Supported employment for people with severe mental illness: a pilot study of an Italian social enterprise with a special ingredient

Abstract

Background People with mental disorders are far more likely to be unemployed than the general population. Two internationally recognized, evidence-based models of interventions for employment for people with severe mental health problems are Individual Placement Support and the Clubhouse. In Italy, a common model is the ‘social enterprise’ (SE), which is a programme run by non-profit organisations that help individuals with disabilities to be employed. Despite SEs spread and relevance in Italy, there are no studies about Italian samples. This paper reports on a pilot evaluation of psychosocial and work outcomes of a SE based in Verona, Italy. The study aims to investigate if people with SMI involved in SE job placements may achieve personal recovery and better outcomes over time, and in comparison with a comparable group of users. Methods This is a pilot descriptive study with three components. A longitudinal design that comprised a functioning description of 33 SE members with a psychiatric disability in two time-points (when they joined the SE—on average 5 years before the study recruitment, and at the study recruitment—year 2018); and a repeated collection of job details of the 33 members in three time points: 2 years before the recruitment,—year 2016; 1 year before the recruitment – year 2017; and at the recruitment—year 2018. An assessment at the recruitment time—year 2018, of SE users’ satisfaction with the job placement, symptoms, functioning, and quality of life (QoL). A cross-sectional study that compared the 33 SE members at the recruitment time—year 2018, with a matched group of people with the following criteria: living in local supported accommodations, being unemployed and not SE members. The two groups were compared on ratings of psychopathology, functioning, and QoL. Descriptive analyses were done. Results At the recruitment time – year 2018, all SE participants showed a significant better functioning (p < 0.001) than when they joined the SE—when they had been employed for an average of 5 years. In comparison to the matched group, SE members had significantly better functioning (p = 0.001), psychopathology (p = 0.007), and QoL (p = 0.034). According to their SE membership status, participants comprised trainees (21.2%) and employee members (78.8%). Trainees compared to employees had lower autonomies, functioning, QoL and more severe psychopathology. Over the two years prior to study recruitment, trainees showed stable poor autonomies, while employee members showed a variation from average autonomies in the 2 years before the recruitment time – year 2016, to good ones at the recruitment time – year 2018. Over the two years, all SE members set increasing numbers of objectives in all three domains. All SE participants reported high levels of satisfaction with all aspects of the job placement. Conclusions SE that provides tailored support to assist people to gain employment skills may be an effective component in helping recovery from SMI.

Social Enterprise as a Pathway to Work, Wellness, and Social Inclusion for Canadians with Mental Illnesses and/or Substance Use Disorders

“…The use of WISEs in the mental health sector originated in response to the historic exclusion of persons with mental illness and addictions from employment (Elmes, 2019;Gidron, 2017;Pache & Santos, 2013). Specific advantages of WISEs for these populations identified in past research include enhanced social integration and reduced stigma (Krupa, Sabetti, & Lysaght, 2019;Lysaght, Jakobsen, & Granhaug, 2012;Villotti, Zaniboni, Corbière, Guay, & Fraccaroli, 2018); improved incomes and social position (Elmes, 2019); improved work behaviours (Chan, Ryan, & Quarter, 2017); enhanced social connections (Hartley, Yeowell, & Powell, 2019); improved self-confidence (Chan et al, 2017;Villotti et al, 2018); and improved mental health (Martinelli, Bonetto, Bonora, Cristofalo, Killaspy, & Ruggeri, 2022). More specifically, Roy, Baker, and Kerr (2017) identified seven ways in which working in WISEs can contribute to the improved health and wellbeing of vulnerable workers: 1) engaging people in meaningful work; 2) engendering a supportive and safe work environment; 3) improving knowledge and skills; 4) expanding social networks; 5) enabling access to information and welfare; 6) raising public awareness; and 7) building self-worth.…”

Working Ability among Students with Learning Disabilities Enrolled in TVET Education: A Preliminary Study

“…For students with weak learning problems, they focus more on self-management only and are not suitable to be offered work because their abilities are very weak. They also lack selfconfidence and often suffer from health problems (Martinelli et al, 2022). Most of them come to school just to meet the daily routine but none have the goal of learning skills like their friends at medium and high level.…”