Working with schizophrenia: Experts' views on barriers and pathways to employment and job retention

Abstract

BACKGROUND: Unemployment among people with schizophrenia remains high despite slight improvements in vocational rehabilitation services and attitudes towards people with mental health disorders over the years. Experts are in a good position to increase our understanding on why this group still experiences such significant barriers to employment. OBJECTIVE: Interviews explored experts’ views on schizophrenia and employment; with a particular focus on individual, attitudinal and structural barriers, as well as available interventions and their outcomes. METHODS:The sample of 20 experts were recruited using theoretical sampling. The experts consisted of: employment specialists, healthcare professionals, activists from patient organisations, academics, caregivers and employers. A thematic approach was used for analysis. RESULTS: Low expectations of healthcare professionals which were often manifested as minimal recognition of employment as an outcome for people with schizophrenia as well as a “benefits trap” were identified as the strongest barriers to employment. In addition, the IPS model was identified as the most effective to support people to work, but lack of funding to implement the model nationally and concerns of poor implementation were raised by the experts. CONCLUSIONS: More research is required to examine which adaptations are needed for vocational interventions in order to implement them successfully.