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Irvine A, Haggar T. Conceptualising the social in mental health and work capability: implications of medicalised framing in the UK welfare system. Soc Psychiatry Psychiatr Epidemiol 2024; 59:455-465. [PMID: 36912993 PMCID: PMC10944406 DOI: 10.1007/s00127-023-02449-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 02/27/2023] [Indexed: 03/14/2023]
Abstract
PURPOSE This paper asks whether the separation of mental health from its wider social context during the UK benefits assessment processes is a contributing factor to widely recognised systemic difficulties, including intrinsically damaging effects and relatively ineffective welfare-to-work outcomes. METHODS Drawing on multiple sources of evidence, we ask whether placing mental health-specifically a biomedical conceptualisation of mental illness or condition as a discrete agent-at the core of the benefits eligibility assessment process presents obstacles to (i) accurately understanding a claimant's lived experience of distress (ii) meaningfully establishing the specific ways it affects their capacity for work, and (iii) identifying the multifaceted range of barriers (and related support needs) that a person may have in relation to moving into employment. RESULTS We suggest that a more holistic assessment of work capacity, a different kind of conversation that considers not only the (fluctuating) effects of psychological distress but also the range of personal, social and economic circumstances that affect a person's capacity to gain and sustain employment, would offer a less distressing and ultimately more productive approach to understanding work capability. CONCLUSION Such a shift would reduce the need to focus on a state of medicalised incapacity and open up space in encounters for more a more empowering focus on capacity, capabilities, aspirations, and what types of work are (or might be) possible, given the right kinds of contextualised and personalised support.
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Affiliation(s)
- Annie Irvine
- ESRC Centre for Society and Mental Health, King's College London, London, UK.
| | - Tianne Haggar
- The Policy Institute, King's College London, London, UK
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Vieira dos Santos J, Gomes A, Rebelo DFS, Lopes LFD, Moreira MG, da Silva DJC. The consequences of job crafting and engagement in the relationship between passion for work and individual performance of Portuguese workers. Front Psychol 2023; 14:1180239. [PMID: 37663331 PMCID: PMC10473114 DOI: 10.3389/fpsyg.2023.1180239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 06/28/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction This study sought to relate the two types of work passion, harmonious passion and obsessive passion, to the organizational consequences of engagement, job crafting, and perceived individual job performance. This study was based on the Employee Work Passion Appraisal model and conducted to evaluate possible statistical associations of the dualistic approach of passion used as an antecedent of positive and negative organizational outcomes (engagement, job crafting, and perceived individual job performance). Methods The data collection and analysis for this study were accomplished by a transversal and quantitative study design. A non-probabilistic method was used to select a convenience sample composed of 305 Portuguese workers and was collected online from March to October 2020. The proposed hypotheses were evaluated using partial structural equation models. Results Overall, the results supported the proposed hypotheses and showed that harmonious passion positively affected organizational outcomes, while obsessive passion negatively affected these outcomes; notably, our findings also revealed high individual performance, high obsessive passion, and consequently, a significant increase in structural labor resources, a significant decrease in harmful labor demands, and high absorption. Discussion The findings highlight the importance of distinguishing between harmonious passion and obsessive passion in understanding their consequences for organizational outcomes. Promoting harmonious passion while managing the potential negative effects of obsessive passion is crucial for enhancing positive job-related behaviors and performance. Future research should explore interventions and strategies to foster harmonious passion, mitigate the negative impacts of obsessive passion, and ultimately improve overall work engagement and performance.
