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U.S. Department of Health and Human Services Department of Health and Human Services
Substance Abuse and Mental Health Services Administration

Substance Abuse & Mental Health Services Administration

Last Updated: 6/22/2012

SAMHSA’s Resource Center to Promote Acceptance,
Dignity and Social Inclusion Associated with
Mental Health (ADS Center)


Books, Articles and Research

Social Inclusion of People With Severe Mental Illness Living in Community Housing Programs
As part of a large-scale cross-sectional study seeking to assess institutes for residential care in the Netherlands, this study sought to determine if individuals living in supported independent living versus those in residential care experienced any differences in social inclusion on a variety of measures. Researchers found that while individuals in supported independent living situations were more likely to participate in activities and to have visitors, there was no difference in vocational participation between the groups. Based on these findings, they concluded that it is important that vocational programs be made available for individuals in both types of housing settings. This study's findings also highlight the success of mental health policies often supported across Western Europe that aim to rehabilitate individuals in community-based facilities and support them in being active participants in their communities.

A Randomized Controlled Trial of Supported Employment Among Veterans With Posttraumatic Stress Disorder
This randomized controlled study sought to determine the difference in impact between individual placement and support (IPS) supported employment and Veterans Health Administration Vocational Rehabilitation Program (VRP) treatment for veterans experiencing posttraumatic stress disorder. Over the course of the 12-month study, 76 percent of IPS participants were able to find competitive employment compared to 28 percent of VRP participants. Furthermore, IPS participants were able to work for a longer period of time and get higher wages. With gainful employment recognized as a vital component of recovery and wellness, this study highlights the need for improved job placement services in conjunction with other kinds of support.

How Your Mental Health May Be Impacting Your Career
This article discusses political and social factors that affect the employment potential and poverty risks for people with mental health problems. Barriers within both employment and health systems that do not properly accommodate or address mental health issues are examined, and potential solutions are introduced.

Mentally Ill Patients Deserve Equality
In this live chat, the host and four mental health service providers discuss discrimination and injustice faced by people with mental health issues as they seek medical treatment for general health concerns. These issues make it difficult for people with serious mental illnesses to get needed medical attention, which is reflected in the fact that these individuals live on average 25 years less than those in the general population, often as a result of preventable illnesses. Chat participants note the need for sensitivity and diversity training in the medical industry, as well as the improvement in treatment when doctors are able to become aware of each individual's personal narrative and provide medical care tailored to that narrative, rather than to the individual's mental health diagnosis.

Mental Illness At Work: My Schizophrenia Helped Me Find A Job (Video)
In these excerpts from her interview with mental health blogger Natasha Tracy, Lisa Halpern, the Director of Recovery Services at Vinfen, a nonprofit mental health services provider, discusses the onset of her schizophrenia, her path to recovery, and how her experiences led her to her current position in which she supervises 18 peer recovery supporters and oversees peer services at Vinfen.

Low Quality Job As Bad For Health As No Job
Although studies have shown that one's mental health has a tendency to improve once employed, the research described in this article suggests that one's mental health can be impacted negatively if the job obtained is of low psychosocial quality. Unfavorable psychosocial work conditions referred to in the study include high demands, low control, low job esteem, and insecurity. Researchers' results showed that unemployed people and individuals with poor-quality jobs had a heightened chance of developing common mental disorders.

Supporting workers with mental health problems to retain employment: Users' experiences of a UK job retention project
Researchers set out to gain a deeper understanding of the connections between challenges experienced in the workplace by people with mental disorders, support received during employment, and job retention. This study showed that feelings of guilt and self-blame among consumers are barriers to job retention but that, with support, individuals are able to improve communication with their employer including communication to seek accommodations, and experience increased confidence in their self-advocacy abilities. Individual interviews were used to collect data that revealed that peer support groups were a useful intervention that helped individuals with mental disorders retain employment. Researchers concluded that interventions that focus on the employee, his or her work, and the workplace offer more hope than those that focus solely on the individual for improving employment among individuals with mental disorders.

A study of the impact of social support development on job acquisition and retention among people with psychiatric disabilities
In this study, researchers explored the connection between methods for developing social support and employment-related outcomes among people with mental health problems receiving Supported Employment services. Researchers found that individuals with higher numbers of unpaid supporters were more likely to be employed for longer periods of time. Person-Centered Planning was noted as an effective technique in building support; it is a way of building natural, unpaid social supports to promote continued employment.

Social firms: A means for building employment skills and community integration
In Europe, social firms are commercial businesses that create opportunities for work and social integration for people with challenges to employment. This article describes a case study in which a Norwegian social firm worked to provide employment for workers with mental and substance use disorders. The article also discusses the value of this approach as a training option, as a means of supporting social integration, and as a method of countering negative and harmful attitudes and beliefs about people with mental health problems.

