Employment programs for people with psychiatric disability: the case for change

Abstract

This paper evaluates the effectiveness of disability employment policy in assisting people with psychiatric disability to find, or return to, paid work. We argue that the poor employment outcomes from current programs establish the need for a paradigmatic shift in the form of a state‐provided Job Guarantee (JG) for people with psychiatric disability. In the absence of measures to generate suitable jobs, forthcoming changes to the eligibility criteria for Disability Support Pension will create risks rather than opportunities. Under the JG, the Federal Government would maintain a ‘buffer stock’ of minimum wage, public sector jobs to provide secure paid employment for this highly disadvantaged group. The role of the state in this alternative model is two fold. First, the state must provide the quantum of JG jobs required. Second, the state must ensure the design of jobs is flexible enough to meet the heterogeneous and variable support needs of workers. This will require effective integration of the JG scheme with mental health, rehabilitation and employment support services.

Gatekeeping disability income support: A conceptual model

“…Research on the definition of disability is limited and mostly descriptive. For example, the definition of disability is often explained to provide context but seldom analysed (see, for example, Bill, Cowling, Mitchell, & Quirk, ; Forchuk et al, ; Gewurtz, ). Mabbett () examines the definition of disability but in a broader sense for all social policies, rather than disability income support specifically.…”

Financial turning points and transitions for people with multiple sclerosis: Towards sustainable employment outcomes

“…The purpose of this paper is to showcase the previously unexamined experience of Financial Turning Points and Financial Transitions for people with MS. Unemployment (or unplanned early retirement) is central to economic hardship and social exclusion, having deleterious effects on selfconfidence, competence, and social participation for those with disability (Berthoud, 2008;Bill, Cowling, & Quirk, 2006;Waghorn, Collister, Killackey, & Sherring, 2007). This is demonstrably evident in Australia where almost half the population of people with disability are living at or below the poverty line (Bennett, 2011).…”

“…Remaining involved in paid work is not only central to identity and financial independence (Bill et al, 2006), it is an increasingly important source of income for those with disability, especially in light of increasingly scarce Australian disability government support and a recently confirmed national context depicting almost half of people with disability living at or below the poverty line. In Australia, while the recent Federal Government proposed changes to the DSP are argued to encourage people with MS (and other disability) back into paid employment (MS Australia, 2011;Nevile & Lohmann, 2011) it remains the case that increased employment opportunities for people with disability are only possible if there are suitable jobs for them to go to (Bill et al, 2006) and employers prepared to employ them . While access to paid employment is the assumed alternative for those assessed as ineligible for the DSP, or receiving reduced pension support as a result of changed provisions, there is strong evidence that gaining access to employment remains difficult.…”

“For the Crime of Being Different…”:

“…The outcomes for those unemployed prematurely (including those officially documented as a medical retirement) are financial hardship, deleterious effects on self-confidence, competence, and social participation, exacerbating their social and economic marginalisation (Berthoud 2008;Bill et al 2006;Waghorn et al 2007), along with a reduced quality of life, a lower standard of living, and fewer opportunities to participate in valued social roles ). Unemployment, for anyone, also results in increased health problems, stress and other negative physiological outcomes (Argyle 1989;Lewchuk et al 2008;Nettleton 1995).…”