Disabling working environments and mental health: A commentary

"It Is a Big Spider Web of Things": Sensory Experiences of Autistic Adults in Public Spaces

Background

Sensory processing differences are commonly experienced by autistic individuals, and some sensory experiences can greatly impact the mental health and quality of life of individuals. Previous research suggests that adapting the sensory nature of environments may improve individual experiences and engagement with these spaces. However, knowledge about which public places are particularly disabling is limited, especially from the perspective of autistic individuals. Little is also known about what in the sensory environment makes them particularly disabling.

Methods

In this participatory research study, we investigated the sensory experiences of autistic adults in public spaces. We used an online focus group method, recruiting 24 autistic adults across 7 focus groups. We applied content analysis, reflexive thematic analysis, and case study analysis.

Results

The results of the content analysis showed that supermarkets, eateries (i.e., restaurants, cafés, pubs), highstreets and city/town centers, public transport, health care settings (i.e., doctor's surgeries and hospitals), and retail shops and shopping centers are experienced to be commonly disabling sensory environments for autistic adults. However, outdoor spaces, retail shops, museums, concert venues/clubs, cinemas/theaters, and stadiums are identified to be commonly less disabling sensory environments. In addition, through reflexive thematic analysis we identified 6 key principles that underlie how disabling or enabling sensory environments are: Sensoryscape (sensory environment), Space, Predictability, Understanding, Adjustments, and Recovery. We represented these principles as a web to emphasize the interconnected, dimensional spectrum of the different themes. Lastly, we used case study analysis to evidence these principles in the commonly disabling sensory environments for richer detail and context and to provide credibility for the principles.

Conclusions

Our findings have important implications for businesses, policy, and built environment designers to reduce the sensory impact of public places to make them more enabling for autistic people. By making public spaces more enabling, we may be able to improve quality of life for autistic individuals.

The working disadvantaged: the role of age, job tenure and disability in precarious work

BACKGROUND

Precarious work is an increasingly common characteristic of industrialized labor markets that can widen health inequities, especially among disadvantaged workforce segments. Study objectives are to compare precarious employment in workers with and without disabilities, and to examine the modifying effect of disability in the relationships between age, job tenure and precarious work.

METHODS

Employed Canadians with (n = 901) and without disabilities (n = 901) were surveyed on exposure to precarious working conditions. Information on age and job tenure were collected from respondents along with sociodemographic, health and work context details. Multivariable logistic models examined the association between disability and precarious work. Also, multigroup probit models examined precarious work for young (18-35 yrs), middle-aged (36-50 yrs) and older adults (> 50 yrs) and job tenure and was stratified by participants with and without disabilities.

RESULTS

Almost equal proportions of young, middle-aged and older participants were recruited. Mean job tenure of participants was 9.5 years (SD = 9.0). Close to one-third of participants reported working precariously. At the multivariable level, a disability was not associated with working precariously. However, multigroup modelling indicated that disability was a significant effect-modifier. Older adults with a disability had a 1.88 times greater odds of reporting precarious work when compared to young adults (OR = 1.88, 95%CI 1.19, 2.98). When reporting a disability, longer job tenure was related to a 0.95 times lower odds of precarious work (OR = 0.95 95%CI 0.93, 0.98). The relationship between age and job tenure was not significant for those not reporting a disability.

DISCUSSION

Precarious work has the potential to affect workers with and without disabilities. For those with a disability, being an older adult and/or a new worker can contribute to a greater likelihood of being employed precariously. Policies and programs can be recommended to address precarious working conditions and related health inequities for people with disabilities based on life and career phase.

'I'm proud of how far I've come. I'm just ready to work': mental health recovery narratives within the context of Australia's Disability Employment Services

Background

Employment is recognised as facilitating the personal and clinical recovery of people with psychosocial disability. Yet this group continue to experience considerable barriers to work, and, constitute a significant proportion of individuals engaged with Disability Employment Services (DES). Recognition of the role of recovery-oriented practice within DES remains limited, despite these approaches being widely promoted as best-practice within the field of mental health.

Methods

The Improving Disability Employment Study (IDES) aims to gather evidence on factors influencing employment outcomes for Australians with disability. Descriptive analysis and linear regression of IDES survey data from 369 DES participants, alongside narrative analysis of data collected through 56 in-depth interviews with 30 DES participants with psychosocial disability, allowed us to explore factors influencing mental health, well-being and personal recovery within the context of DES.

Results

Psychosocial disability was reported as the main disability by 48% of IDES respondents. These individuals had significantly lower scores on measures of mental health and well-being (44.9, 48.4 respectively, p ≤ 0.01), compared with respondents with other disability types (52.2, 54.3 p ≤ 0.01). Within this group, individuals currently employed had higher mental health and well-being scores than those not employed (47.5 vs 36.9, 55.5 vs 45.4 respectively, p ≤ 0.01). Building on these findings, our qualitative analysis identified five personal recovery narratives: 1) Recovery in spite of DES; 2) DES as a key actor in recovery; 3) DES playing a supporting role in fluctuating journeys of recovery; 4) Recovery undermined by DES; and, 5) Just surviving regardless of DES. Narratives were strongly influenced by participants’ mental health and employment status, alongside the relationship with their DES worker, and, participants’ perspectives on the effectiveness of services provided.

Conclusion

These findings re-iterate the importance of work in supporting the mental health and well-being of people with psychosocial disability. Alongside access to secure and meaningful work, personal recovery was facilitated within the context of DES when frontline workers utilised approaches that align with recovery-orientated practices. However, these approaches were not consistently applied. Given the number of people with psychosocial disability moving through DES, encouraging greater consideration of recovery-oriented practice within DES and investment in building the capacity of frontline staff to utilise such practice is warranted.