leading researcher of the Department of medical and social expertise and medical rehabilitation of disabled people of the Institute of Rehabilitation and Habilitation of Disabled, Albced^ Federal Scientific and Educational Centre of Medkal and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: expert-oksana@mai1.ru; https://orcid.org/0000-0002-8019-8963.

Ermolenko Tatiana Valerievna — PhD in Medical sciences (Cand. Med. Sci), Deputy Director of the Institute of Additional Professional Education, Albredt Federal Scientific and Educational Centre of Medkal and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: tatva1erm@yandex.ru; https://orcid.org/0000-0002-3903-5417.

Pavlova Stefanida Vasilevna — PhD in Medical sciences (Cand. Med. Sci), Head of the Department of early assistance to children and their families of the Institute of Rehabilitation and Habilitation of the Disabled, Albredt Federal Scientific and Educational Centre of Medkal and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: stefanida-pav1ova@yandex.ru; https://orcid.org/0000-0003-4353-8823.

Salogub Aleksandra Mikhailovna — PhD in Psychological sciences (Cand. Psych. Sci), leading researcher of the Department of early assistance to children and their families of the Institute of Rehabilitation and Habilitation of the Disabled, Albredt Federal Scientific and Educational Centre of Medkal and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: a1exis1005@yandex.ru; https://orcid.org/0009-0001-4576-7614.

Zubkova Raisa Yurievna — Head of HR department, А1ЬгссЫ Federal Scientific and Educational Centre of Medkal and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: raisa.zu@mail.ru.

Annotation:

Introduction. In order to develop inpatient substitution technologies, the Government of the Russian Federation approved the Concept for the Development of a System of Comprehensive Rehabilitation and Habilitation of Persons with Disabilities in the Russian Federation. The plan of the Concept specifies measures to organize assistance to persons with mental disabilities in obtaining various services, including employment assistance. Measures are also indicated for the development of social employment technologies for those disabled persons who experience significant difficulties in carrying out labor activities. The employment of persons with disabilities is a significant problem. In the total number of adults with disabilities in the Russian Federation, 35.8 % are citizens of working age, and among them the share of working disabled persons is only 26.3 %. Disabled people need employment not only to improve their financial level, but also for social adaptation. There is no single tool in the Russian Federation that would allow to assess the ability of a disabled person to work independently or with assistance.

Aim. Approbation of criteria for establishing the need of disabled persons to be accompanied for labor activity.

Materials and methods. The research methodology was based on the study and generalization of data on the peculiarities of patients with mental disorders in terms of independent performance of labor activity. The study included 331 disabled people with mental disorders living in psychoneurological boarding schools in Voronezh Oblast. We used such research methods as interviewing the subjects and their environment, data collection, study of documentation (individual program of rehabilitation and habilitation of the disabled). Methods of descriptive statistics (absolute, relative, mean values, mean error) were used. The method of correlation analysis was applied, using the Spearman correlation coefficient and the IBM SPSS Statistics 22 program.

Results. In the approbation participated 106 (32 %) capable persons with disabilities with impaired mental functions, 220 (66 %) incapable persons with disabilities, and 5 (2 %) disabled persons with limited capacity. According to persons with impaired mental functions, 235 (70.9 %) of the respondents had never worked. At the time of approbation, 69 (20.8 %) were undergoing adaptation to work or occupational therapy in the residential institution, 2 (0.6 %) were periodically working part-time, and 1 (0.3 %) disabled person was employed part-time in the residential institution. According to the data of individual programs of rehabilitation and habilitation of the disabled, 11 (3.3 %) of the studied persons have no restrictions on their ability to work, I degree — 2 (0.6 %), II degree — 256 (77.3 %), III degree — 62 (18.7 %). 13 ICF domains were assessed, for 5 of which information was provided by the immediate environment. One of the domains assesses the need for the disabled person to have auxiliary equipment for labor and employment. Depending on the number of points scored, the degree of impairment of the person’s autonomy in terms of independent performance of labor activities is assessed, which affects the scope and duration of support services, as well as its type.

Discussion. Taking into account the diagnosis, capacity status and level of education among the studied disabled people with mental disorders, social employment is the preferred form of employment. Based on the results of approbation, criteria were proposed to establish the need of a disabled person in the provision of services to support labor activity and social employment.

Conclusion. According to the results of approbation, the criteria for determining the need for accompaniment of disabled people for labor activity can be used to determine the need for accompaniment (assistance) for labor or other productive activities.

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