Barriers to and facilitators of employment for people with psychiatric disabilities in Africa: a scoping review

Abstract

Background: Despite the importance of inclusive employment, described in Goal 8 of the Sustainable Development Goals (SDGs), employment of persons with psychiatric disabilities in Africa is lower than among the general population. Objective: The aim of this scoping review is to explore evidence related to the barriers to and facilitators of employment of persons with psychiatric disabilities in Africa. Methods: A literature search was conducted using six relevant electronic databases of articles published between 1990 and 2017. Results: Eight studies were identified and analysed regarding barriers and facilitators of employment of persons with psychiatric disabilities. The dynamic adaptation of the bio-psycho-social model was used as an analytical framework. Identified barriers include ill health, (anticipated) psychiatric illness, social stigma and discrimination, negative attitudes among employers and the lack of social support and government welfare. Facilitators of employment include stability of mental illness, heightened self-esteem, a personal decision to work despite stigma, competitive and supported employment, reduction in social barriers/stigma and workplace accommodations. Conclusion: Employment of persons with psychiatric disabilities is essential, yet there is dearth of scientific evidence to identify contextual models that might be useful in African countries and other low-and middle countries (LMICs). This gap in information would benefit from further research to improve the employment rates of persons with psychiatric disabilities in Africa.

Factors associated with internalized stigma for Indonesian individuals diagnosed with schizophrenia in a community setting

“…In the current study, the level of internalized stigma was higher in subjects having no friends, but not significantly different by gender, education level and living status. This was consistent with another study in China (Zhang et al, 2019), where it was found that internalized stigma was significantly negatively associated with perceived social support and social Given that unemployment is associated with higher risk of having stigma, providing vocational rehabilitation and employment support could be beneficial and meaningful to reduce internalized stigma and promote recovery (Ebuenyi, Syurina, Bunders, & Regeer, 2018;Hielscher, & Waghorn, 2017). In particular, in a collectivist culture, as with other Asian countries, an emphasis on family interdependence is pervasive and powerful (Lauber & Rossler, 2007).…”

Expectations management; employer perspectives on opportunities for improved employment of persons with mental disabilities in Kenya*

“…These reports are supported by the initial observations of the Committee on the Rights of Persons with Disabilities, which stated that in Kenya, only 1% of persons with disabilities are employed [3]. It is pertinent to note that employment in low-and middle-income countries is largely in the informal sector, such as self-employment, family business, small privately owned businesses, especially for persons with low skills [12,13]. Hence, in addition to the stigma against mental illness, the structure of the labour market may also be responsible for the challenges of employment for persons with mental disabilities.…”

Perspectives of mental healthcare providers on pathways to improved employment for persons with mental disorders in two lower middle-income countries

“…It consisted of seven open-ended and 11 closed questions in English. The questions for the qualitative and quantitative data were developed based on a literature review and empirical study by the authors [3,37] It explored the perspectives of psychiatrists and occupational/community health physicians on the ability of persons with mental disorders to work and perceived barriers to and facilitators of their employment. The questionnaire also explored the pre-employment assessment of mental illness, accommodation made for persons with mental illness at the workplace, and what employers can do to improve employment for persons with mental disorders.…”

“…The stigma borne by the family and other individuals deprives persons with mental disorders of the health care they deserve; and, sadly, the actions of certain healthcare workers may also stigmatize them further. Stigma and discrimination thrive on cultural bias and ignorance and constitute a limitation to work opportunities for persons with mental disorders [3,31,45]. Studies have previously documented the interplay between poverty and mental health [41,46].…”