Psychiatric/Psychosocial Rehabilitation (PSR) in Relation to Vocational and Educational Environments: Work and Learning

Abstract

Introduction: People with serious mental illness (SMI) have an interest in working, but they experience high levels of marginalization from the community based labour force. Psychiatric/psychosocial rehabilitation (PSR) has advanced a variety of innovative approaches to address the range of individual, occupational, workplace and societal factors that contribute to this marginalization. Employment and education-related approaches consistent with the values of PSR include those that are directly focused on securing and sustaining employment or education, and those that create employment opportunities. The objective of this review was to summarize the evidence for these approaches, report predictors of outcomes where available and identify relevant gaps and other issues. Method: A selective (but within that comprehensive) narrative review of the peer reviewed literature was conducted to evaluate the status of the scholarship for four employment and education-related intervention approaches in this area. Results: The individual placement and support (IPS) model has demonstrated efficacy in improving employment outcomes. There are few empirical studies of social businesses and other initiatives to create employment for people with SMI, although there has been a recent wave of promising literature and research on these approaches. There is some support for supported education for this population, with a recent focus on the potential of supported education that is directly linked to employment supports. Conclusion: Work and education participation is improved with approaches that provide direct and comprehensive supports to individuals with SMI as they engage in work and school. Career trajectories, the social status of jobs and the economic status of individuals are emerging issues for further study to promote full social inclusion.