Social Care Workers Research Articles

Barriers and facilitators to ex-service personnel obtaining employment within social care roles with older people: a scoping review

PurposeThis purpose of this paper is to review evidence about the barriers and facilitators to ex-service personnel obtaining employment within social care roles. Social care has long-standing, well-recognised problems of staff recruitment and retention. Policymakers and employers are exploring if there are untapped sources of potential employees. Some ex-service personnel may be interested in exploring a move to social care work with older people but may face barriers to such a move which may need to be addressed.Design/methodology/approachDatabases and grey literature were searched systematically to provide an overview of evidence on this topic. In total, 23 articles were included in the review.FindingsA narrative analysis revealed barriers to ex-service personnel obtaining employment within social care not only related to their previous occupation, health status and identity but also facilitators related to the sector’s severe recruitment challenges and the transferable skills of ex-service personnel. Evidence suggests that learning from health services may be highly relevant and transferable.Research limitations/implicationsThis review was confined to English language studies published between 2008 and 2018. Few mentioned specific user or client groups.Originality/valueThis review identified evidence suggesting that learning from health services may be highly relevant and transferable to the social care sector so as to facilitate the transition of more ex-service personnel into social care work with older people.

Acceptability of AAI from the Perspective of Elderly Clients, Family Members, and Staff-A Pilot Study.

Although animal-assisted interventions (AAIs) are increasingly part of comprehensive rehabilitation and many of its effects are already well described, the methodology for performing AAI depends on the specific patient, animal, and treatment objective. Acceptability of AAI from all involved members is a little explored area. Thus, 214 respondents (32 AAI clients, 146 family members, and 36 healthcare and social care workers; 98 males, 116 females; mean age 46.3 years (±16.5 SD)) completed a list of statements focused on AAI with a dog. This list was distributed directly in nursing homes, retirement homes, and in households with home hospice care. All statements were rated on a Likert scale of 0–3. The results show that AAI is generally very well received, with over 90% of respondents considering AAI to be beneficial. The perception of AAI and trusting the handler with their dog was evaluated very positively, as well as possible concerns about hygiene. The results were in many cases affected by demographic factors of the respondents (age, gender, role in AAI, education, and size of settlement). It seems appropriate in future studies to focus on the attitude of individual groups, and thus advance the methodology of implementing AAI.

Exploring the challenges faced by frontline workers in health and social care amid the COVID-19 pandemic: experiences of frontline workers in the English Midlands region, UK

ABSTRACT The first cases of Coronavirus (COVID-19) were reported in Wuhan, China in December 2019. Globally millions of people have been diagnosed with the virus whilst thousands have died. As the virus kept spreading health and social care frontline workers (HSCFW) were faced with difficulties when discharging their duties. This paper was set out to explore the challenges faced by different frontline workers in health and social care during the COVID-19 pandemic. The research utilized an explorative qualitative approach. A total of forty (N = 40) in-depth one-to-one semi-structured interviews were undertaken with HSCFW who included support workers (n = 15), nurses (n = 15), and managers (N = 10). Health and social care workers were drawn from domiciliary care and care homes (with and without nursing services). All the interviews were done online. The data were thematically analyzed, and the emergent themes were supported by quotes from the interviews held with participants. Following data analysis the research study found that lack of pandemic preparedness, shortage of Personal Protective Equipment (PPE), anxiety and fear amongst professionals, challenges in enforcing social distancing, challenges in fulfilling social shielding responsibility, anxiety and fear amongst residents and service users, delay in testing, evolving PPE guidance and shortage of staff were challenges faced by frontline health and social care workers during COVID-19 pandemic. The results of the current study point to a need for adequate pandemic preparedness within the health and social care sector to protect both frontline workers and the individuals they look after.

The Trauma Within Our Knowledge Bundles

Trauma holds a sacred space in the knowledge bundles of many Indigenous helpers, including myself.A knowledge bundle represents the knowledge that an individual holds within themselves. This bundleconsists of experiential knowledge, knowledge shared through teachings, and knowledge received throughgenetic memory. This article explores the potential trauma Indigenous social workers may face priorto practice, within post-secondary programs, and during practice. The literature written by Indigenoushelpers working alongside trauma in the field of social work provides incredibly valuable knowledge forcurrent helpers, as well as for students just beginning their journey into the social work field. How mightIndigenous helpers working within the field of social work care for the trauma they may carry within theirown knowledge bundles? This article examines how Indigenous helpers prepare to work with trauma,how they may navigate trauma within practice, and what happens after re-stimulation of traumatic events.

