Perspectives on Employment Integration, Mental Illness and Disability, and Workplace Health

Abstract

This paper reviews the literature on the interplay between employment integration and retention of individuals diagnosed with mental health and related disability (MHRD). Specifically, the paper addresses the importance of an integrative approach, utilizing a social epidemiological approach to assess various factors that are related to the employment integration of individuals diagnosed with severe mental illness. Our approach to the review incorporates a research methodology that is multilayered, mixed, and contextual. The review examines the literature that aims to unpack employers' understanding of mental illness and their attitudes, beliefs, and practices about employing workers with mental illness. Additionally we offer a conceptual framework entrenched within the social determinants of the mental health (SDOMH) literature as a way to contextualize the review conclusions. This approach contributes to a holistic understanding of workplace mental health conceptually and methodologically particularly as practitioners and policy makers alike are grappling with better ways to integrate employees who are diagnosed with mental health and disabilities into to the workplace.

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

“…A multi-country exploratory survey in Europe revealed the willingness of employers to improve inclusion in the workplace and their need for specialist assistance to provide accommodation in the workplace for persons with mental disabilities [16]. However, a review by Khalema and Shankar suggested that globally, the majority of employers are unwilling to employ persons with severe mental illness on account of their perceived poor work ability [17]. According to Krupa et al there are many myths about the work ability of persons with a mental illness.…”

Evaluating outcomes in an adult inpatient psychiatric rehabilitation unit

“…28 Premorbid factors such as education and employment history, illness-related factors such as negative symptoms, comorbidity and the need for frequent hospitalisation, social factors such as stigma and poor interpersonal skills, and environment-related factors such as low expectations, underestimation and/or underutilisation of skills, and restricted work project opportunities, are all likely to play a role. [27][28][29][30][31][32][33][34] Vocational support programmes that include inter agency collaboration and adhere to the individual placement and support (IPS) model with the use of an integrated community employment specialist, have been shown to be most effective in helping those with mental health disabilities gain and sustain employment, and should form part of any psychiatric rehabilitation service. 35 …”

Food insecurity and work impairment in people with severe mental disorders in a rural district of Ethiopia: a cross-sectional survey

“…Given the high burden of physical health problems in people with SMD [56], this could have led us to incorrectly attributing impact on work impairment and food insecurity to SMD. We also did not measure medication side effects which could adversely affect work capacity [57], although most participants were not taking psychotropic medication at the time of the study. It is possible that poverty, disability, discrimination and poor social support are all proxies for more severe and enduring illness which is then associated with food insecurity, but this is unlikely as we were able to adjust for symptom severity and duration of illness.…”