The proportion currently employed has remained stable at 22% since the last national survey in 1997. Policy makers and service providers could do more to ensure people with psychotic disorders obtain access to more effective forms of assistance with respect to both their continuing education and employment. More effective vocational and educational interventions for people with psychotic disorders appear to be urgently needed.

No abstract

Money, social engagement and employment are the most important challenges for people with psychotic illness, as well as good physical and mental health. An integrated approach to recovery is needed to optimise service delivery and augment evidence-based clinical practice with measures to improve physical health and social circumstances. Meeting these challenges has the potential to reduce costs to government and society, as well as promote recovery.

Recovery as a concept has gained increased attention in the field of mental health. There is an expectation that service providers use a recovery framework in their work. This raises the question of what recovery means, and how it is conceptualised and operationalised. It is proposed that service providers approach the application of recovery principles by considering systematically individual recovery goals in multiple domains, encompassing clinical recovery, personal recovery, social recovery and functional recovery. This approach enables practitioners to focus on service users' personal recovery goals while considering parallel goals in the clinical, social, and role-functioning domains. Practitioners can reconceptualise recovery as involving more than symptom remission, and interventions can be tailored to aspects of recovery of importance to service users. In order to accomplish this shift, practitioners will require effective assessments, access to optimal treatment and care, and the capacity to conduct recovery planning in collaboration with service users and their families and carers. Mental health managers can help by fostering an organisational culture of service provision that supports a broader focus than that on clinical recovery alone, extending to client-centred recovery planning in multiple recovery domains.

Persons with psychotic disorders have low rates of labour force participation and may benefit from greater participation in educational and vocational services. Implications for policy development are discussed.

Findings indicate that people with intellectual disability are at high risk of developing comorbid serious mental illness. Dual diagnosis is however, often overlooked due to difficulties associated with establishing a diagnosis of a mental disorder in people with an intellectual disability, a problem which is heightened when the individual's capacity to participate in a clinical assessment is limited.

People with a mental illness are among the most socially and economically marginalised members of the community. They experience high levels of unemployment and nonparticipation in the labour force. Unemployment has a number of negative effects including the loss of purpose, structure, roles and status and a sense of identity which employment brings. Employment enables social inclusion in the wider community and is an important way that people with a mental illness can meaningfully participate in the wider community. Australia has a mental health strategy, which guides the ongoing reform of mental health services. However, specific strategies to address the social and economic marginalisation of people with a mental illness have not been addressed. A recovery-oriented approach is recommended, which integrates the key sectors involved. To date there has been little intersectoral collaboration between the various sectors such as mental health services, housing, and vocational services. People require more role-specific assistance to enable them to participate in socially valued roles implicit with citizenship. There is a need to formulate improved pathways to assistance and more evidence-based forms of assistance to re-establish career pathways. This report aims to: 1) collect relevant overseas and Australian evidence about the employment of people with mental illness; 2) identify the potential benefits of employment; 3) describe patterns of labour force participation in Australia among people with mental illness; 4) identify how mental illness can cause barriers to employment; 5) outline the type of employment restrictions reported by people with mental illness; 6) identify the evidence-based ingredients of employment assistance; 7) identify relevant policy implications; and 8) suggest strategies to improve employment outcomes and career prospects for people with mental illness.

Vocational professionals aware of the stigma associated with psychiatric disability, generally exercise caution when disclosing psychiatric or disability related information to employers. However, few professionals directly address stigma or specify disclosure strategies in vocational rehabilitation plans. Integrated information tailored to vocational professionals is needed to guide this aspect of vocational rehabilitation practice. We review recent evidence with legal and ethical information relevant to vocational rehabilitation. Key elements of disclosure and stigma-countering strategies are identified which can be incorporated into the career planning, job preparation, job securing and job retaining phases of vocational rehabilitation plans.