This paper reviews the literature on the interplay between employment integration and retention of individuals diagnosed with mental health and related disability (MHRD). Specifically, the paper addresses the importance of an integrative approach, utilizing a social epidemiological approach to assess various factors that are related to the employment integration of individuals diagnosed with severe mental illness. Our approach to the review incorporates a research methodology that is multilayered, mixed, and contextual. The review examines the literature that aims to unpack employers’ understanding of mental illness and their attitudes, beliefs, and practices about employing workers with mental illness. Additionally we offer a conceptual framework entrenched within the social determinants of the mental health (SDOMH) literature as a way to contextualize the review conclusions. This approach contributes to a holistic understanding of workplace mental health conceptually and methodologically particularly as practitioners and policy makers alike are grappling with better ways to integrate employees who are diagnosed with mental health and disabilities into to the workplace. 1. Introduction Employment is an important social determinant of health and participation in employment can enhance health and wellbeing. Unfortunately, the majority of individuals with serious mental illness are unemployed [1–5]. For those with mental illness who are employed there is increasing evidence that current workplace environments are contributing to the development and/or exacerbation of mental illness and disability [6, 7]. Limited mental health literacy among employers has been identified as a major barrier to people diagnosed with mental health and related disability (MHRD), making a successful return to work or sustaining employment difficult [8]. Although there is a considerable body of the clinical literature on the experiences of individuals with severe mental health illness in the workplace, much less has been written about an epidemiological approach to understanding employers’ perspectives on hiring workers who experience mental illness and related disability and the kinds of support they need for reintegrating these workers in the workplace. A research approach proposed in this paper makes it possible to assess employers’ perspectives on employing workers with mental illness and related disability, their attitudes and concerns about employing workers with these conditions, and the kinds of information and support they need to facilitate the worker’s return to work.
References
[1]
W. A. Anthony, “Characteristics of people with psychiatric disabilities that are predictive of entry into the rehabilitation process and successful employment outcomes,” Psychosocial Rehabilitation Journal, vol. 17, pp. 3–14, 1994.
[2]
P. G. Arns and J. A. Linney, “Work , self and life satisfaction for persons with severe and persistent mental disorders,” Psychosocial Rehabilitation Journal, vol. 17, pp. 63–80, 1993.
[3]
G. R. Bond, R. E. Drake, K. T. Mueser, and D. R. Becker, “An update on supported employment for people with severe menial illness,” Psychiatric Services, vol. 48, no. 3, pp. 335–346, 1997.
[4]
R. Bland, “Mental Health in Alberta: updates of interest,” in Proceedings of the CMHA Annual Meeting, 2006.
[5]
G. R. Bond, R. E. Drake, and D. R. Becker, “An update on randomized controlled trials of evidence-based supported employment,” Psychiatric Rehabilitation Journal, vol. 31, no. 4, pp. 280–290, 2008.
[6]
National Mental Health Association, “Supported employment for persons with psychiatric disabilities: a review of effective services,” July 2005, http://nmha.org/pedu/adult/supported_employment.pdf.
[7]
J. H. Noble, R. S. Honberg, L. Lee Hall, and L. M. Flynn, “Nami executive summary,” Journal of Disability Policy Studies, vol. 10, no. 1, pp. 10–17, 1999.
[8]
M. Kirby, “Out of the shadows at last-transforming mental health, mental illness and addiction services in Canada,” Final Report of the Standing Senate Committee on Social Affairs, Science and Technology, 2006.
[9]
T. Krupa, B. Kirsh, L. Cockburn, and R. Gewurtz, “A model of stigma of mental illness in employment,” Work, vol. 33, no. 4, pp. 413–425, 2009.
[10]
D. Gilbride, R. Stensrud, C. Ehlers, E. Evans, and C. Peterson, “Employers' attitudes toward hiring persons with disabilities and vocational rehabilitation services,” Journal of Rehabilitation, vol. 66, no. 4, pp. 17–23, 2000.
[11]
M. McQuilken, J. H. Zahniser, J. Novak, R. D. Starks, A. Olmos, and G. R. Bond, “The work project survey: consumer perspective on work,” Journal of Vocational Rehabilitation, vol. 18, no. 1, pp. 59–68, 2003.
[12]
K. Sanderson and G. Andrews, “Common mental disorders in the workforce: recent findings from descriptive and social epidemiology,” Canadian Journal of Psychiatry, vol. 51, no. 2, pp. 63–75, 2006.
[13]
A. A. Murphy, M. G. Mullen, and B. Spagnolo, “Enhancing individual placement and support: promoting job tenure by integrating natural supports and supported education,” The American Journal of Psychiatric Rehabilitation, vol. 8, pp. 37–61, 2005.