“Yo lo que Quiero es Trabajar”. Hombres que Trabajan en el Sector del Cuidado Social

En este artículo exploramos las experiencias y percepciones de los hombres en trabajos de cuidado en España para comprender las razones por las que se introdujeron en este sector laboral, porqué continúan, cómo se perciben y en qué medida el género importa en sus experiencias laborales. Utilizamos datos de la investigación cualitativa que estamos realizando en Cataluña (España) sobre hombres cuidadores. Este texto se basa en 31 entrevistas semiestructuradas a trabajadores del sector del cuidado social. Nuestros resultados muestran que la crisis económica ha conducido a que hombres autóctonos entren a trabajar en un sector poco cualificado como es el de los cuidados, modificando así el proceso de estratificación basado en género, clase y migración. Descubrimos que la "escalera de cristal" tiene un efecto muy limitado en el trabajo de cuidado ya que las ventajas que disfrutan los hombres solo se relacionan con la facilidad con la que acceden a dichos trabajos. Finalmente, encontramos que los hombres cuidadores negocian su masculinidad a través de la tensión entre las normas culturales y de clase que les obligan a tener un trabajo y las características subvaloradas o feminizadas de su trabajo.

Advance care planning in the community: factors of influence

ObjectivesThis study aims to identify factors among British community-based adults associated with advance care planning engagement. Factors are then compared among six domains of wishes: medical care, spiritual and religious...

COVID-19 highlights risks of healthcare and social care workers attending work while ill.

As COVID-19 affects healthcare and social care systems around the world, reports of infection among healthcare and social care workers continue to accumulate.

Abstract A002: Use of electronic health record data to improve generalizability of social support research in cancer: CRN pilot study

Abstract Abstract Background: Social support is an important predictor of breast cancer treatment adherence, quality of life, and survival. However, prior research has been predominantly representative of non-Latina white women and those with common breast cancer subtypes. We considered whether information from the electronic health record (EHR) could be developed and used to enhance representativeness of social support research in breast cancer. Methods: We conducted interviews with oncologists, breast care coordinators, nurse practitioners, and social workers to determine the nature and extent of social support data collection in patients with breast cancer and/or information in the EHR that might help to identify patients with low social support. We also reviewed EHR records for variables that have been used to measure structural and functional support. We included in our analysis 27,584 patients diagnosed with invasive breast cancer in Kaiser Permanente Northern California (KPNC) from 2006-2017. We evaluated concurrent validity of potential social support measures against levels of the gold standard Medical Outcomes Study Social Support measure, collected in the Pathways Study, a study of 4,505 women with stage I-IV invasive breast cancer. We further evaluated predictive validity of measures with overall mortality using National Death Index data. Finally, we evaluated the performance of an index based on the sum of widely available variables and mortality in the total population; scores ranged from 0 (low social support)-4 (high social support). Results: Variables widely available in the EHR included marital status, living status (i.e., whether living alone or with someone), religious status (i.e., indicator of religious involvement or not), availability of information about an emergency contact, and ICD V- and Z- codes for social problems. Variables determined to be not widely available included: support person on day of visit, transportation issues, and detailed descriptions of social support. Marital status, religious status, living status, presence of an emergency contact, and presence of ICD codes for social problems were each related to less than median levels of social support in Pathways. All indicators predicted subsequent patient mortality except living status which modified the association of the other predictors. Adjusted for age at diagnosis, race/ethnicity, and AJCC stage, compared to women with four points (high support) (reference), women with 3, odds ratio (OR)=1.31, 95% confidence interval (CI): 1.21-1.43; 2, OR=1.62 (1.46-1.80); and 0-1 (low support), OR=1.96 (1.54-2.49) points, had elevated risks of mortality; the association was larger in those who lived alone. We had adequate statistical power to explore associations in racial/ethnic subgroups and in women with triple negative breast cancer. Conclusions: Variables available in the EHR may be used to measure social support in breast cancer patients. Citation Format: Candyce H Kroenke, Elizabeth Eldridge. Use of electronic health record data to improve generalizability of social support research in cancer: CRN pilot study [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A002.

