Public policy and employment of people with disabilities: exploring new paradigms

The Time Is Ripe for Entrepreneurship in Vocational Rehabilitation: A Four-Pronged Approach

The field of rehabilitation has laid a great foundation for the monumental entrepreneurial changes that have occurred to the worldwide economy due to the COVID-19 pandemic. The use of self-employment as an outcome has fallen below 1% of Vocational Rehabilitation closures but can rise as the field takes a four-pronged approach to helping individuals become entrepreneurs. The idea of entrepreneurship fits rehabilitation philosophy and through training, legislation, and new vision many persons with disabilities can find successful careers as entrepreneurs.

Barriers to and facilitators of employment for people with psychiatric disabilities in Africa: a scoping review

BACKGROUND

Despite the importance of inclusive employment, described in Goal 8 of the Sustainable Development Goals (SDGs), employment of persons with psychiatric disabilities in Africa is lower than among the general population.

OBJECTIVE

The aim of this scoping review is to explore evidence related to the barriers to and facilitators of employment of persons with psychiatric disabilities in Africa.

METHODS

A literature search was conducted using six relevant electronic databases of articles published between 1990 and 2017.

RESULTS

Eight studies were identified and analysed regarding barriers and facilitators of employment of persons with psychiatric disabilities. The dynamic adaptation of the bio-psycho-social model was used as an analytical framework. Identified barriers include ill health, (anticipated) psychiatric illness, social stigma and discrimination, negative attitudes among employers and the lack of social support and government welfare. Facilitators of employment include stability of mental illness, heightened self-esteem, a personal decision to work despite stigma, competitive and supported employment, reduction in social barriers/stigma and workplace accommodations.

CONCLUSION

Employment of persons with psychiatric disabilities is essential, yet there is dearth of scientific evidence to identify contextual models that might be useful in African countries and other low-and middle countries (LMICs). This gap in information would benefit from further research to improve the employment rates of persons with psychiatric disabilities in Africa.

Advocacy Issues and Strategies for the 21st Century

The authors conducted key informant interviews with 16 disability advocacy and research leaders; half of the interviews were with leaders in shaping national disability policy during and after passage of the Americans with Disabilities Act of 1990, and half were with state and local leaders representing constituencies who had not had a visible presence at the national level. During audiotaped telephone interviews, we asked the informants to identify the top 5 advocacy priorities for the next 10 years, as well as what strategies they thought could advance the disability advocacy agenda. Two overarching themes emerged: the impact of poverty among people with disabilities and the connections among various advocacy issues. The authors discuss the 5 issues most often cited by the participants, as well as issues particular to various constituencies, and draw conclusions about what strategies would advance the disability agenda.

Reasons for job separations in a cohort of workers with psychiatric disabilities

We explored the relative effects of adverse working conditions, job satisfaction, wages, worker characteristics, and local labor markets in explaining voluntary job separations (quits) among employed workers with psychiatric disabilities. Data come from the Employment Intervention Demonstration Program in which 2,086 jobs were ended by 892 workers during a 24 mo observation period. Stepped multivariable logistic regression analysis examined the effect of variables on the likelihood of quitting. Over half (59%) of all job separations were voluntary while 41% were involuntary, including firings (17%), temporary job endings (14%), and layoffs (10%). In multivariable analysis, workers were more likely to quit positions at which they were employed for 20 h/wk or less, those with which they were dissatisfied, low-wage jobs, non-temporary positions, and jobs in the structural (construction) occupations. Voluntary separation was less likely for older workers, members of racial and ethnic minority groups, and those residing in regions with lower unemployment rates. Patterns of job separations for workers with psychiatric disabilities mirrored some findings regarding job leaving in the general labor force but contradicted others. Job separation antecedents reflect the concentration of jobs for workers with psychiatric disabilities in the secondary labor market, characterized by low-salaried, temporary, and part-time employment.

Hiring discrimination against people with disabilities under the ADA: characteristics of charging parties

INTRODUCTION

This article describes findings from a causal comparative study of the characteristics of Charging Parties who filed allegations of Hiring discrimination with the U.S. Equal Employment Opportunity Commission (EEOC) under Title I of the Americans with Disabilities Act (ADA) between 1992 and 2005.