[14]
K. W. D. Liu, V. Hollis, S. Warren, and D. L. Williamson, “Supported-employment program processes and outcomes: experiences of people with Schizophrenia,” The American Journal of Occupational Therapy, vol. 61, no. 5, pp. 543–554, 2007.
[15]
C. Macias, L. T. DeCarlo, Q. Wang, J. Frey, and P. Barreira, “Work interest as a predictor of competitive employment: policy implications for psychiatric rehabilitation,” Administration and Policy in Mental Health, vol. 28, no. 4, pp. 279–297, 2001.
[16]
G. Morgan, “We want to be able to work,” Mental Health Today, pp. 32–34, 2005.
[17]
T. Stephens and N. Joubert, “The economic cost of mental health problems in Canada,” Chronic Diseases in Canada, vol. 22, pp. 18–23, 2001, http://www.phac-aspc.gc.ca/publicat/cdic-mcc/22-1/d_e.html.
[18]
W. Spaulding and M. Sullivan, “From laboratory to clinic: psychological methods and principles in psychiatric rehabilitation,” in Handbook of Psychiatric Rehabilitation, R. P. Liberman, Ed., vol. 166, pp. 30–55, 1992.
[19]
S. R. McGurk, K. T. Mueser, P. D. Harvey, R. LaPuglia, and J. Marder, “Cognitive and symptom predictors of work outcomes for clients with schizophrenia in supported employment,” Psychiatric Services, vol. 54, no. 8, pp. 1129–1135, 2003.
[20]
B. Kirsh, T. Krupa, L. Cockburn, and R. Gewurtz, “Work initiatives for persons with severe mental illnesses in Canada: a decade of development,” Canadian Journal of Community Mental Health, vol. 25, no. 2, pp. 173–191, 2006.
[21]
J. A. Cook, “Employment barriers for persons with psychiatric disabilities: update of a report for the president's commission,” Psychiatric Services, vol. 57, no. 10, pp. 1391–1405, 2006.
[22]
L. Cockburn, T. Krupa, J. Bickenbach et al., “Work and psychiatric disability in Canadian disability policy,” Canadian Public Policy, vol. 32, no. 2, pp. 197–211, 2006.
[23]
T. L. Scheid, “Employment of individuals with mental disabilities: business response to the ADA's challenge,” Behavioral Sciences & the Law, vol. 17, pp. 73–91, 1999.
[24]
N. Sartorius and H. Schulze, Reducing Stigma due to Mental Illness: A Report from a Global Program of the World Psychiatric Association, Cambridge University Press, 2005.
[25]
H. Stuart, “Mental illness and employment discrimination,” Current Opinion in Psychiatry, vol. 19, no. 5, pp. 522–526, 2006.
[26]
E. Diksa and E. S. Rogers, “Employer concerns about hiring persons with psychiatric disability: results of the employer attitude questionnaire,” Rehabilitation Counseling Bulletin, vol. 40, no. 1, pp. 31–44, 1997.
[27]
J. A. Cook, L. A. Razzano, D. M. Straiton, and Y. Ross, “Cultivation and maintenance of relationships with employers of people with psychiatric disabilities,” Psychosocial Rehabilitation Journal, vol. 17, no. 3, pp. 103–116, 1994.
[28]
O. F. Wahl, “Mental health consumers' experience of stigma,” Schizophrenia Bulletin, vol. 25, no. 3, pp. 467–478, 1999.
[29]
B. Schulze and M. C. Angermeyer, “Subjective experiences of stigma. A focus group study of schizophrenic patients, their relatives and mental health professionals,” Social Science and Medicine, vol. 56, no. 2, pp. 299–312, 2003.
[30]
D. R. Becker, R. E. Drake, G. R. Bond, H. Xie, B. J. Dain, and K. Harrison, “Job terminations among persons with severe mental illness participating in supported employment,” Community Mental Health Journal, vol. 34, no. 1, pp. 71–82, 1998.
[31]
N. E. Khalema and N. Eshkakogan, Recruitment and Retention of Human Service Personnel in the Human Service Sector: A Research Report, Government of Alberta Children and Youth Services Branch and MacEwan Institute for Research on Family & Youth, 2008.
[32]
J. M. Levy, D. J. Jessop, A. Rimmerman, and P. H. Levy, “Employment of persons with severe disabilities in large businesses in the United States,” International Journal of Rehabilitation Research, vol. 14, no. 4, pp. 323–332, 1991.
[33]
C. Hand and J. Tryssenaar, “Small business employers' views on hiring individuals with mental illness,” Psychiatric Rehabilitation Journal, vol. 29, no. 3, pp. 166–173, 2006.
[34]
H. W. H. Tsang, B. Angell, P. W. Corrigan et al., “A cross-cultural study of employers' concerns about hiring people with psychotic disorder: implications for recovery,” Social Psychiatry and Psychiatric Epidemiology, vol. 42, no. 9, pp. 723–733, 2007.
