Does Employment Promote Recovery? Meanings from Work Experience in People Diagnosed with Serious Mental Illness

Abstract

Employment has been highlighted as a determinant of health and as an essential milestone in the recovery process of people with serious mental illness. Different types of programs and public services have been designed to improve the employability of this population. However, there has not been much interest in the meanings attributed to these experiences and the negative aspects of work experience. In this research, we explored the meanings that participants attributed to their work experience and the impact of work on their recovery process. Research participants lived in Andalusia (Spain), a region in southern Europe with a high unemployment rate. Two versions of a semi-structured interview were designed: one for people who were working, and one for unemployed people. Participants’ narratives were categorized according to grounded theory and the analyses were validated in group sessions. Apart from several positive effects for recovery, the analysis of the narratives about work experience outlined certain obstacles to recovery. For example, participants mentioned personal conflicts and stress, job insecurity and meaningless jobs. While valid, the idea that employment is beneficial for recovery must be qualified by the personal meanings attributed to these experiences, and the specific cultural and economic factors of each context.

Annex

Semi-structured interview for the analysis of work experiences in people with severe mental disorders.

(Version for people who have worked in the past but are now unemployed)

• Name:

• Age:

• Working time:

• Time unemployed:

• Diagnosis:

• Province:

• Interview number:

• Education Level:

• I would like you to concentrate and remember the day you started working for the first time. Tell me, how did you start work? What people or institutions helped you and how did you get the job?

Organization and structure of daily life

• What changed in your life the day you started working? What are the differences between your life when you were working and now that you do not work?

• Has your schedule changed since you stopped working? Have you had a hard time getting used to not working?

• How has being unemployed affected your ability to do your shopping?

• Has the amount and type of people you mix with changed much since you’ve been out of work? For example, have your type of friends changed?

Meaning of working and becoming unemployed

• Do you remember what it meant to you when you started working? Did starting to work change what you thought about yourself? Did you notice that people, family or friends, thought of you or behaved differently with you when you started working?

• Do you remember what it meant to you when you lost your job? Did being unemployed change what you thought about yourself? Did you notice people, family or friends, thinking about you or behaving differently to you when you were made unemployed?

Labour-Health-Stress

• How did starting to work affect your health, particularly your mental health? (Explore problems related to stress, cognitive problems and the use of services)

• How did stopping work affect your health, especially your mental health? (Explore problems related to stress, cognitive problems and the use of services)

Job Search

• You’d like to find a job, wouldn’t you? What are you doing to find a job?

• What people or institutions are helping you to look for work?

• Imagine for a moment that you find a job, could you describe what would be a good job for you? Would it be different from the job or jobs you have already had?

• Can you imagine any negative effects that working could have on your life? Could you tell us about them? And any positive effects of becoming unemployed?

Would you like to add anything else?