Work - Volume 33, issue 4

Article Type: Other

DOI: 10.3233/WOR-2009-0885

Citation: Work, vol. 33, no. 4, pp. 377-379, 2009

Authors: Jackson, Yanina | Kelland, Jill | Cosco, Theodore D. | McNeil, Diane C. | Reddon, John R.

Article Type: Research Article

Abstract: Background: Numerous studies have demonstrated the beneficial effects of vocational rehabilitation on vocational outcomes in individuals with a mental illness, yet effects on secondary outcomes remain largely unexplored. This study investigates the impact of vocational rehabilitation on the utilization of emergency, ambulatory care and inpatient services in individuals with a mental illness. Methods: Using a repeated measures study design, the utilization of health services by individuals with a mental illness (n= …37) was compared before and during their engagement in training and employment at a social enterprise – a form of vocational rehabilitation. Results: Individuals with a mental illness had significantly less emergency department visits (p=0.01), ambulatory care visits (p=0.01) and hospital admissions (p=0.05), but no difference in hospital length of stay (p=0.39), during training/employment, compared to pre-training/employment at a social enterprise. Conclusion: The reduction in health services utilization found in this study may reflect symptom and overall health improvement, highlighting the importance of vocational rehabilitation programs for individuals with a mental illness. In addition, results from this study can inform stakeholders and policymakers about the impact of vocational rehabilitation on the healthcare system to help guide decisions regarding program implementation or continuation, and funding allocation. Show more

Keywords: Vocational rehabilitation, employment, secondary outcomes, health services utilization, mental illness

DOI: 10.3233/WOR-2009-0886

Citation: Work, vol. 33, no. 4, pp. 381-387, 2009

Authors: Bergmans, Yvonne | Carruthers, Anne | Ewanchuk, Elizabeth | James, Judy | Wren, Kate | Yager, Christina

Article Type: Research Article

Abstract: Background: The experiences and barriers associated with the return to paid employment following healing from recurrent suicide attempts related to mental illness have not been addressed in the literature to date. Method: This paper is a collaborative case study between graduates (experts by experience) and facilitators of a psychosocial/psychoeducational group for people with recurrent suicide attempts. The journeys taken by the experts by experience are explored through thematic narrative analysis. Findings/Results: Issues of stigma, disclosure, …accommodations, maintaining wellness and coming to re-define a sense of self were consistent themes found throughout all narratives. Conclusions: The paper identified key areas of challenge and celebration, suggesting the need for enhanced support from health care providers, workplace managers, supervisors and colleagues for successful transitions into the workplace. Show more

Keywords: Mental illness, suicide, return to work, stigma

DOI: 10.3233/WOR-2009-0887

Citation: Work, vol. 33, no. 4, pp. 389-394, 2009

Authors: Sobowale, Gordon | Cockburn, Lynn

Article Type: Research Article

Abstract: Background: This case study presents the career path of a young Canadian man, George, as he recovered from significant mental illness and became a support worker in the mental health field. Approach: The authors use a case study approach to highlight a unique and individualized partnership which developed between George and a supported employment program. Findings: The staff in the program assisted George to find work and to embark on an exciting career path. The authors …describe George's journey from unemployed client to volunteer and student to full-time worker. Several specific strategies and approaches were used including time unlimited support, attention to client preferences and personal growth, advocacy, and seeing the career journey as a multi-step process. Conclusion: Implications for other programs are discussed. The use of individual stories can deepen understandings of the benefits of supported employment programs. This case study reflects how a supported employment program successfully assisted one person's career path. Show more

Keywords: Supported employment, toronto, case study, recovery, work

DOI: 10.3233/WOR-2009-0888

Citation: Work, vol. 33, no. 4, pp. 395-400, 2009

Authors: Cowls, Jocelyn | Galloway, Edith

Article Type: Research Article

Abstract: Background: This research explores the observation that people who have had traumatic life experiences may connect with work in an unhealthy way, impacting their ability to return to work successfully. Purpose: This research aims to understand how past traumatic experiences influence career choice and workplace behaviour and, given this understanding, consider how occupational therapists can facilitate change towards a successful return to work. Methods: Semi-structured interviews were used to gather information …from twenty-five clients experiencing depression, anxiety or post-traumatic stress disorder. Clients were followed for six months following their planned return to work date. Findings: Participants identified re-enacting unhealthy past experiences at work through: focusing on the needs of others, seeking acceptance and avoidance. Healthy change was created through engaging in coping strategies and partnering with the occupational therapist and workplace stakeholders on return to work planning. Implications: To facilitate a successful return to work, clients must become aware of how their traumatic histories play a role in their current career choices and workplace behavior. With this awareness, occupational therapists and clients may work together towards creating healthy change in the present. Show more

Keywords: Traumatic re-enactment, return to work, depression, anxiety, post-traumatic stress disorder

DOI: 10.3233/WOR-2009-0889

Citation: Work, vol. 33, no. 4, pp. 401-411, 2009

Authors: Krupa, Terry | Kirsh, Bonnie | Cockburn, Lynn | Gewurtz, Rebecca

Article Type: Research Article

Abstract: Background: Stigma has been identified as an important barrier to the full community participation of people with mental illness. This study focuses on how stigma operates specifically within the domain of employment. Objectives: The purpose was to advance the development of theory related …to the stigma of mental illness in employment to serve as a guiding framework for intervention approaches. Method: The study used a constructivist grounded theory methodology to analyze over 500 Canadian documents from a diverse range of sources and stakeholders, and interviews with 19 key informants. Findings: The paper develops several key components central to the processes of stigma in the work context. These include the consequences of stigma, the assumptions underlying the expressions of stigma, and the salience of these assumptions, both to the people holding them and to the specific employment situation. Assumptions are represented as varying in intensity. Finally specific influences that perpetuate these assumptions are presented. Implications: The model suggests specific areas of focus to be considered in developing intervention strategies to reduce the negative effects of stigma at work. Show more

