High non-participation in the labour force and unemployment remain challenging for adults with serious mental illness.
OBJECTIVES:
This study examined the personal experiences of people with serious mental illness when seeking, obtaining and maintaining competitive employment. The aim was to increase understanding of personal experiences of employment and how these experiences can be used to inform the assistance provided in support of clients’ competitive employment goals.
METHODS:
Qualitative data from a two-year period were thematically analysed from one participating site in a multi-site trial of employment services integrated with public funded community mental health treatment and care.
RESULTS:
Both positive and negative themes arose. Positive themes included: Aspirations for a better life, receiving feedback on good job performance, employment displacing preoccupation with illness, and employment improving self-esteem and reducing financial stress. Negative themes included stigma experiences, stress, and health difficulties. Both positive and negative experiences did not depend on type of employment service assistance nor key client characteristics such as age, sex, and diagnostic category.
CONCLUSIONS:
Despite its many benefits, employment can also increase the risk of negative personal experiences. These findings suggest that employment service providers could do more to assist people who commence employment, to reduce the risk of negative personal experiences and to enhance the benefits of competitive employment.
BeckerDR, DrakeRE, BondGR, XieH, DainBJ, HarrisonK. Job terminations among persons with severe mental illness participating in supported employment. Community Mental Health Journal1998;34:71–81.
2.
BeckerD, WhitleyR, BaileyEJ, DrakeRE. Long-term employment trajectories among participants with severe mental illness in supported employment. Psychiatric Services2007;58:922–928.
3.
BondG. Supported Employment: Evidence for an evidence-based practice. Psychiatric Rehabilitation Journal2004;27(4):345–359.
4.
BondGR, DrakeRE, BeckerDR. An update on randomized controlled trials of evidence-based supported employment. Psychiatric Rehabilitation Journal2008;31(4):280–290.
5.
BoyceM, SeckerJ, JohnsonR, FloydM, GroveB, SchneiderJ, SladeJ. Mental health service users’ experience of returning to paid employment. Disability and Society2008;23:77–88.
6.
BondG, DrakeRE. Making the case for IPS Supported Employment. Administration and Policy in Mental Health Services2014;41:69–73.
7.
ConnellM, KingR, CroweT. Can Employment Positively Affect the Recovery of People with Severe Mental Illness?Psychiatric Rehabilitation Journal2011;35(1):59–63.
8.
CrainM, PenhaleC, NewsteadC, ThomsonL, HeahT, BarclayK. The contribution of IPS to recovery from serious mental illness: A case study. Work2009;33:459–464.
9.
CunninghamK, WolbertR, BrockmeierMB. Moving beyond the illness: Factors contributing to gaining and maintaining employment. American Journal of Community Psychology2000;28:481–494.
10.
EklundM, HanssonL, BejerholmU. Relationships between satisfaction with occupational factors and health related variables in schizophrenia outpatients. Soc Psychiatry Psychiatr Epidemiol2001;36:79–85.
11.
EklundM, HanssonL, AhlqvistC. The importance of work as compared to other forms of daily occupations for wellbeing and functioning among persons with long term mental illness. Community Mental Health Journal2004;40(5):465–477.
12.
FosseyEM, HarveyCA. Finding and sustaining employment: A qualitative meta-synthesis of mental health consumer views. Canadian Journal of Occupational Therapy2010;77:303–314.
13.
GoldbergSG, KilleenMB, O’DayBL. The Disclosure Conundrum: How People with Psychiatric Disabilities Navigate Employment. Psychology, Public Policy & Law2005;11(3):463–500.
14.
HendersonC, BrohanE, ClementC, WilliamsP, LassmanF, SchaumanO, DockeryL, FarrellyS, MurrayJ, MurphyC, SladeM, ThornicroftG. Decision aid on disclosure of mental health status to an employer: Feasibility and outcomes of a randomised controlled trial. The British Journal of Psychiatry2013;203(5):350–357.
15.
HenryAD, LuccaAM. Facilitators and barriers to employment: The perspectives of people with psychiatric disabilities and employment service providers. Work2004;22:169–182.
16.
HoneyA. The impact of mental illness on employment: Consumers’ perspectives. Work2003;20:267–76.
17.
HoneyA. Benefits and drawbacks of employment: Perspectives of people with mental illness. Qualitative Health Research2004;14:381–395.
18.
KilleenMB, O’DayBL. Challenging expectations: How individuals with psychiatric disabilities find and keep work. Psychiatric Rehabilitation Journal2004;28:157–163.
19.
KoletsiM, NiersmanA, van BusschbachJT, CattyJ, BeckerT, BurnsT, FiorittiA, KalkanR, LauberC, RosslerW, TomovT, WeirsmaD. Working with mental health problems: Clients experiences of IPS, vocational rehabilitation and employment. Social Psychiatry and Psychiatric Epidemiology2009;44:961–970.
20.
LeufstadiusC, EklundM, ErlandssonLK. Meaningfulness in work –Experiences among employed individuals with persistent mental illness. Work2009;34:21–32.
21.
LiuKWD, HollisV, WarrenS, WilliamsonDL. Supported-employment program processes and outcomes: Experiences of people with schizophrenia. American Journal of Occupational Therapy2007;61:543–554.
22.
McQuilkenM, ZahniserJH, NovakJ, StarksRD, OlmosA, BondGR. The work project survey: Consumer perspectives at work. Journal of Vocational Rehabilitation2003;18:59–68.
23.
MunroI, EdwardKL. The recovery journey: Employment support for people with depression and other mental illnesses. Australian e-Journal for the Advancement of Mental Health2008;7(2):104–111.
24.
SeckerJ, MembreyH, GroveB, SeebohmP. The how and why of workplace adjustments: Contextualizing the evidence. Psychiatric Rehabilitation Journal2003;27:3–9.
25.
SiegalDI, GreenJ, AbbottA, MogulM, PatacsilM. Barriers to employment: Returners to welfare and those who left the welfare and employment rolls. Social Policy Journal2004;3:19–37.
26.
SiuPSK, TsangHWH, BondGR. Nonvocational outcomes for clients with severe mental illness. Journal of Vocational Rehabilitation2010;32(1):15–24.
27.
TsangHWH. Augmenting vocational outcomes of supported employment by social skills training. Journal of Rehabilitation2003;69(3):25–30.
28.
WaghornG, ChantD, KingR. Work-related self-efficacy among community residents with psychiatric disabilities. Psychiatric Rehabilitation Journal2005;29(2):105–113.
29.
WaghornG, SpowartCE. Managing personal information in supported employment for people with psychiatric disabilities. Ch 13 in Vocational rehabilitation and mental health. LloydC, (ed). New York: John Wiley and Sons2010.
30.
WaghornG, HarrisM, KingJ, ClearyC. Building a career of your choice. A guide for service users, families, and mental health professionals. Second Edition. Brisbane.. Mental Health, Alcohol and Other Drugs Directorate Queensland2011.
McGaheyE, WaghornG, LloydC, MorrisseyS, WilliamsPL. A formal plan for self-disclosure enhances supported employment outcomes among young people with severe mental illness. Early Intervention in Psychiatry2010. doi: 10.1111/ei12196.
34.
LloydC. WaghornG. The Importance of Vocation in Recovery for Young People with Psychiatric Disabilities. British Journal of Occupational Therapy2007;70(2):50–59.
35.
BoyatzisRE. Transforming qualitative information: Thematic analysis and code development. Thousand Oaks, London & New Delhi: SAGE Publications1998.
36.
CreswellJW, MillerDL. Determining validity in qualitative inquiry. Theory into Practice2000;39(3):124–130.
