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[失业与成瘾:日出项目]

[Unemployment and Addiction: The SUNRISE Project].

作者信息

Scherbaum N, Specka M, Kaspar C, Mikoteit T, Lieb B

机构信息

Klinik für abh. Verhalten und Suchtmedizin, LVR-Klinikum Essen, Essen.

Stadt Essen, JobCenter Essen, Essen.

出版信息

Gesundheitswesen. 2018 Jan;80(1):73-78. doi: 10.1055/s-0042-107345. Epub 2016 Jun 14.

Abstract

OBJECTIVES

In the SUNRISE-project, the unemployment benefit office refers long-term unemployed clients (25-49 years old) to medical and psychological specialists of an addiction clinic, if substance-related problems are suspected as an obstacle for job placement. The present study aims at characterizing these clients with respect to educational qualifications, vocational training, diagnosed addictive disorders, and other mental disorders. Of special interest is the temporal sequence of unemployment and addictive disorders.

METHOD

Officials referred clients to medical examination if substance abuse was suspected. The examination was based on Europ-ASI, diagnosis of mental disorders based on SCID-I and SCID-II.

RESULTS

In 87 out of the first 100 examined persons, an addictive disorder was diagnosed, most frequently alcohol-related disorders, and often multiple addictive disorders. These 87 clients were on average 40 years old (SD 8.5), and mostly male (73 out of 87 clients). About one-third had very low school qualification, and 55.2% had not completed vocational training. An additional psychiatric diagnosis was made in 51.7%. Addictive disorders had commenced during adolescence or early adulthood in most cases. The longest duration of continuous employment was 3 years (median). In only a few cases (7.4%), the current period of unemployment had started before regular substance use.

CONCLUSION

Many long-term unemployed clients examined here showed deficits in schooling and vocational training, early onset of regular substance use, and additional mental disorders. In most cases, the addictive disorder did not emerge as a consequence of unemployment, but had existed before. Programs combining the efforts of unemployment benefit offices and the healthcare system are needed for these clients to help them gain access to the regular job market.

摘要

目的

在“日出”项目中,如果怀疑与物质相关的问题是求职的障碍,失业福利办公室会将长期失业的客户(25至49岁)转介到成瘾诊所的医学和心理专家处。本研究旨在描述这些客户在教育程度、职业培训、诊断出的成瘾性障碍和其他精神障碍方面的特征。特别感兴趣的是失业和成瘾性障碍的时间顺序。

方法

如果怀疑有药物滥用,官员会将客户转介进行医学检查。检查基于欧洲成瘾严重程度指数(Europ-ASI),精神障碍诊断基于精神疾病诊断与统计手册第一版(SCID-I)和第二版(SCID-II)。

结果

在前100名接受检查的人中,有87人被诊断出患有成瘾性障碍,最常见的是与酒精相关的障碍,而且常常是多种成瘾性障碍。这87名客户的平均年龄为40岁(标准差8.5),大多数为男性(87名客户中有73名)。约三分之一的人学历很低,55.2%的人未完成职业培训。另外有51.7%的人有其他精神疾病诊断。大多数情况下,成瘾性障碍在青春期或成年早期就已开始。连续就业的最长时长为3年(中位数)。只有少数情况(7.4%)下,当前的失业期在规律使用物质之前就已开始。

结论

在此接受检查的许多长期失业客户在学校教育和职业培训方面存在不足,规律使用物质的情况出现较早,并且还有其他精神障碍。在大多数情况下,成瘾性障碍并非失业的结果,而是早已存在。需要将失业福利办公室和医疗保健系统的努力结合起来的项目,以帮助这些客户进入正规就业市场。

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