The Interface of Employment, Health, Family Support, and Human Services for People with Psychiatric Disabilities

Monday, 30 July 2012: 10:45 AM

Linda E. Jensen, PhD, RN, MN
Clarkson College, Omaha, NE

Learning Objective 1: To identify healthcare challenges for people with psychiatric disabilities who attempt to return to work.

Learning Objective 2: To identify strategies for interdisciplinary teams including nurse practitioners, psychiatrists, social workers, family members, and peer specialists for people with psychiatric disabilities.

Purpose: The burden of mental illness on health and productivity in the United States and throughout the world has long been underestimated.  Psychiatric illnesses account for over 15% of the burden of disease and disability in the United States and was found to be second in causes of disability by a World Health Organization report on Global Burden of Disease (2008).  The purpose of this research was to interview persons with severe mental illnesses to determine healthcare and service challenges for them in returning to employment and to identify strategies to assist them. 

Methods:  Fifty people with severe mental illnesses were recruited for interviews through advocacy organizations and day rehabilitation centers.  A semistructured guide was utilized for the audio-recorded interviews which were then transcribed.  The researchers listened to the recordings, made corrections, and used QSR N6 software for content analysis.  Data were sorted and coded acording to questionnaire categories wih free and tree nodes developing as the analysis progressed.  Themes were checked for validity with a randomly selected subset of 10 subjects from those interviewed. 

Results: Challenges to Employment included difficulty of maintaining a full time job while caring for their health needs and practitioner appointments, fears of losing their Medcaid coverage, anxiety during the job orientation process, and fears of stigma from fellow employees.

Conclusion: Recommendations were submitted to a legislative committee working on Medicaid reform, and included forming interdisciplinary teams including nurse practitioners, psychiatrists, pharmacists, social workes, family members, and peer specialists to facilitate more people returning to employment.