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Affiliation(s)
| | - Alexandra Gomes
- Centro de Investigação em Psicologia (CIP, UAlg), Lisbon, Portugal
| | | | - Luis Felipe Dias Lopes
- Centro de Ciências Naturais e Exatas (CCSH, UFSM), Programa de Pós-graduação em Administração, Universidade Federal de Santa Maria, Santa Maria, Brazil
| | - Martiele Gonçalves Moreira
- Centro de Ciências Naturais e Exatas (CCSH, UFSM), Programa de Pós-graduação em Administração, Universidade Federal de Santa Maria, Santa Maria, Brazil
| | - Deoclécio Junior Cardoso da Silva
- Centro de Ciências Naturais e Exatas (CCSH, UFSM), Programa de Pós-graduação em Administração, Universidade Federal de Santa Maria, Santa Maria, Brazil
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Cheng Q, Cunningham EB, Shih S, Amin J, Bruneau J, Artenie AA, Powis J, Litwin AH, Cooper C, Dalgard O, Hellard M, Bruggmann P, Marks P, Lacombe K, Stedman C, Read P, Hajarizadeh B, Dunlop AJ, Conway B, Feld JJ, Dore GJ, Grebely J. Patient-Reported Outcomes During and After Hepatitis C Virus Direct-Acting Antiviral Treatment Among People Who Inject Drugs. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:883-892. [PMID: 36646278 DOI: 10.1016/j.jval.2022.12.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/29/2022] [Accepted: 12/20/2022] [Indexed: 06/04/2023]
Abstract
OBJECTIVES People who inject drugs (PWID) are at a high risk of hepatitis C virus (HCV) infection. HCV cure is associated with improved patient-reported outcomes (PROs), but there are little data among PWID. This study aimed to assess the change in PROs during and after HCV direct-acting antiviral (DAA) treatment. METHODS This analysis used data from 2 clinical trials of DAA treatment in PWID. PROs assessed included health-related quality of life, social functioning, psychological distress, housing, and employment. Generalized estimating equations and group-based trajectory modeling were used to assess changes in PROs over time. RESULTS No significant changes in the 3-level version of EQ-5D scores, EQ visual analogue scale scores, social functioning, psychological distress, and housing were observed over the 108-week study period. There was a significant increase in the proportion of participants employed (18% [95% confidence interval (CI) 12%-23%] at baseline to 28% [95% CI 19%-36%] at the end of the study). Participants were more likely to be employed at 24 weeks and 108 weeks after commencing treatment. Having stable housing increased the odds of being employed (odds ratio 1.70; 95% CI 1.00-2.90). The group-based trajectory modeling demonstrated that most outcomes remained stable during and after DAA treatment. CONCLUSIONS Although no significant improvement was identified in health-related quality of life after HCV DAA treatment, there was a modest but significant increase in employment during study follow-up. The study findings support the need for multifaceted models of HCV care for PWID addressing a range of issues beyond HCV treatment to improve quality of life.
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Affiliation(s)
- Qinglu Cheng
- The Kirby Institute, University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia.
| | - Evan B Cunningham
- The Kirby Institute, University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia
| | - Sophy Shih
- The Kirby Institute, University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia
| | - Janaki Amin
- The Kirby Institute, University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia; Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Julie Bruneau
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada; Département de médecine, Université de Montréal, Montréal, QC, Canada
| | - Adelina A Artenie
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England, UK
| | - Jeff Powis
- Infection Prevention and Control, Michael Garron Hospital, Toronto, ON, Canada
| | - Alain H Litwin
- Prisma Health Addiction Medicine Centre, Greenville, SC, USA; School of Medicine - Greenville, University of South Carolina, Greenville, SC, USA; School of Health Research, Clemson University, Clemson, SC, USA
| | - Curtis Cooper
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Olav Dalgard
- Department of Infectious Diseases, Akershus University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Margaret Hellard
- The Burnet Institute, Melbourne, VIC, Australia; Department of Infectious Disease, The Alfred Hospital, Melbourne, VIC, Australia
| | | | - Philippa Marks
- The Kirby Institute, University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia
| | - Karine Lacombe
- Faculté de médecine, Sorbonne Université, Paris, France; Infectious Diseases Department, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Catherine Stedman
- Department of Medicine, University of Otago, Christchurch, New Zealand; Gastroenterology Department, Christchurch Hospital, Christchurch, New Zealand
| | | | - Behzad Hajarizadeh
- The Kirby Institute, University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia
| | - Adrian J Dunlop
- Drug & Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, NSW, Australia; Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Brian Conway
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
| | - Jordan J Feld
- Toronto Centre for Liver Disease, University Health Network, Toronto, ON, Canada
| | - Gregory J Dore
- The Kirby Institute, University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia; St Vincent's Hospital, Sydney, NSW, Australia
| | - Jason Grebely
- The Kirby Institute, University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia
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Mallick S, Islam MS. The impact of co-location employment partnerships within the Australian mental health service and policy context: A systematic review. Int J Ment Health Nurs 2022; 31:1125-1140. [PMID: 35429075 PMCID: PMC9543853 DOI: 10.1111/inm.13007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/30/2022] [Accepted: 04/01/2022] [Indexed: 11/28/2022]
Abstract
Adults with a serious persistent mental illness (SPMI) express a strong desire to work. However, they continue to experience higher levels of unemployment, barriers, and occupational exclusion that impact their vocational outcomes and choice of work. The aim of this study was to investigate the impact of co-location partnerships between adult mental health and disability employment services (DES) on employment outcomes and consumer choice of work for adults with a SPMI. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, a systematic literature review was conducted by searching four databases. The relationship between mental health, employment, and DES was examined. Inclusion criteria were adults with a SPMI; employment services and outcomes; and job retention and sustainability. Twelve studies met inclusion criteria. All studies were peer-reviewed, Australian-based, and published between 01 January 2017 and 30 August 2021. Individual placement and support (IPS); DES practice, funding, policy, and reform within the Australian mental health system; and barriers to participation in DES were the three main themes that emerged. Findings highlight the importance of joint, co-location partnerships between mental health and employment services, including a collaborative approach to policy reform between both services, to assist adults with a SPMI to gain and sustain competitive employment. Vocational, non-vocational, systemic, and structural barriers still exist; hence, adults with a SPMI continue to face challenges with gaining and sustaining long-term employment. Hence, it is important for these partnerships to be systematically set up to support the complexity of the employment journey for adults with a SPMI.
