Interest in and Obstacles to Pursuing Work Among Unemployed Dually Diagnosed Individuals

Abstract

Employment status is commonly used as a sign of stability in recovery and an outcome variable for substance abuse treatment and research. However, there has been little attention in the literature on the topic of work for the dually diagnosed (i.e., persons diagnosed with both substance use and mental health disorders). Data collected in 1999 are presented on expressed interest in and perceived barriers to pursuing work and on the utilization of vocational rehabilitation (voc-rehab) services among unemployed members of a dual recovery self-help fellowship (N = 130). While members generally expressed high interest in working, they also cited multiple obstacles to attaining and maintaining employment. A path model was specified and tested. Significant contributors to interest in working were substance use status and physical health rating. Consistent with our hypotheses, mental health symptoms and greater perceived obstacles (e.g., stigma, fear of failure, and insufficient skills) were significant contributors to perceived difficulty in pursuing work, whereas substance use, physical health, and recency of employment were not. Finally, those who perceived less difficulty in pursuing work were more likely to utilize voc-rehab services, and men were more likely than women to use these facilities; interest in work was not significantly associated with utilizing voc-rehab services. The roles of mental health disorders and substance use in relation to pursuit of employment are discussed, as well as that of perceived obstacles such as stigma. The paper addresses the setting of realistic vocational goals and possible strategies to mitigate barriers to increased employment of dually diagnosed individuals.

Mental Health as a Mediator of Gender Differences in Employment Barriers among Drug Abusers

“…Laudet and colleagues (1) report that individuals with mental health problems often have fewer work-related skills, fewer interpersonal skills such as time management, impulse control, and self-presentation, and are likely to have more difficulty succeeding in the workplace than are individuals without mental health problems. These problems are amplified when an individual has both mental health and drug abuse problems.…”

Predictors of Referral to Supported Employment Among Consumers with Co-Occurring Mental and Substance Use Disorders

“…Several studies found that substance use disorders do not impair capacity to work beyond the already significant impairments due to severe mental illness (Bell et al 2002;Cook et al 2007;Drebing et al 2002;Laudet et al 2002;Pickett-Schnek et al 2002;Sengupta et al 1998). Drebing and colleagues found no added risk of non-compliance with vocational rehabilitation associated with a co-occurring substance use disorder compared to individuals with psychiatric disorders.…”

“…Despite the strong evidence to date of the effectiveness of Supported Employment programs, gaps in knowledge remain, especially for persons with co-occurring mental and substance disorders (Laudet et al 2002). There has been little examination concerning which consumers get referred to Supported Employment programs and which mental health consumers do not get referred.…”

“…The identification of such facilitators and barriers can provide useful information to mental health agencies in enhancing utilization of Supported Employment programs. Factors affecting consumers' willingness to work and consumers' perceived difficulty in obtaining work, and thus interest in being referred to Supported Employment programs, that have been identified in the literature include: previous work experience, work motivation, mental health symptomatology, substance use problems, consumer selfefficacy, consumer perception of unmet needs for vocational assistance, and receipt of entitlement income by consumers (Anthony 1994;Braitman et al 1995;CraneRoss et al 2000;Estroff 1997;Fabian 1992;Laudet et al 2002;Linhorst 2006;Macias et al 2001;Van Dongen 1996). Agency level factors that may impact referral to Supported Employment pertain to differences between consumers and practitioners regarding consumers' need for employment and need for vocational assistance (Casper and Carloni 2006;Crane-Ross et al 2000).…”

Werkhervatting van zieke en niet-zieke werklozen

“…Zieke werklozen hebben minder kans op werkhervatting dan gezonde werklozen. 7 Verder is gebleken dat geestelijke gezondheidsklachten in het algemeen 19 en psychosomatische klachten in het bijzonder 20 werkhervatting belemmeren.…”