The relevance of transformational leadership for promoting professional social work competence with EBPA.

Health care social workers' attitudes towards evidence-based practice (EBP) are an indispensable precursor of implementing EBP. Using a subset including 405 health care social workers from the first nationally representative survey of social workers in China, this study empirically assesses how transformational leadership (TFL) promotes health care social workers' attitudes towards EBP. The results show that organisational learning capacity (OLC) and professional competence (PC) fully mediate the positive relationship between TFL and EBP attitudes. Furthermore, TFL, OLC and PC explain 56% of the variance in health care social workers' attitudes towards EBP. This result supports the perspective that both organisational factors and individual factors may facilitate social workers' positive attitudes towards EBP, but organisational factors are more important. Therefore, to adopt, use and sustain EBP in health care social work, learning and innovation in the organisation should be increased. Furthermore, it is important to help social workers improve their PC.

COVID-19 in the UK and Occupational Health and Safety: Predictable not Inevitable Failures by Government, and Trade Union and Nongovernmental Organization Responses.

This commentary examines the occupational health and safety issues faced by the UK workers in the COVID-19 pandemic, against the background of government cuts in health care and in occupational health and safety budgets, and a deregulatory climate. The UK government has been obsessed, blinkered, and distracted by the desire to leave the European Union (Brexit). The state of knowledge about the virus, especially from international agencies that identified pandemic threats and strategies to combat it, is outlined. UK politicians, government bodies, medical and scientific advisors, and employers periodically ignored or abused that knowledge. Regulatory and ministerial inaction and errors on the workplace virus risks emerged. In contrast, several trade unions, health professional bodies, and nongovernmental organizations identified COVID-19 threats from poor personal protection equipment, working practices, and knowledge gaps and offered solutions for health care workers, social care workers, production workers, and service workers in “essential” occupations.

Fighting cancer in coronavirus disease era: organization of work in medical oncology departments in Emilia Romagna region of Italy.

Aim: To assess which and when measures were applied to reduce coronavirus disease (COVID-19) spreads have been applied in medical oncology departments. Materials & methods: We surveyed all medical oncology departments from the Italian Emilia Romagna region via a multidomain questionnaire. The questions covered items on patients, healthcare workers, risk reduction measure and clinical trials. Results: A total of 12 centers involving 861 healthcare members joined the survey. The measures applied to patients and health workers partially converged in all the departments while major divergences were found in the clinical trials domain. High rate of COVID-19 infection occurred among medical doctors (21/208, 10.1%) and social care workers (13/110, 11.8%). Rate of infection among nurses was 5.7% (24/418). Conclusion: All measures able to reduce risk of COVID-19 infection must be applied in medical oncology departments. Early introduction of risk reduction measures may be a critical issue.

Applying the Collaborative Care Model to treat depression and anxiety in breast cancer (BC) patients.

e14004 Background: Depression and anxiety are frequent causes of excess morbidity for cancer patients, but access to mental health care, including outpatient psychiatry, is limited across academic and community settings. The Collaborative Care Model (CoCM) is a team-based model of care that is proven to leverage limited mental health resources across a wider population in primary care (Raney L, Am J Psychiatry, 2015). Evidence suggests that CoCM can be effectively applied to cancer populations too (Walker J, Gen Hosp Psychiatry, 2009). Methods: The investigators adapted CoCM to treat depression and anxiety in an academic BC clinic. A quality protocol was approved by the institutional board. All English-speaking BC patients were screened for depression using the PHQ-2 and PHQ-9. Patients with PHQ-9 ≥15 or clinical suspicion of severe anxiety or depression were referred to CoCM. The CoCM intervention included social work care management and regular case reviews by a psychiatrist. Medical oncologists prescribed all psychiatric medications. Patients were referred to mental health services in the community as needed. Results: From November 2018 through January 2020, a total of 74 patients were enrolled in CoCM. Median age was 50 years (range: 28-74 years) with BC stages I-III (n = 49, 66.2%) and stage IV (n = 25, 33.8%). Treatments within the cohort include: endocrine therapy (n = 39, 52.7%), chemotherapy (n = 18, 24.3%), observation (n = 9, 12.1%), single agent HER2 inhibitor targeted therapy (n = 4, 5.4%), immunotherapy (n = 2, 2.7%), single agent CDK4/6 inhibitor (n = 1, 1.4%), and radiation (n = 1, 1.4%). Of the 74 patients, 28 had PHQ-9 scores ≥15 at enrollment. On average, ending PHQ-9 scores decreased 39% from the initial score (average beginning score of 19.3 and ending score of 11.3 [n = 19]). 50 patients had GAD-7 ≥10 at enrollment. On average, ending GAD-7 scores decreased 36% from the initial score (average beginning score of 15.4 and ending score of 9.9 [n = 32]). On a 5-point scale, the average patient satisfaction score was 4.3 [range: 4.1-4.5] and the average medical oncology satisfaction score was 4.6 [range: 4.5-4.7]. Financial viability is promising based on projections that 93.4% of psychiatry costs (10% salary + benefits) are covered by reimbursements for care and 2 existing social workers serving as care managers. Conclusions: The collaborative care model is an effective and financially sustainable approach to promptly address depression and anxiety symptoms in BC. Further studies are needed to assess its applicability to patients with other forms of cancers.

