Hospital-based industrial therapy units and the people who work within them - an Irish case analysis using a soft-systems approach.

Occupational training and employment is seen as a central concern in the delivery of community-orientated mental health services aimed at enhancing the quality of life of people with enduring mental illness. A range of schemes from sheltered to open employment now operates in a number of countries, with a concomitant growth of interest in their evaluation. At the same time, hospital-based workshops, often referred to as industrial therapy units (ITUs), have steadily declined because they are seen as outdated and less efficacious compared with community-located training and employment. However, whether the total disappearance of the traditional ITU is a positive development may be open to question. This paper reports on a study of five mental health hospital-based sheltered workshops located in one Health Board area in Ireland, which catered for the needs of people with enduring mental health problems. Utilizing a soft-systems methodological approach, it examined their role and significance to 'users' who spent occupational time in them, the staff who worked in them and the clinicians who referred users to them.