Enabling the return-to-work process among people with affective disorders: A multiple-case study

Johanson, Suzanne; Markström, Urban; Bejerholm, Ulrika

doi:10.1080/11038128.2017.1396356

Cited by 19 publications

(19 citation statements)

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“…The first author (UL), an occupational therapist with long experience from MH and vocational rehabilitation services conducted all interviews, which were retrospective and aimed at getting the informants to tell about their experience of starting to work as openly and freely as possible. The thematic interview guide was composed by the first author and took inspiration from the IES project interview guide developed by the second author (UB) [23] and the Worker Role Interview instrument [39]. The guide was the basis for each interview and started with the broad, openended question based on the main theme of identity, participation, and work.…”

Section: Data Collectionmentioning

confidence: 99%

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Work identity development in young adults with mental health problems

Liljeholm

Bejerholm

2019

Scandinavian Journal of Occupational Therapy

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Background: How we identify ourselves is strongly related to employment. Young adults are a vulnerable group with regard to entering the Labor market. If they also have mental health problems, entering becomes more difficult and increases risk of early marginalization. Nevertheless, working can be essential for personal recovery process. Aims: To explore experiences of young adults with mental health problems who are starting to work, with a focus on the process of developing work identity. Methods: Grounded theory design was used. The data collection consisted of 13 in-depth interviews with young adults with mental health problems aged 19-26 years, who had worked for at least three months. Results: The experience of starting to work contributed to a process of internal and external change, new feelings, challenges, and understanding of the surrounding world. Former negative thought patterns became more positive. New roles and occupational patterns were developed and altered views on abilities, and thus self-efficacy. This development contributed to a work identity, and new directions in life. Conclusions: There is therapeutic potential in supporting work identity development, and this support can empower the personal recovery process for young adults.

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Section: Data Collectionmentioning

confidence: 99%

“…Moreover, the intervention group had a higher sense of empowerment, fewer symptoms, and higher levels of community integration [20,21]. Qualitative research points in the same direction [11,22,23]. An integration of mental health and vocational rehabilitation services that lead to work may increase the chance of recovery [17,24].…”

Section: Introductionmentioning

confidence: 97%

Work identity development in young adults with mental health problems

Liljeholm

Bejerholm

2019

Scandinavian Journal of Occupational Therapy

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“…Timeuse strategies are used for balancing other daily activities and to promote a working life. The IES model is described in detail in a previous study [10]. The enabling component is then integrated with the supported employment principles, which include competitive employment as the goal, eligibility based on the person's willingness to participate and work, job searches that should start early in the process, support based on the participant's preferences, integration of the vocational plan with mental healthcare treatment, continuous and not time-limited support, benefit counselling, continuous job recruitment, and employer networking [34].…”

Section: The Ies Modelmentioning

confidence: 99%

“…This study focuses on implementation of a recently advanced return-to-work (RTW) model, Individual Enabling and Support (IES), that was developed based on evidencebased processes of supported employment for persons with severe mental illness. Time use, motivational support, and cognitive support strategies were added to better fit the support needs of persons with affective disorders [10,11].…”

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confidence: 99%

Implementation of a novel return-to-work approach for persons with affective disorders in a traditional vocational rehabilitation context: a case study

Johanson

Markström

Larsson

et al. 2020

Int J Ment Health Syst

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Background: The person-centred Individual Enabling and Support (IES) model is a novel return-to-work (RTW) intervention for people with affective disorders that was developed from evidence-based supported employment for persons with severe mental illness. Typically, supported employment is integrated into mental healthcare and provides a network around the service user and close collaboration with employment and insurance services and employers. Introducing integrated models into a highly sectored welfare system that includes traditional mental healthcare and vocational rehabilitation is challenging. Greater knowledge is needed to understand how facilitating or hindering factors influence this introduction. The aim of this study was to investigate essential components in implementation of the IES model. Methods: A case-study was conducted and included four mental healthcare services. Data collection was comprised of semi-structured interviews with 19 key informants, documentation from meetings, and reflection notes. Analyses were performed according to directed content analysis, using the components of the Consolidated Framework of Implementation Research (CFIR) as a guiding tool. Fidelity assessments were performed at 6 and 12 months. Results: Anticipating RTW support for the target group, and building collaborative relationships and a network with employment specialists that engaged staff in every organization were components that resulted in the greatest facilitation if IES implementation. Barriers consisted of difficulty in integrating employment specialists into the mental healthcare teams, insufficient engagement of first line managers, reorganization and differing perceptions of the IES model fit into a traditional vocational context. Delivery of the IES model had good fidelity. Conclusions: The IES model can be implemented with good fidelity, several model advantages, and context adaptation. Team integration difficulties and negative perceptions of model fit in a traditional vocational rehabilitation context can be overcome to a certain degree, but this is insufficient for sustainable implementation on a larger scale. Policy and guidelines need to promote integrative and person-centred RTW approaches rather than a segregated stepwise approach. Further implementation studies in the traditional vocational rehabilitation context are needed.

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“…Previous research has shown that integrated mental health and vocational services, that is supported employment, that aimed to support competitive employment among adults (mean age 40 years) with mental health problems resulted in gains in acquiring and keeping employment (Bejerholm, Larsson, & Johanson, 2017) and a greater sense of empowerment . The service users also experienced fewer depressive symptoms and higher levels of engagement in everyday life activities compared with those in traditional services that focused separately on clinical and personal recovery Areberg, Björkman, & Bejerholm, 2013;Johanson, Bejerholm, & Markström, 2017;Porter, Lexén, Johansson, & Bejerholm, 2018). Previous research shows that vocational efforts that lead to sustainable career development for persons with mental health problems are essential for personal recovery (Bejerholm & Areberg, 2014;Boardman et al, 2003;Dunn et al, 2008;Provencher et al, 2002).…”

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confidence: 94%

An integrated mental health and vocational intervention: A longitudinal study on mental health changes among young adults

2020

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The increase in mental health problems among young adults has become a serious public health challenge (National Board of Health & Welfare, 2013). During 2000-2010, the number of young adults who had contact with mental health services in Sweden increased by about one third. In 2016, alarming statistics were seen. Fifteen per cent of young women and 10% of young men aged 18-24 years needed some form of psychiatric treatment (National

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Enabling the return-to-work process among people with affective disorders: A multiple-case study

Abstract: Providing a combination of these strategies integrated with supported employment could promote self-efficacy and engagement in the RTW process among people on sick leave due to an affective disorder.

Cited by 19 publications

References 51 publications

Work identity development in young adults with mental health problems

Work identity development in young adults with mental health problems

Implementation of a novel return-to-work approach for persons with affective disorders in a traditional vocational rehabilitation context: a case study

An integrated mental health and vocational intervention: A longitudinal study on mental health changes among young adults

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