Pedagogical devices as children’s social care levers: A study of social care workers’ attitudes towards boarding schools to care for and educate children in need

It has been proposed that boarding schools in England can be used to provide a stable education and care environment for vulnerable children in need, and the government is expanding their use. However, for vulnerable children to be placed in boarding schools, social workers will need to be willing to contemplate boarding as a viable care option. In this study we interviewed N = 21 social care practitioners including directors, senior and middle managers, frontline social workers, social worker‐academics and family support workers who work with vulnerable children. Using thematic analysis of the transcribed interviews, seven major themes identified a range of issues and concerns held by social care workers about placing vulnerable children in boarding schools. We present these themes and consider the issues that will have to be addressed prior to changes in policy and practice. The study concludes that many of those within the social work profession are unlikely to consider boarding as an intervention for children in need. Further research in this area is a matter of urgency.

Social work in hospice and palliative care in Europe: Findings from an EAPC survey.

Social work is considered to be a key player in Hospice and Palliative Care. To prove this claim, the Social Worker Task Force within the European Association for Palliative Care (EAPC) decided to carry out a survey. The aim of this survey was to generate basic data and thus to create a basis for further development of Palliative Care Social Work (PCSW) in Europe. The online survey consisted of two parts: in Part 1, the 57 collective members of the EAPC were asked to fill in an online questionnaire containing questions about basic data. In Part 2, individual Palliative Care Social Workers (SWs) from all over Europe were asked to fill in another questionnaire with a focus on the basic conditions concerning their jobs as well, as on their tasks and roles. Thirty-two collective members of the EAPC completed the online questionnaire. SWs can be found in all of the Palliative Care settings, but there are considerable differences between the countries concerning the prevalence of SWs. Only five countries (20%) reported specialized qualification training in PCSW and just around half of the responding SWs had such a specialized training. The responding SWs (n = 360) were quite content with their working conditions. Tasks concerning patient and family and tasks concerning the interprofessional team were most prominent. There is a significant role overlap with other professions. The study reveals a very mixed picture of PCSW in Europe. This could be due to the high adaptability of social work, which is to be as flexible as possible to the needs of its clients. However, significant patterns, similarities, and differences emerge. The present study may, therefore, serve as a basis for further in-depth studies.

