Promoting mental health through employment and developing healthy workplaces: the potential of natural supports at work | Knowledge Translation for Employment Research Center

Authors:	Siporin, S. and Lysack, C.
Year Published	2003
Publication	Health Education Research
Volume	18
Number	2
Pages	207-215
Publisher	Oxford University Press
Background	In England, policy developments in the field of mental health are stimulating interest in employment for mental health service users as a means of mental health promotion. To date, research that might assist in increasing employment rates amongst this group has focused largely on the question of which service users are most likely to benefit from vocational interventions and, more recently, on models of vocational support. Less is known about how employers can assist people in their transition or return to work.
Purpose	This study draws on the accounts of 17 employment project clients to identify workplace factors that were associated with job retention. Specific objectives were: (1) To identify a sample of employment support service users who had retained open, competitive employment for 12 months or longer. (2) To identify a sample where employment had broken down after a period of less than 12 months employment. (3) To explore the experiences of both groups from their own perspective. (4) To explore the perspectives of the other key individuals involved, including employment project workers and workplace managers. (5) To identify factors associated with the success or breakdown of supported employment on the basis of the accounts obtained.
Setting	The study was conducted at five project sites in England. Of the five projects, two were based in geographically and demographically diverse areas of outer London (Projects A and B), one operated in a semi-rural area of southeast England (Project C), and one in an urban area of the southeast (Project D). The fifth project (Project E) was based in a Midlands city.
Sample	Clients of the five projects who had current or recent experience of open employment were invited to a meeting at their project where the research and what would be involved was explained. As a result of the meetings some clients decided not to take part because they had not disclosed their mental health problems at work, while others who were currently employed had not yet been in their job for a year. These clients therefore withdrew from the study. In total, 10 male clients and seven female clients did take part. Eleven clients had been able to retain open employment for 12 months or longer, while the other six clients jobs had ended within 12 months for reasons they themselves saw as problematic.
Data Collection	With participants permission, the interviews were tape recorded and transcribed verbatim. A staged analysis was then carried out. Initially, each job was treated as a case and the 17 cases were divided into jobs that had been retained and jobs that had broken down. Data relating to each case (i.e. the client‚, project worker‚ and manager‚ accounts of a job) were then grouped under broad categories according to whether they related to employment support, workplaces or service users personal circumstances. Data within each category were analysed to generate subcategories within each main category, e.g. workplace factors relating to managers, colleagues and conditions of employment. These were then compared across cases in order to identify those factors that were associated with job retention and job breakdown. As noted earlier, in this article we focus on clients accounts of those factors relating to the workplace.
Control	There was no control or comparison condition.
Findings	Specific adjustments such as flexibility about working hours, work schedules and job tasks emerged as crucial in enabling clients to deal with the effects of medication, and to regain stamina and confidence. Over and above these, however natural supports of a kind from which any employee would arguably benefit were equally important. In this respect the main themes revolved around training and support to learn the job, supportive interpersonal relationships at work, workplace culture, and approaches to staff management. Themes from the findings might equally provide a productive focus for workplace health promotion more generally, using organization development approaches.
Conclusions	On the basis of this study, four organizational initiatives in particular might help to ensure that workplaces are mentally healthy, both for mental health service users starting or returning to work, and for other employees: Ensuring that a formal period of induction, of sufficient length, is routine practice for all new employees. For many jobs, induction will need to include formal training geared to the employee‚ pace of learning, opportunities to observe colleagues work and the explicit identification of sources of support for tackling problems that arise. Embedding attention to employees ongoing development in routine workplace practice through formal supervision and appraisal procedures. Team building aimed at creating a welcoming workplace where difference is accepted and employees strengths are valued. Training and other learning opportunities, e.g. action learning sets, for managers, covering mental health and safety at work, team building, and individual staff management. Opportunities to explore the boundaries between a friendly, supportive approach and ensuring that work is completed would be particularly valuable, as would training in techniques for providing constructive criticism for employees.
URL	http://her.oxfordjournals.org/content/18/2/207.full
Disabilities	Emotional disturbance
Populations	Male & Female
Outcomes	Employment acquisition \| Increase in tenure
NIDILRR Funded	No
Research Design	Single group, Case reports, Qualitative, Observational
Peer Reviewed	Yes

Year Published

2003

Publication

Health Education Research

Volume

18

Number

2

Pages

207-215

Publisher

Oxford University Press

Background

In England, policy developments in the field of mental health are stimulating interest in employment for mental health service users as a means of mental health promotion. To date, research that might assist in increasing employment rates amongst this group has focused largely on the question of which service users are most likely to benefit from vocational interventions and, more recently, on models of vocational support. Less is known about how employers can assist people in their transition or return to work.