[35]
B. Angell, M. Spitzmueller, and P. Corrigan, “Stigma in the hiring process: employer perceptions of mental illness and substance abuse,” in Work and Well-being Research and Evaluation Program, Centre for Addiction and Mental Health, 2009.
[36]
H. Stuart, “Stigma and work,” Health Papers, vol. 5, pp. 100–111, 2004.
[37]
C. Mizzoni and B. Kirsh, “Employer perspectives on supervising individuals with mental health problems,” Canadian Journal of Community Mental Health, vol. 25, no. 2, pp. 193–206, 2006.
[38]
M. L. Kirzner, R. Baron, and I. Rutman, Employer Participation in Supported and Transitional Employment for Persons with Long Term Mental Illness, Matrix Research Institute, Philadelphia, Pa, USA, 1992.
[39]
L. Cockburn, B. Kirsh, T. Krupa, and R. Gewurt, “Mental health in the workplace: why businesses are paying attention,” Occupational Therapy Now, vol. 6, no. 5, 2004.
[40]
J. Shankar and F. Collyer, “Support needs of people with mental illness in vocational rehabilitation programs: the role of the social network,” International Journal of Psychosocial Rehabilitation, vol. 7, pp. 15–28, 2003.
[41]
J. Shankar, “The role of ongoing support in improving job tenure for people who experience psychiatric disability,” Fourth Annual Mental Health Showcase, Alberta, Canada, 2008.
[42]
R. Warner, Recovery from Schizophrenia: Psychiatry and Political Economy, Routledge, London, UK, 1994.
[43]
E. Yelin, “The impact of labor market trends on the employment of persons with disabilities,” American Rehabilitation, vol. 26, pp. 21–33, 2001.
[44]
M. J. Prince, “What about a disability rights act for Canada? Practices and lessons from America, Australia and United Kingdom,” Canadian Public Policy, vol. 36, no. 2, pp. 199–214, 2010.
[45]
Internal Revenue Service IRS, 2013, http://www.irs.gov/Businesses/Small-Businesses-&-Self-Employed/Tax-Benefits-for-Businesses-Who-Have-Employees-with-Disabilities.
[46]
Service Canada, 2013, http://www.servicecanada.gc.ca/eng/of/index.shtml?utm_source=Opportunities+Fund+for+Persons+with+Disabilities&utm_medium=Link&utm_campaign=Action_Plan_Skills_Fall_2013.
[47]
Alberta Human Services, “Employment First Strategy. Making Progress,” 2014, http://humanservices.alberta.ca/disability-services/employment-first.html.
[48]
Australian Disability Employment Services, 2014, http://www.humanservices.gov.au/customer/services/centrelink/disability-employment-services.
[49]
Disabilities Act in Austria, 2014, http://www.ohchr.org/Documents/Issues/Disability/SubmissionWorkEmployment/ResponseAustria.pdf.
[50]
M. Corbière, N. Lanct？t, T. Lecomte et al., “A pan-canadian evaluation of supported employment programs dedicated to people with severe mental disorders,” Community Mental Health Journal, vol. 46, no. 1, pp. 44–55, 2010.
[51]
E. Latimer, “An effective intervention delivered at sub-therapeutic dose becomes an ineffective intervention,” The British Journal of Psychiatry, vol. 196, no. 5, pp. 341–342, 2010.
[52]
G. R. Bond, R. E. Drake, and D. R. Becker, “An update on randomized controlled trials of evidence-based supported employment,” Psychiatric Rehabilitation Journal, vol. 31, no. 4, pp. 280–290, 2008.
[53]
M. P. Salyers, A. B. McGuire, G. R. Bond et al., “What makes the difference? Practitioner views of success and failure in two effective psychiatric rehabilitation approaches,” Journal of Vocational Rehabilitation, vol. 28, no. 2, pp. 105–114, 2008.
[54]
S. R. McGurk, K. T. Mueser, K. Feldman, R. Wolfe, and A. Pascaris, “Cognitive training for supported employment: 2-3 year outcomes of a randomized controlled trial,” The American Journal of Psychiatry, vol. 164, no. 3, pp. 437–441, 2007.
[55]
M. Corbière, N. Lanct？t, T. Lecomte, et al., “A pan-canadian evaluation of supported employment programs dedicated to people with severe mental disorders,” Community Mental Health Journal, vol. 46, no. 1, pp. 44–55, 2010.
[56]
OECD Mental Health Work Project, Sick on the Job? Myths and Realities about Mental Health and Work, 2011.
[57]
P. Allan, “For employer productivity is critical,” Health Care Papers, vol. 5, no. 2, pp. 95–97, 2005.