Empowerment in supported employment research and practice: Is it relevant?
Researchers in this study explored the connection between empowerment and quality of life of individuals with mental disorders entering supported employment. This study also examined empowerment's relationship to engagement in community life and individuals' experience with negative attitudes and beliefs. Results reaffirmed the value of empowerment in the supported employment setting and the importance in considering social and community integration benefits of having a job.

The road from addiction recovery to productivity: Ending discrimination against people with alcohol and drug problems
This article explores the discrimination commonly experienced by individuals with substance use disorders, including discrimination in policies that limit employment and health care. Researchers discuss the role of these discriminatory actions on one's recovery and a project, Join Together, that works to address discrimination.

Supported education for adults with psychiatric disabilities
This article reports on the results of a study undertaken to assess the effectiveness of the Bridge Program, a 12-session supported education program for adults with mental health conditions. Study results showed that participation in this program, which includes a combination of skill development sessions and one-on-one mentoring, helped participants' academic skill levels improve, along with their social skills and levels of professionalism. At a 6-month followup, 63 percent of those who had completed the program had enrolled in an educational program or job training, had obtained employment, or were applying to a specific program in the next year.

Building a cross disability peer employment support model: Report to the New York State Medicaid infrastructure grant
This report examines the prevalence of unemployment and underemployment among individuals with disabilities. Its findings identify peer support as a way of improving social capital, one's relationships and connections outside the mental health and addictions systems, and social networks for this group. This increase in social interactions was found to increase individuals' employment connections and opportunities. Researchers offer recommendations to help in developing peer employment support models to help individuals with disabilities secure employment.

America's plague of incarceration: A plague of prisons; the epidemiology of mass incarceration in America
This review of Ernest Drucker's book A Plague of Prisons: The Epidemiology of Mass Incarceration in America discusses the theme of Drucker's book, which is the significant individual and societal damage that has resulted from treating drug use as a criminal problem rather than as a public health crisis. The review also covers Drucker's recommendations for remedying this situation. Drucker discusses the need for prevention strategies including drug treatment, education, and job training; and concrete community supports to allow for reintegration upon release from prison. He also notes the need for drug law reforms and addressing of targeting of minorities and impoverished communities by law enforcement.

Dismantling the poverty trap: Disability policy for the twenty-first century
This article explores the high rate of poverty and unemployment that many individuals with disabilities experience and the role that economic reforms can play in addressing these issues. Researchers share recommendations for guiding such reforms.

Building partnerships: Conversations with communities about mental health needs and community strengths
This report produced by the UC Davis Center for Reducing Health Disparities examines the needs of underserved communities, strategies to prevent mental disorders, and ways to address mental health needs specifically while also identifying strengths within the community. Researchers partnered with agencies, members, and advocates within specific communities to give them an opportunity to express their view of what is needed in their community with the goal of helping counties develop their plans and programs for the prevention of mental disorders. Participants' responses highlighted a number of key factors within these communities, including the prevalence of violence and trauma, the role of social conditions such as poverty and unemployment as being a hindrance to community well-being, and the lack of affordable services available in communities.

Inclusion of people with mental health disabilities into the workplace: Accommodation as a social process
This literature review discusses issues related to successful integration of people with mental health challenges into the workplace, especially the role that managers, supervisors and coworkers play in this process.

Does the scientific evidence support the recovery model?
The recovery model is a social movement that has continued to impact the development of mental health services worldwide. Some of its basic principles include optimism about outcome from psychosis, empowerment of individuals with behavioral health problems, and collaborative decision-making regarding treatment. This editorial highlights data that suggest positive outcomes for consumers with schizophrenia when optimism is incorporated into recovery. The editorial discusses how empowering individuals throughout recovery can enhance the process. The research shows that employment helps people recover from psychosis and demonstrates the importance of addressing the negative, internalized perceptions of behavioral health problems during recovery. This editorial goes on to address other ways in which these basic recovery model principles are supported by scientific research.

Accommodating Veteran Employees with Mental Health Issues: Addressing Post Traumatic Stress Disorder and Traumatic Brain Injury
This report provides resources and ideas on workplace accommodations for returning veteran employees with behavioral health problems. It is geared towards employers, employee assistance professionals, and others who support veteran employees. The report highlights key indicators that an employee may need support, provides statistics on Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI), and guidance on how to develop appropriate workplace accommodations.

