Interventions to Improve Employment Outcomes for Workers Who Experience Mental Illness

Abstract

T he employment problems of individuals who experience mental illness are receiving considerable attention as mounting evidence demonstrates the extent of their personal, social, and economic impact. Physicians and other service providers in primary care settings hold much of the responsibility for delivering treatment for mental illness and are expected to attend to work-related issues. However, these providers may have limited knowledge about the nature and scope of current work interventions. This paper discusses current practices in employment interventions for individuals who experience mental illness. It begins with a brief background section that introduces the reader to mental illness-related work disability, levels of employment marginalization, and the status of research in the field. Specific interventions are then presented from 2 perspectives: interventions directed to the individual employee and employer-level interventions that create workplace structures to prevent mental illness and support mental health. The

Occupational Therapy Interventions for Employment and Education for Adults With Serious Mental Illness: A Systematic Review

“…The burden of depression, for example, is estimated to be $83.1 billion, including $51.5 billion in workplace costs and $26.1 billion in direct medical costs (Greenberg et al, 2003). According to Krupa (2007), these costs may be compounded because serious mental illness can affect education and work careers relatively early in life, resulting in a long period of burden for the individual and society.…”

Psychosocial Functioning in Bipolar Disorder from a Social Justice Perspective

“…In the absence of institutional protection, funding and support, structural stigma directly circumscribes the opportunities of people with BD to improve their clinical, social and vocational functioning (Baldwin & Marcus, 2011;Boyd et al, 2011;Corrigan, Watson, Heyrman, et al, 2005;Krupa, 2007;Michalak et al, 2007;Michalak et al, 2011). Thus, people with BD may struggle to function in part because they attempt to negotiate a social environment that is not designed to accommodate their limitations (e.g.…”

“…Qualitative studies (Michalak et al, 2007;Tse & Yeats, 2002) indicate that augmenting employment in BD requires interventions in four key areas: illness management, social support, and employer-employee relations, as well as in combating broader societal barriers such as stigma and disincentives to working embedded in disability regulations (Elinson et al, 2007;Tse & Yeats, 2002). Evidence-based supported employment (SE) programs that include early intervention after diagnosis, integrated clinical care and vocational services (Cook et al, 2005;Cook et al, 2008), training in goal-setting, cognitive and social skills (Arbesman & Logsdon, 2011;Cook, 2006;Cook et al, 2008;Krupa, 2007;Krupa et al, 2009), a collaborative and individualized approach to rapid employment placement without lengthy pre-placement training, and especially, highintensity on-the-job support of unlimited duration (G. R. Bond & Kukla, 2011;Cook et al, 2005;Evans & Bond, 2008;McHugo, Drake, & Becker, 1998), address the first three of these areas.…”

An International Perspective on Worker Mental Health Problems: Who Bears the Burden and How are Costs Addressed?

“…65 Much of this evidence base has focused on individual interventions rather than on more complex integrated approaches to workplace mental health promotion. Although it is beyond the scope of our paper to review the literature in this area, Krupa's article 66 in this issue provides a detailed discussion of possible approaches.…”