Rising to the challenge of COVID-19

Journal of Prescribing PracticeVol. 2, No. 5 EditorialFree AccessRising to the challenge of COVID-19Tom AllawayTom AllawayEditorSearch for more papers by this authorTom AllawayPublished Online:12 May 2020https://doi.org/10.12968/jprp.2020.2.5.213AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Tom AllawayIn the midst of the COVID-19 pandemic, I am humbled by the stories I am hearing from the frontline about you, our healthcare workers. From talking to many of the journal's regular contributors who are working day-to-day to help the public in their roles, I can only begin to comprehend the sacrifice you are making.Of course, the news is largely consumed with news of the pandemic, and it can be an overwhelming experience watching every day. As the number of deaths continues to grow, I think it is important to consider how many lives have also been saved. Whether progress is being made quickly enough is questionable; the UK government today (29 April 2020) announced the virus testing is now being extended to millions more, including any of those who can't work from home, all care home residents and staff and those over 65 (BBC News, 2020). No 10 aims to hit its target of 100 000 tests per-day by tomorrow, with just over 43 000 taking place as of Monday – by the time this issue is published, we will know whether this target was reached. One statistic indicating that the measures in place may be working is the number of people in hospital with illnesses related to COVID-19 has fallen from a peak of 21 000 on April 13 to 15 796 on April 27 (Giles, 2020). There is continued concern about the government's failings to provide the necessary PPE to healthcare workers, which will undoubtedly continue to be an invaluable resource that should be considered an unquestionable necessity at such a time. Health Secretary, Matt Hancock, told BBC News (2020b) ‘we have been moving heaven and earth’ to get sufficient PPE to the frontline in a ‘mammoth effort’. We shall see if these promises are met.Yesterday, like many others around the country, I partook in the one-minute silence to remember the healthcare and key workers we have lost thus far during the pandemic. Andrea Sutcliffe, the chief executive and registrar of the Nursing and Midwifery Council, said: ‘our tribute in silence…is as important as the noisy cheering for the NHS, social care and key workers on a Thursday evening’.As of today, the total number of confirmed COVID-19 cases sits at 161 145 and 21 678 deaths (Worldometer, 2020). This figure is going to rise, but I have faith your continued perseverance against the virus will win out. If there is one thing I have learnt from being the editor of this journal over the past five months, it is that the NMP community will continue to rise to the challenges faced – your resilience and determination should never be underestimated.Here at the Journal of Prescribing Practice, I'm doing my best to stay on top of the many Rapid Guidelines that the National Institute for Health and Care Excellence are publishing to guide prescribing for conditions that put patients in the ‘at-risk’ category. Some of these can be found in our Updates page (p214) this week. Elsewhere, our regular contributor Ruth Paterson examines the continued guidance and treatment on those presenting to hospital with suspected severe COVID-10 infection (p220).Once again: take care, stay safe, and thank you. References BBC News. Coronavirus: Testing opens for millions more people in England. 2020a. https://www.bbc.co.uk/news/uk-52466814 (accessed 29 April 2020) Google ScholarBBC News. Coronavirus: PM ‘focused on PPE delivery’ on return to work. 2020b. https://www.bbc.co.uk/news/uk-politics-52455778 (accessed 29 April 2020) Google ScholarGiles, G. How close is the UK to easing the coronavirus lockdown. 2020. https://www.ft.com/content/d0dc03f2-eafa-497e-a982-c10b147605ed (accessed 29 April 2020) Google ScholarWorldometer. Coronavirus. 2020. https://www.worldometers.info/coronavirus/country/uk/ (accessed 29 April 2020) Google Scholar FiguresReferencesRelatedDetails 2 May 2020Volume 2Issue 5ISSN (print): 2631-8385ISSN (online): 2631-8393 Metrics History Published online 12 May 2020 Published in print 2 May 2020 Information© MA Healthcare LimitedPDF download

Sharpening the global focus on ethnicity and race in the time of COVID-19

Sharpening the global focus on ethnicity and race in the time of COVID-19

Creating a Seat at the Table: How Family Meetings Elucidate the Palliative Care Social Work Role.

Background: Palliative care social workers (PCSWs) play a crucial role in optimizing communication and family-centered care for seriously ill patients. However, PCSWs often struggle to demonstrate and receive open acknowledgment of their essential skill set within medical teams. Objective: This case discussion focuses on the care of patients and families surrounding family meetings to highlight the crucial role of the PCSW in (1) preparing the family; (2) participating in the provider meeting; (3) participating in the family meeting; and (4) following up after the meeting. The aim is to illuminate how the PCSWs can demonstrate their unique and essential skill set to medical teams and as a means of furthering the work of psychosocial clinicians throughout medical systems. Conclusion: As the medical model continues to shift toward family-centered care, it is crucial for medical teams to optimize their partnership with patients and families. PCSWs can offer a trauma-informed biopsychosocial-spiritual lens that is instructed by continuity of care and exemplary clinical and rapport-building skills. PCSWs can play a critical role in optimizing communication, support, collaboration, and family-centered whole-person care.