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Affiliation(s)
- Sue Mallick
- Vocational Consultant/Senior Occupational Therapist, Western Sydney Local Health District (WSLHD), Mental Health Services, NSW Health, Westmead, New South Wales, Australia
| | - Md Shahidul Islam
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, New South Wales, Australia
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Weld-Blundell I, Shields M, Devine A, Dickinson H, Kavanagh A, Marck C. Vocational Interventions to Improve Employment Participation of People with Psychosocial Disability, Autism and/or Intellectual Disability: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212083. [PMID: 34831840 PMCID: PMC8618542 DOI: 10.3390/ijerph182212083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/11/2021] [Accepted: 11/14/2021] [Indexed: 11/16/2022]
Abstract
Objective: To systematically review interventions aimed at improving employment participation of people with psychosocial disability, autism, and intellectual disability. Methods: We searched MEDLINE, Embase, PsycINFO, Web of Science, Scopus, CINAHL, ERIC, and ERC for studies published from 2010 to July 2020. Randomized controlled trials (RCTs) of interventions aimed at increasing participation in open/competitive or non-competitive employment were eligible for inclusion. We included studies with adults with psychosocial disability autism and/or intellectual disability. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias II Tool. Data were qualitatively synthesized. Our review was registered with PROSPERO (CRD42020219192). Results: We included 26 RCTs: 23 targeted people with psychosocial disabilities (n = 2465), 3 included people with autism (n = 214), and none included people with intellectual disability. Risk of bias was high in 8 studies, moderate for 18, and low for none. There was evidence for a beneficial effect of Individual Placement and Support compared to control conditions in 10/11 studies. Among young adults with autism, there was some evidence for the benefit of Project SEARCH and ASD supports on open employment. Discussion: Gaps in the availability of high-quality evidence remain, undermining comparability and investment decisions in vocational interventions. Future studies should focus on improving quality and consistent measurement, especially for interventions targeting people with autism and/or intellectual disability.
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Affiliation(s)
- Isabelle Weld-Blundell
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia; (I.W.-B.); (M.S.); (A.K.); (C.M.)
| | - Marissa Shields
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia; (I.W.-B.); (M.S.); (A.K.); (C.M.)
| | - Alexandra Devine
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia; (I.W.-B.); (M.S.); (A.K.); (C.M.)
- Correspondence:
| | - Helen Dickinson
- School of Business, University of New South Wales, Canberra 2610, Australia;
| | - Anne Kavanagh
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia; (I.W.-B.); (M.S.); (A.K.); (C.M.)
| | - Claudia Marck
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia; (I.W.-B.); (M.S.); (A.K.); (C.M.)
