Enhancing Work-Focused Supports for People with Severe Mental Illnesses in Australia

Abstract

Persons with severe mental illness (SMI) have reduced workforce participation, which leads to significant economic and social disadvantage. This theoretical review introduces the strategies that have been implemented to address this issue. These include Individual Placement and Support (IPS) services, the most widely researched form of supported employment, to which cognitive remediation has more recently been recognised in the USA, as an intervention to improve employment outcomes by addressing the cognitive impairments often experienced by people with SMI. The authors review the international literature and discuss specifically the Australian context. They suggest that Australia is in a prime position to engage clients in such a dual intervention, having had recent success with increasing access to supported employment programs and workforce reentry, through implementation of the Health Optimisation Program for Employment (HOPE). Such programs assist with gaining and maintaining employment. However, they do not address the cognitive issues that often prevent persons with SMI from effectively participating in work. Thus, optimising current interventions, with work-focused cognitive skills development is critical to enhancing employment rates that remain low for persons with SMI.

Activity participation patterns of community mental health consumers

“…Findings from previous research have consistently found generally low levels of participation in domestic, employment and social activities for consumers in comparison to the general community, and this remains a stubbornly persistent problem. The employment rate identified in this study (19.58%) is lower than that reported internationally (Becker et al., 2007; Broyd et al., 2016) but is congruent with the rate consistently reported in Australian studies for the past 2 decades (Contreras et al., 2012; Waghorn et al., 2012). As noted by the World Health Organization and Calouste Gulbenkian Foundation (2014), there is a relationship between employment and mental illness that increases their respective negative influences on each other.…”

Implementation of the individual placement and support approach – facilitators and barriers

“…They identify four themes that emerge as challenges to implementation: fear on the part of professionals, individuals and their families that work will have a negative impact on the client, a culture of low expectations, failure to provide the support that is proven to work, and the global recession. Contreras et al (2012) review the research from Australia and New Zealand and maintain that the central challenge for implementing IPS is the incorporation of the vocational assistance into the public mental health services. Boardman (2013) summarizes the research on IPS and possible barriers for implementation and points to clients' motivation, self-efficacy and previous employment history.…”

Beskæftigelsesrettede indsatser for mennesker med psykiske lidelser - et pilotstudie

“…Derudover er de teamorienteret og professionelle og effektive ift. administration af deres tid og ressourcer på de forskellige opgaver (Quimby et al 2001, van Erp et al 2007, Koletsi et al 2009, Glover et al 2011, Boardman 2013, Contreras et al 2012, Larson et al 2014). …”

“…I den internationale forskning er der ligeledes primaert fokus på at generere indsigter i implementeringsprocesserne set fra de professionelles perspektiv. Enkelte studier beskaeftiger sig med deltagernes/brugernes karakteristika og strategier som en faktor, der har indflydelse på IPS indsatsens outcome, og enkelte studier inddrager brugernes erfaringer i forståelsen af de komplekse implementeringsprocesser (Quimby et al 2001,Koletsi et al 2009, Areberg et al 2012, Boardman 2013, Contreras et al 2012, Lexén et al 2013. I den politologiske implementeringsforskning udgør målgruppens adfaerd og interesser et selvstaedigt studieobjekt i forståelsen af implementeringen af offentlig politik (Winther og Lehmann Nielsen, 2008).…”