METHODS

Charging Party Characteristics derived from 19,527 closed Hiring allegations are compared and contrasted to 259,680 closed allegations aggregated from six other prevalent forms of discrimination including Discharge and Constructive Discharge, Reasonable Accommodation, Disability Harassment and Intimidation, and Terms and Conditions of Employment. Tests of Proportion distributed as chi-square are used to form comparisons along a variety of factors including age, gender, impairment, and ethnicity.

RESULTS

Most allegations of ADA job discrimination fall into the realm of job retention and career advancement as opposed to job acquisition. Hiring allegations, however, tend to be filed by Charging Parties who are disproportionately male, younger or older applicants, white, and coping with physical or sensory disabilities.

CONCLUSION

Prevailing theories about stigma suggest that negative attitudes are more prevalent toward persons with behavioral disabilities. However, this study provides clear evidence that one behavioral manifestation of negative attitudes, Hiring discrimination, is more often directed at persons with physical or sensory impairments. More outreach regarding ADA rights appears indicated for individuals who share the aforementioned characteristics.

An analysis of the definitions and elements of recovery: a review of the literature

As mental health recovery gains traction, many people have put forward varying definitions. Few attempts have been made to create a dimensional analysis of the recovery literature that assesses the growing consensus about what recovery is or what its definition should entail. This paper incorporates an ecological framework to take the individual's life context into account while emphasizing both the reestablishment of one's mental health (i.e., first order change) and the mitigation of the oppressive nature of barriers imposed by the greater community (i.e., second order change) so that people may experience social integration and community inclusion.

Demographic characteristics and employment among people with severe mental illness in a multisite study

People with psychiatric disabilities experience disproportionately high rates of unemployment. As research evidence is mounting regarding effective vocational programs, interest is growing in identifying subgroup variations. Data from a multisite research and demonstration program were analyzed to identify demographic characteristics associated with employment outcomes, after adjusting for the effects of program, services, and study site. Longitudinal analyses found that people with more recent work history, younger age, and higher education were more likely to achieve competitive employment and to work more hours per month, while race and gender effects varied by employment outcome. Results provide strong evidence of demographic subgroup variation and need.

Combining evidence-based practice with stakeholder consensus to enhance psychosocial rehabilitation services in the Texas benefit design initiative

This article describes the use of evidence-based practice along with a multi-stakeholder consensus process to design the psychosocial rehabilitation components in a benefit package of publicly funded mental health services in Texas. The Texas Benefit Design initiative demonstrates how the combination of science and consensus can be used as a powerful tool for change. It applies the findings of rigorous research regarding psychosocial rehabilitation service delivery approaches that achieve positive outcomes in real world, community settings. At the same time, it makes use of the unique knowledge and experience that mental health service consumers, providers and other advocates can bring to service system design and planning.

‘How Do You Pay Your Rent?’ Social Policies And The President’s Mental Health Commission

Mental health policy involves broad social policies related to housing, education, work disability and rehabilitation, welfare, and criminal justice. The modern era of community care has moved patients, clinicians, and policymakers from closed institutions into the mainstream of society and its health and human service systems. The importance of knowing about the broad array of human services and their policies is reflected in the deliberations and policy recommendations of the President's New Freedom Commission on Mental Health. It is hoped that these recommendations will provide a roadmap for further change to enable people affected by severe mental illness "to live, learn, work, and participate fully in their communities."

Technology for independence: a community-based resource center

Despite the prominence of the disability civil rights model--with its values of inclusion and empowerment--the majority of social and policy research conducted to date has not sufficiently included the perspective of persons with disabilities in the research process and as uniquely qualified researchers themselves. This article describes a new project, "Technology for Independence: A Community-Based Resource Center" (CBRC). Over a five-year period, the CBRC will attempt to enhance community and consumer-directed disability organizations to design, implement, and disseminate research that promotes access to and use of assistive technology (AT). The CBRC will use strategies such as leadership training, participatory action research, technical assistance, web-assisted training, and annual symposia. A primary goal of the CBRC is to increase the capacity of community organizations to conduct research on AT that is scientifically rigorous and relevant to disability services, policy, and law.