Practical Activity of Community Mental Health（４）

「生活の場でみるメンタルヘルス」として今回は，職場におけるメンタルヘルスを復職支援活動での知見に基づきながら検討した。対象としたのは，復職にあたって困難を感じている感情障害もしくは適応障害の範疇に入る人たちであった。躁病エピソードを繰り返しているタイプが２名，単相性にうつ病エピソードを繰り返しているタイプが３名，適応障害タイプが1名であった。それぞれのタイプ毎に，復職にあたっての心理的問題や具体的な対応方法を「疾病性」と「事例性」の観点から考えた。躁うつ病圏の人たちは「疾病性」が「事例性」に先行し，復職にあたっては他者に対して他罰的であった。単相性うつ病圏の人たちでは「疾病性」と「事例性」が混在し，復職にあたっては他者の評価を恐れる気持ちが強かった。一方，適応障害では「事例性」が「疾病性」に先行しており，対人関係はより複雑で深刻であることを指摘した。さらに復職支援のためのシステム作りに関しても若干の考察を加えた。Objective: Mental health in place of work was studied in the paper. I was consulted by six persons who had leave of absence because of mental disorders and were expected to resume their office before long. Their mental problems were examined to support their rework. Method: Subjects were three persons with depressive episodes, two persons with manic episodes and one person with adjustment disorder. Their mental states facing difficulties of rework were compared with each other. Results: The persons with manic episodes were anxious about relapse of the disease and not afraid of other people in their office. The persons with depressive episodes feared that other people around them detected the symptoms of their disorder and too conscious of what other people say. The person with adjustment disorder had worse personal relations in place of work than the other persons and needed continuous psychotherapy. Conclusions: A further examination of rework programs was carried out on the base of these 6 cases