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Devine A, Shields M, Dimov S, Dickinson H, Vaughan C, Bentley R, LaMontagne AD, Kavanagh A. Australia's Disability Employment Services Program: Participant Perspectives on Factors Influencing Access to Work. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11485. [PMID: 34770000 PMCID: PMC8582653 DOI: 10.3390/ijerph182111485] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/21/2021] [Accepted: 10/29/2021] [Indexed: 11/17/2022]
Abstract
Disability employment programs play a key role in supporting people with disability to overcome barriers to finding and maintaining work. Despite significant investment, ongoing reforms to Australia's Disability Employment Services (DES) are yet to lead to improved outcomes. This paper presents findings from the Improving Disability Employment Study (IDES): a two-wave survey of 197 DES participants that aims to understand their perspectives on factors that influence access to paid work. Analysis of employment status by type of barrier indicates many respondents experience multiple barriers across vocational (lack of qualifications), non-vocational (inaccessible transport) and structural (limited availability of jobs, insufficient resourcing) domains. The odds of gaining work decreased as the number of barriers across all domains increased with each unit of barrier reported (OR 1.22, 95% CI 1.07, 1.38). Unemployed respondents wanted more support from employment programs to navigate the welfare system and suggest suitable work, whereas employed respondents wanted support to maintain work, indicating the need to better tailor service provision according to the needs of job-seekers. Combined with our findings from the participant perspective, improving understanding of these relationships through in-depth analysis and reporting of DES program data would provide better evidence to support current DES reform and improve models of service delivery.
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Affiliation(s)
- Alexandra Devine
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia; (M.S.); (S.D.); (C.V.); (R.B.); (A.K.)
| | - Marissa Shields
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia; (M.S.); (S.D.); (C.V.); (R.B.); (A.K.)
| | - Stefanie Dimov
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia; (M.S.); (S.D.); (C.V.); (R.B.); (A.K.)
| | - Helen Dickinson
- School of Business, University of New South Wales, Canberra 2610, Australia;
| | - Cathy Vaughan
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia; (M.S.); (S.D.); (C.V.); (R.B.); (A.K.)
| | - Rebecca Bentley
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia; (M.S.); (S.D.); (C.V.); (R.B.); (A.K.)
| | - Anthony D. LaMontagne
- School of Health and Social Development, Deakin University, Melbourne 3125, Australia;
| | - Anne Kavanagh
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia; (M.S.); (S.D.); (C.V.); (R.B.); (A.K.)
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McDowell C, Fossey E, Harvey C. Moving clients forward: a grounded theory of disability employment specialists' views and practices. Disabil Rehabil 2021; 44:5504-5512. [PMID: 34190004 DOI: 10.1080/09638288.2021.1937341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE This study sought to better understand the views and practices of disability employment specialists working with clients with mental illness. Specifically, it explored what helps and hinders employment specialists in their work. MATERIALS AND METHODS A constructivist grounded theory methodology was used. Semi-structured interviews with 16 disability employment specialists from four employment service providers in Victoria, Australia, were transcribed and analysed through initial coding, focused coding, and constant comparative methods. RESULTS Analysis led to the substantive grounded theory of "moving clients forward." The key themes included "taking a firm but fair approach," "meeting clients where they are at," "getting clients ready for work," "managing the interface between clients and employers," and as a consequence, "working under pressure." CONCLUSIONS These findings contribute the first grounded theory of how Australian disability employment specialists work with clients with mental illness and enhance understanding of employment specialists' notions of job readiness and their use of discretion in implementing seemingly contradictory employment-related policies. Practice tensions for these employment specialists could be reduced by modifying disability employment policies, and through training to deliver evidence-based practices that offer varied vocational services, pathways, and adjunct interventions tailored to clients' interests, needs and readiness for change.IMPLICATIONS FOR REHABILITATIONAustralian disability employment specialists experience tensions between meeting the needs of clients with mental illness and feeling pressured to adhere to performance-based funding and disability employment policies.Greater emphasis on evidence-based, individualised vocational interventions would better align with a recovery orientation and offer vocational options tailored to the needs and goals of job seekers with mental illnessFurther training and systemic support is needed for disability employment specialists to adopt evidence-based practices in their work with jobseekers with mental illness.Since Australian disability employment specialists describe considering the "job readiness" of clients in practice, the usefulness of this concept merits further investigation.
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Affiliation(s)
- Caitlin McDowell
- Department of Community and Clinical Allied Health, La Trobe University, Melbourne, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.,Melbourne Health, NorthWestern Mental Health, Melbourne, Australia.,Psychosocial Research Centre, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Ellie Fossey
- Psychosocial Research Centre, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,Department of Occupational Therapy, Monash University, Frankston, Australia.,Living with Disability Research Centre, School of Allied Health, La Trobe University, Melbourne, Australia
| | - Carol Harvey
- Psychosocial Research Centre, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,Living with Disability Research Centre, School of Allied Health, La Trobe University, Melbourne, Australia
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