P67 Risk factors for musculoskeletal pain amongst health and social care workers in the UK: results from the Health and Employment After Fifty (HEAF) study

Abstract Background Musculoskeletal disorders are one of the main causes of sickness absence in the UK and their prevalence is likely to increase in workers, with the rise of state pension age. Previous research has shown that these conditions are common among health and social care workers. Therefore, we aimed to describe the prevalence of musculoskeletal pain among health and social care workers and to explore personal and occupational risk factors for pain at specific anatomical sites and for multi-site pain. Methods We used data from the second year of follow up of the Health and Employment After Fifty (HEAF) study, a cohort study of 8,134 adults aged 50-64, recruited through 24 English general practices. Health and social care workers, identified through the Standard Occupational Classification 2010, were the focus of this cross-sectional analysis. The outcome under investigation was self-reported pain lasting more than a day in the past month, at one or more of eight anatomical sites: neck, low back, mid-back, shoulder, elbow, wrist/hand, knee, foot/ankle. Socio-demographic variables, self-reported health measures, psychosocial work factors (job dissatisfaction, lack of appreciation, lack of support) and occupational activities (kneeling or squatting for more than 1 hr/day, standing for most of the day) were ascertained through postal questionnaire, and associations with pain at specific anatomical sites and multi-site (≥2 anatomical sites) pain were explored with logistic regression, firstly adjusted for age and sex and then adjusted for additional confounders. Results A total of 282 participants were working in health and social care at second year follow up. Mean age was 59 years and 90% of them were women. Of these workers, n = 199 (71%) reported pain in at least one site, while n = 147 (52%) reported multi-site pain. The most reported anatomical sites with pain were knee and low back, with a prevalence of 39% and 34% respectively. Significant risk factors for knee pain were poor self-rated health (OR = 4.2; 95%CI 2.1 to 8.2) and being exposed to kneeling for longer than an hour/day at work (OR = 2.0; 95%CI 1.2 to 3.4). Similar results were found for low back pain, while for multi-site pain mental exhaustion also appeared to have an effect. None of the socio-demographic variables or psychosocial work factors influenced the outcomes. Conclusion In a sample of health and social care workers in the UK, the prevalence of low back, neck and multi-site pain is high. The common risk factors were being exposed to kneeling at work and reporting poor/fair health. Disclosures S. D'Angelo: None. G. Ntani: None. H. Syddall: None. E.C. Harris: None. C. Linaker: None. M. Stevens: None. K. Walker-Bone: None.

Documenting the contributions of palliative care social work: testing the feasibility and utility of tracking clinical activities using medical records

ABSTRACTAccess to data on quality metrics can better equip palliative care social workers to identify and address gaps in patient care, establish standards and accountability for social work functions on the interdisciplinary team, and evaluate the impact of interventions. The objective of this demonstration project was to create and pilot a data collection format in the patient electronic medical record (Epic) for documentation of social work metrics at each inpatient consultation, and to build corresponding pilot reports relevant to quality improvement goals. The successful implementation and initial pilot reports were reviewed for the feasibility of longer-term applications.

Perspectives of mental healthcare providers on pathways to improved employment for persons with mental disorders in two lower middle-income countries

BackgroundMental disorders affect employment and the ability to work, and mental healthcare providers are important in the promotion of health and employment for affected individuals. The objective of this study is to explore the perspectives of mental healthcare providers on pathways to improved employment for persons with mental disorders in two lower middle-income countries.MethodsOur study participants included mental healthcare providers (psychiatrists, occupational physicians, psychologists, and social care workers) from Kenya and Nigeria. Qualitative interviews and a focus group discussion were conducted with 15 professionals in Kenya and online questionnaires were completed by 80 professionals from Nigeria.ResultsThe study participants suggested that work is important for the recovery and wellbeing of persons with mental disorders. A complex interplay of factors related to the health of persons with mental disorders and the socioeconomic system in their setting were identified as barriers to their work ability and employment. Participants proposed four pathways to improved employment: including information on reducing stigma, better healthcare, policy advocacy in employment, and government commitment to healthcare and social welfare. Public education to reduce stigma and better healthcare were the highest reported facilitators of employment.ConclusionsPersons with mental disorders require multilevel support and care in obtaining and retaining employment. A better mental healthcare system is essential for the employment of persons with mental disorders.