Purpose

This study draws on the accounts of 17 employment project clients to identify workplace factors that were associated with job retention. Specific objectives were:
(1) To identify a sample of employment support service users who had retained open, competitive employment for 12 months or longer.
(2) To identify a sample where employment had broken down after a period of less than 12 months employment.
(3) To explore the experiences of both groups from their own perspective.
(4) To explore the perspectives of the other key individuals involved, including employment project workers and workplace managers.
(5) To identify factors associated with the success or breakdown of supported employment on the basis of the accounts obtained.

Setting

The study was conducted at five project sites in England. Of the five projects, two were based in geographically and demographically diverse areas of outer London (Projects A and B), one operated in a semi-rural area of southeast England (Project C), and one in an urban area of the southeast (Project D). The fifth project (Project E) was based in a Midlands city.

Sample

Clients of the five projects who had current or recent experience of open employment were invited to a meeting at their project where the research and what would be involved was explained. As a result of the meetings some clients decided not to take part because they had not disclosed their mental health problems at work, while others who were currently employed had not yet been in their job for a year. These clients therefore withdrew from the study. In total, 10 male clients and seven female clients did take part. Eleven clients had been able to retain open employment for 12 months or longer, while the other six clients jobs had ended within 12 months for reasons they themselves saw as problematic.

Data Collection

With participants permission, the interviews were tape recorded and transcribed verbatim. A staged analysis was then carried out. Initially, each job was treated as a case and the 17 cases were divided into jobs that had been retained and jobs that had broken down. Data relating to each case (i.e. the client‚, project worker‚ and manager‚ accounts of a job) were then grouped under broad categories according to whether they related to employment support, workplaces or service users personal circumstances. Data within each category were analysed to generate subcategories within each main category, e.g. workplace factors relating to managers, colleagues and conditions of employment. These were then compared across cases in order to identify those factors that were associated with job retention and job breakdown. As noted earlier, in this article we focus on clients accounts of those factors relating to the workplace.

Control

There was no control or comparison condition.

Findings

Specific adjustments such as flexibility about working hours, work schedules and job tasks emerged as crucial in enabling clients to deal with the effects of medication, and to regain stamina and confidence. Over and above these, however natural supports of a kind from which any employee would arguably benefit were equally important. In this respect the main themes revolved around training and support to learn the job, supportive interpersonal relationships at work, workplace culture, and approaches to staff management. Themes from the findings might equally provide a productive focus for workplace health promotion more generally, using organization development approaches.

Conclusions

On the basis of this study, four organizational initiatives in particular might help to ensure that workplaces are mentally healthy, both for mental health service users starting or returning to work, and for other employees:
Ensuring that a formal period of induction, of sufficient length, is routine practice for all new employees. For many jobs, induction will need to include formal training geared to the employee‚ pace of learning, opportunities to observe colleagues work and the explicit identification of sources of support for tackling problems that arise.
Embedding attention to employees ongoing development in routine workplace practice through formal supervision and appraisal procedures.
Team building aimed at creating a welcoming workplace where difference is accepted and employees strengths are valued.
Training and other learning opportunities, e.g. action learning sets, for managers, covering mental health and safety at work, team building, and individual staff management. Opportunities to explore the boundaries between a friendly, supportive approach and ensuring that work is completed would be particularly valuable, as would training in techniques for providing constructive criticism for employees.

URL

http://her.oxfordjournals.org/content/18/2/207.full

Disabilities

Emotional disturbance

Populations

Male & Female

Outcomes

Employment acquisition | Increase in tenure

NIDILRR Funded

No

Research Design

Single group, Case reports, Qualitative, Observational

Peer Reviewed

Yes