From outsider to participant: a qualitative study about attaining and retaining work among persons with mental illness.

BACKGROUND

In Norway, the number of people on sick leave and health-related absence from work has increased over the last few years, and mental illness is one of the main contributing factors. Individual Placement and Support (IPS) and the Qualification Program (QP) are two work-oriented measures offered by Norwegian labor and welfare authorities, aimed at increasing labor market participation among people with health-related problems. The aim of this study was to explore which factors people with mental illnesses found helpful for attaining and retaining work, and their experiences with taking part in IPS and the QP.

METHODS

The study had a qualitative explorative design. Eight semi-structured interviews with individuals who had attained and retained work after receiving IPS or taking part in the QP were conducted. The data were analyzed using systematic text condensation, a thematic and descriptive, cross-case analysis strategy.

RESULTS

The analysis revealed three main themes, each related to the contexts of work and daily life: (1) inclusion and support, (2) structure and routines, and (3) motivation and self-confidence. The participants emphasized the importance of feeling included and supported both at work and by their family and friends. Furthermore, structures and routines at work and in the participants' daily lives kept them engaged and made them feel better, which was important for retaining work. Having the motivation to attain and retain work was essential and seemed to increase over time together with improved self-confidence as a result of being able to stay at work.

CONCLUSION

Inclusion, support, structure, routines, and motivation are decisive for people with mental illnesses in changing their view of their health and increasing their independence and experiences of coping in work and everyday life. Taking part in work-oriented measures seemed to function as a "gateway" to changing behavior for the participants, both in work situations as well as more generally in life.