function. While impairments in physical rehabilitation include vision or hearing loss, reduced range of motion in an extremity, and loss of strength in a muscle group, psychiatric impairments can include thought disorder and speech incoherence, delusions, hallucinations, anxiety, depression, loss of concentration or memory, distractibility, and apathy and anhedonia. Thus, psychiatric symptoms and cognitive-emotional deficits are both correlates of the course and outcome of psychiatric illnesses and of the pathological processes in the nervous system. Presumably, these impairments are somewhat specific for each of the major mental disorders and vary with the severity of the underlying psychobiological vulnerability. The specificity of the impairments enables diagnosticians to categorize psychiatric disorders reliably (e.g., DSM-W); however, there is considerable overlap between disorders as evidenced by the presence of delusions and hallucinations in a variety of psychotic disorders (Prohl and Andreasen 19861 When functional limitations imposed by psychiatric impairments result in decrements in the ability to perform certain activities, the individual is said to have a disability. Disabilities are defined as inability or limitation to perform tasks expected of an individual within a social environment (Frey 1984). Among individuals with severe psychiatric disorders such as schizophrenia, disabilities include poor self-care skills (e.g., cooking, cleaning, grooming, and teeth care), social withdrawal and seclusiveness, abandonment of family responsibilities, and work incapacity. DSM-III (American Psychiatric Association 1980) has highlighted the importance of these disabilities by including them as criteria for many diagnosable psychiatric conditions. To be diagnosed as having schizophrenia, for example, it is not sufficient to experience the characteristic symptoms of thought disorder, delusions and hallucinations, but the person also must evince a "deterioration from a previous level of functioning in such areas as work, social relations, and self-care" (American Psychiatric Association, 1980, p. 189). The disabilities shown by persons with psychiatric disorders are influenced by the same protective and risk factors that influence the appearance, exacerbation, and remission of symptoms or impairments. Thus, correlations between symptoms and disabilities would be expected; however, not every impairment results in a disability. Furthermore, similar patterns of disability can result from different disorders and impairments. Persons with mental retardation or affective disorders may have the same profile of disabilities as those with schizophrenia. Social and vocational disabilities form a major cluster of behaviors that both reflect and influence the course and outcome of a psychiatric disorder. Research data substantiate a consistent relationship between a person's abilities and vocational outcome. For example, in every study in which work adjustment skills were assessed, they were found to be significantly related to future work performance (Anthony and Jansen 1984). Similar to these data on work adjustment skills, ratings of interpersonal or social skills have been found to predict vocational performance even though social functioning was measured differently in the various studies (Anthony, Cohen, and Cohen 1984). A final element in the rehabilitation model is handicap, which occurs when disabilities place the individual at a disadvantage relative to others in society. This can occur through stigma and discrimination, as when employers are reluctant to hire persons with mental illnesses Handicap also occurs because society does not provide settings where mentally ill persons can find accommodation and compensation for their impairments and disabilities. Wheelchairs and ramps have enabled paraplegics to overcome their impairments and disabilities to find remunerative work and fulfilling recreation; hence, their handicaps are compensated. Because mentally ill persons require special social environments to compensate for their problems, overcoming handicap is much more difficult. Long-term institutional care in State and county mental hospitals was formerly society's