DOI: 10.3233/WOR-2009-0890

Citation: Work, vol. 33, no. 4, pp. 413-425, 2009

Authors: Lal, Shalini | Mercier, Celine

Article Type: Research Article

Abstract: Background: Intersectoral action is now widely recognized as an effective approach to addressing the social determinants of health. In particular, collaboration between different sectors of the community has been recommended as a strategy for developing employment opportunities for persons diagnosed with mental illness. However, there is limited evidence on the actual implementation of intersectoral action between the employment and mental health sector. Methods: Case study methodology was utilized to examine a unique …partnership formed under the principles of public health and local development to create a social enterprise. Stakeholders representing organizations from several sectors of the community, including health and employment, partnered to develop work opportunities for a population that is disadvantaged from the mainstream employment market including (but not exclusive to) persons diagnosed with mental illness. The three main methods of inquiry were: semistructured interviews, participant observation and collected documentation. Findings: Stakeholders experienced several kinds of challenges during the implementation process and used different strategies to manage these challenges. The findings suggest barriers and facilitators to successful intersectoral action initiatives, some of which are directly applicable to the context of employment and mental illness. Conclusion: Several lessons are drawn from these experiences. Show more

Keywords: Employment, mental illness, intersectoral, collaboration, work

DOI: 10.3233/WOR-2009-0891

Citation: Work, vol. 33, no. 4, pp. 427-437, 2009

Authors: Dewa, Carolyn S. | Dermer, Stanley W. | Chau, Nancy | Lowrey, Scott | Mawson, Susan | Bell, Judith

Article Type: Research Article

Abstract: The rise in globalization, new technologies and changes in workforce demographics have created new work environments. As a result, countries around the world are seeking to restructure their educational systems to better prepare future generations for the challenges that they will face in this new labour market. These trends have also introduced new and increased demands on the educational sector and especially school principals who are responsible for the quality of education in schools. This study …examines the association between mental health status and self-reported working conditions of principals. Our findings highlight potential mental health problems among principals. The results provide evidence that their satisifaction with their work characteristics are associated with their mental health status. They also indicate areas in which school boards may be well positioned to address some of the potential organizational difficulties encountered by this group. Show more

DOI: 10.3233/WOR-2009-0892

Citation: Work, vol. 33, no. 4, pp. 439-448, 2009

Authors: Moll, Sandra | Holmes, Jennifer | Geronimo, Julie | Sherman, Deb

Article Type: Research Article

Abstract: Background: Peer support is gaining recognition as a valuable component of mental health service delivery, and a meaningful employment opportunity for mental health consumers. Despite the potential benefits of peer support, there continues to be many barriers to the development and funding of peer positions. Method: The overall purpose of this multi-site project was to build capacity for employment of trained peer providers in local, community-based mental health programs. A collective case study approach …was adopted to explore how peer support was integrated into traditional mental health services. In-depth interviews were conducted with both new and established peer providers and their managers in six different programs. Findings: Analysis of interview transcripts led to identification of key work transitions for peer support workers, from defining and establishing roles, to negotiating the learning curve, and dealing with the challenges associated with their unique role as both consumer and provider. Conclusion: Effective integration of peer support requires consideration of the work role, unique needs of the worker, and the overall workplace environment. Integrating peer support providers is a process that evolves over time and does not end once someone is hired. Show more

Keywords: Mental illness, employment, peer support, case study

DOI: 10.3233/WOR-2009-0893

Citation: Work, vol. 33, no. 4, pp. 449-458, 2009

Authors: Crain, Michael | Penhale, Caroline | Newstead, Catherine | Thomson, Leigh | Heah, Tom | Barclay, Karen

Article Type: Research Article

Abstract: Background: Individual Placement and Support (IPS) is an effective, evidence-based intervention to support transition to paid work for individuals who have a serious mental illness. Currently, there is a lack of qualitative reporting from the people receiving IPS and their support networks. Approach: A case study of a 42-year-old-man who has schizophrenia and who attends a community mental health team in a Canadian urban centre is presented. His experience and that of his mother, employer, and clinical supports …are shared through semi-structured interviews. The authors of this paper include a peer researcher who has been a participant in an IPS program. Findings: The enduring and individual support of IPS is credited with being central to the study subject's successful acquisition and maintenance of paid employment. His involvement in paid work is also associated with improved health outcomes, including a significant reduction in the frequency of medical appointments to monitor his mental health. Improved social skills and self-efficacy are also reported. Conclusion: Provision of IPS services within a multidisciplinary mental health team can promote the acquisition of durable employment for individuals in recovery from serious mental illness. Clinicians are reminded to check their assumptions regarding which individuals could benefit from IPS, and are encouraged to take their lead from clients in determining whether to commence or continue employment services. Show more

Keywords: IPS, recovery, mental illness, vocational rehabilitation, case study

DOI: 10.3233/WOR-2009-0894

Citation: Work, vol. 33, no. 4, pp. 459-464, 2009