Recognizing work as a priority in preventing or ending homelessness
This report highlights the role of employment in the lives of homeless individuals. It asserts that, in addition to traditional approaches to assisting homeless clients with resources such as affordable housing and other supportive services, employment should also be a primary focus. Researchers suggest that programs that make work a priority have the potential to help instill higher levels of motivation and hope in homeless individuals who are striving to better their lives and that these programs offer an important tool in preventing and ending homelessness. The paper describes principles, practices, and strategies to use to make employment more central to programs for homeless people.

Recovery in our words: A book of possibilities and hope
Townsend and Griffin offer consumers a planned approach to taking control of mental health problems and interactions with treatment professionals.

Fair society, healthy lives: Strategic review of health inequalities in England post 2010
This paper describes British issues in health equity, social determinants of health, and UK-style societal interventions in both mental health and overall health with mental health playing a critical role.

Mental health, resilience and inequalities
This report explores the evidence that mental health influences a very wide range of outcomes for individuals and communities. These include healthier lifestyles, better physical health, improved recovery from illness, fewer limitations in daily living, and other factors.

Work transitions for peer support providers in traditional mental health programs: unique challenges and opportunities.
Peer support is gaining recognition as a valuable component of mental health service delivery and as a meaningful employment opportunity for mental health consumers. Despite the potential benefits of peer support, there continue to be many barriers to the development and funding of peer positions. This article reports on the results of a multisite project whose goal was to build capacity for employment of trained peer providers in local, community-based mental health programs.

Using Situation Testing to Document Employment Discrimination Against Persons with Psychiatric Disabilities
The authors of this article note that research has suggested that discrimination toward, and inaccurate perceptions of, people with mental health problems may cause people with these problems to be unemployed or underemployed. However, when this article was published, research had not yet looked closely at exclusionary and discriminatory employer behavior. In this article, the authors examine employment among people with mental health problems; review ways to determine how discrimination affects people with mental health problems on the job; and propose a new methodology, situation testing, which they write allows for a better understanding of workplace discrimination toward people with mental health challenges.

Towards social inclusion in mental health?
This article explores the uses of the terms "social exclusion" and "social inclusion" in a mental health context. Focusing on social inclusion as a remedy for the ills of social exclusion, this article discusses implications for contemporary mental health policy, practice, and research and concludes that a better theoretical understanding of causal mechanisms is needed to enable the development of more socially inclusive mental health services.

Vision and Progress: Social Inclusion and Mental Health
This report examines the progress of the National Social Inclusion Programme as it works to implement the activities outlined by the 2004 Mental Health and Social Exclusion Report. Details are given on the progress made so far and on the work still to be done.

Mental Health and Social Exclusion: Social Exclusion Unit Report
This report examines the impact mental health problems have on increasing social exclusion. The report also developed a 27-point action plan to address this problem.

The meaning and importance of employment to people in recovery from serious mental illness: Results of a qualitative study
Given the high rates of unemployment and underemployment among individuals with psychiatric disabilities, only a small number of studies have investigated the role work has in the lives of people who have been successful vocationally during their recovery from serious mental illness. This study sought to add to existing literature by determining how individuals perceive work and its effect on their recovery.

SESAMI study of employment support for people with severe mental health problems: 12-month outcomes
In the context of UK policy to promote employment for people with disability as a means to greater social inclusion, this study investigated how people with severe mental health problems fare in existing supported employment agencies. The aim of the study was to identify factors associated with successful placement in work and to test the impact of working on psychological well-being in this group.

What to do when you think an employee may need mental health help
This fact sheet list the steps you should take when you think an employee may need mental health help. Steps on education, language and encouraging dialogue are dicussed.

Twelve month use of mental health services in a nationally representative, active military sample
This article findings indicate that military institutions should continue public education campaigns to raise awareness and acceptance of mental health issues and should make necessary changes in health delivery systems to gain the trust of military members. The primary objective of this study was to examine the patterns and predictors of mental health service use in active Canadian Force members while also identifying barriers to service use.

Training veterans in recovery
Two female veterans share how peer employment training is making a difference in their recovery from Post Traumatic Syndrome Disorder (PTSD).

Solutions to discrimination in work and housing identified by people with mental illness
This study examines perceived solutions to discrimination in housing and employment situations.

American with Disabilities Act of 1990
The current text of the Americans with Disabilities Act of 1990 ["ADA"], as amended.

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This Web site was developed under contract with the Office of Consumer Affairs in SAMHSA’s Center for Mental Health Services. The views, opinions, and content provided on this Web site do not necessarily reflect the views, opinions, or policies of SAMHSA or HHS. The resources listed in this Web site are not all-inclusive and inclusion on this Web site does not constitute an endorsement by SAMHSA or HHS.