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Baba N, Tanimura A, Ishi Y. Subjective perceptions that affect the continued employment of persons with mental disabilities in Japan: A mixed-methods study. Work 2023:WOR220144. [PMID: 36641725 DOI: 10.3233/wor-220144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Among people with mental disabilities in Japan, 50.7% have left employment within a year despite the provision of employment support. Their subjective perceptions are likely relevant, as many causes for leaving employment are personal. However, thus far, employment continuity assessment has been based on objective indicators, while subjective evaluation remains underdeveloped. OBJECTIVE We conducted a mixed-methods study to identify the subjective characteristics that impact the ability of persons with mental disabilities to continue working while receiving employment support. METHODS In total, 41 participants with mental disabilities in continuous employment were included in the study, and data were collected using a demographic and employment status questionnaire and the Worker's Role Interview. Further, to clarify the constructs related to subjective perceptions of work continuity, the step for coding and theorization (SCAT) method was utilized. RESULTS The results revealed five overarching superordinate concepts and 12 subordinate concepts of subjective perceptions regarding maintaining the current work and the future for participants who continue to work. These perceptions may be related to the participants' experience and the time course of work continuity. Subjective perceptions of difficulty levels were found to be the most and the least difficult for a reasonable accommodation without specific rules and awareness of the effects of work concepts, respectively. CONCLUSION This research could facilitate the development of an employment support system based on people with mental disabilities' subjective needs, thus contributing to their continued employment.
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Gühne U, Pabst A, Kösters M, Hasan A, Falkai P, Kilian R, Allgöwer A, Ajayi K, Baumgärtner J, Brieger P, Frasch K, Heres S, Jäger M, Küthmann A, Putzhammer A, Schneeweiß B, Schwarz M, Becker T, Breilmann J, Riedel-Heller SG. Predictors of competitive employment in individuals with severe mental illness: results from an observational, cross-sectional study in Germany. J Occup Med Toxicol 2022; 17:3. [PMID: 35042511 PMCID: PMC8767732 DOI: 10.1186/s12995-022-00345-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 01/03/2022] [Indexed: 12/02/2022] Open
Abstract
Background Employment is of great importance as it is associated with various positive effects. Individuals with severe mental illness (SMI) are often excluded from competitive employment. Current data on employment of individuals with mental illness are rare, and influencing factors are under-researched. The present study examines possible predictors of competitive employment among individuals with SMI. Methods This was a cross-sectional and multicentered study of 300 individuals with SMI aged 18 to 65 years. The following inclusion criteria were used: (I) diagnosis of schizophrenia, schizotypal and delusional disorders (ICD-10 F2x), or affective disorders (ICD-10 F3x), (II) duration of psychiatric illness ≥ 2 years, and (III) substantial impact of illness on social functioning. Participants were interviewed by trained staff using standardised instruments. The relationship between potential predictors (age, sex, education, marital status, living situation, migration background, psychosocial functioning, age at first mental problem, physical illness, work ability) and employment was analysed using a hierarchic binary logistic regression model. Results Only one-third (34%) of participants were competitively employed. Almost one-third were unemployed (30%), and 28% reported early retirement due to mental illness. Psychosocial functioning was positively associated with competitive employment (OR = 1.09, 95% CI: 1.05 – 1.13, p < 0.001); concurrent chronic physical illness was negatively associated with competitive employment (OR = 0.38, 95% CI: 0.21 – 0.71, p = 0.002). Conclusions Findings confirm a high risk of exclusion from competitive employment among individuals with SMI. Nonetheless, a substantial proportion of individuals are employed. Findings call for efforts to maintain or enhance workforce participation among individuals with SMI. A special focus should be placed on improving physical health and strengthening psychosocial functioning. Trial registration The study was registered in the German Clinical Trials Register (DRKS) under the registration number DRKS00015801 before the start of recruitment (Registration date: 21.02.2019).
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Affiliation(s)
- Uta Gühne
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany.
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
| | - Markus Kösters
- Department of Psychiatry and Psychotherapy II, Ulm University, BKH Günzburg, Günzburg, Germany
| | - Alkomiet Hasan
- Department of Psychiatry, Psychotherapy and Psychosomatic, University of Augsburg, Medical Faculty, BKH Augsburg, Augsburg, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital Munich, Munich, Germany
| | - Reinhold Kilian
- Department of Psychiatry and Psychotherapy II, Ulm University, BKH Günzburg, Günzburg, Germany
| | - Andreas Allgöwer
- Institute for Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | | | - Jessica Baumgärtner
- Department of Psychiatry, Psychotherapy and Psychosomatic, University of Augsburg, Medical Faculty, BKH Augsburg, Augsburg, Germany
| | | | - Karel Frasch
- Department of Psychiatry and Psychotherapy II, Ulm University, BKH Günzburg, Günzburg, Germany.,Department of Psychiatry, Psychotherapy and Psychosomatic, District hospital Donauwörth, Donauwörth, Germany
| | | | - Markus Jäger
- Department of Psychiatry and Psychotherapy II, Ulm University, BKH Günzburg, Günzburg, Germany.,Department of Psychiatry, Psychotherapy and Psychosomatic, District hospital Kempten, Kempten, Germany
| | - Andreas Küthmann
- Department of Psychiatry, Psychotherapy and Psychosomatic, District hospital Memmingen, Memmingen, Germany
| | - Albert Putzhammer
- Department of Psychiatry, Psychotherapy and Psychosomatic, District hospital Kaufbeuren, Kaufbeuren, Germany
| | | | | | - Thomas Becker
- Department of Psychiatry and Psychotherapy II, Ulm University, BKH Günzburg, Günzburg, Germany
| | - Johanna Breilmann
- Department of Psychiatry and Psychotherapy II, Ulm University, BKH Günzburg, Günzburg, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
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