Predictors of Sustained Employment Among Individuals With Serious Mental Illness

Abstract

Despite decades of research, understanding of the employment trajectories of individuals with serious mental illnesses remains elusive. We conducted a 5-year prospective, longitudinal study using a geographically broad sample of individuals who met established criteria for sustained competitive employment (N = 529). We collected data on an annual basis with a specifically designed survey instrument. Despite stable employment at study entry, more than half of the participants experienced work interruptions during the 5-year follow-up period. Predictors of sustained employment included the absence of a trauma diagnosis, Social Security disability income, psychiatric hospitalizations, and difficulties with daily functioning. The presence of a higher quality of life, workplace supports, and a flexible job were also predictive. Results dispel the myth that people with serious mental illnesses cannot be employed for prolonged periods. Interruptions in work trajectories, however, suggest that longer-term supports may increase individuals' capacity to maintain stable employment.

Using the Work Behaviour Inventory and Work Environment Impact Scale to measure employment sustainability for people with severe mental illness in a vocational rehabilitation program

“…Hence supervisors were trained by the occupational therapist to improve on their communication with the participants, which could have supported job retention. This present study is consistent with previous studies which found that positive and supportive supervisor interaction was a significant facilitator of job tenure for workers with SMI (Corbière et al, 2014;Huff et al, 2008;Russinova et al, 2018;Williams et al, 2016).…”

“…Consistent with most prior studies (Russinova et al, 2018), results from this present study also found that age, number of comorbidities, period of unemployment and length of time taken for job placement did not have a significant effect on job tenure. The WEIS items (i.e.…”

“…Luciano et al (2014) pointed out that studies investigating predictors of job tenure for people with SMI are limited and overall findings are inconsistent due to unstandardised measurement of job tenure. Additionally, factors commonly documented in studies investigating vocational outcomes for workers with SMI are demographic or illness related (Cook et al, 2016;Metcalfe et al, 2017;Russinova et al, 2018). While such factors may influence job retention, they are not modifiable and occupation based, therefore it may be more important to consider factors such as work environments and work behaviours in order to facilitate longer job tenure.…”

“…Qualitative studies have reported that positive relationships with supervisors and co-workers, interesting and engaging job duties, flexible work hours and accessibility to the workplace are found to significantly improve job tenure (Huff et al, 2008;Williams et al, 2016). However, literature examining the impact of factors such as job satisfaction and aspects of work environment such as supervisor support on job tenure for people with SMI has been limited (Russinova et al, 2018). On the other hand, studies have found that participants who went through a supported employment programme which combined IPS with work-related social skills training had longer job tenure compared to participants who only received IPS (Zhang et al, 2017).…”

Predictors of employment in people with moderate to severe mental illness participating in a randomized controlled trial of Individual Placement and Support (IPS)

“…Involuntary hospitalization seems to be a strong negative predictor of employment. Although it does not seem to have been included in previous studies, it does seem like hospitalizations with no specifications of voluntariness is a consistent negative predictor of employment ( Cook et al, 2001 ; Nordt et al, 2007 ; Russinova et al, 2018 ). In this study, a multiple regression model examining possible confounding with anxiety and depression was tested, but was not significant, indicating that its association with employment is unique.…”