Changes in the nature and intensity of stress following employment among people with severe mental illness receiving individual placement and support services: an exploratory qualitative study

Abstract

Background: Most people with severe mental illness (SMI) want to work. Individual placement and support (IPS) programs have proven effective in helping them obtain and keep competitive jobs. Yet, practitioners often fear that competitive jobs might be too stressful.

Aims: To explore how the nature and intensity of stress experienced by IPS clients changed after the transition from looking for work to being employed.

Methods: Semi-structured interviews explored the experiences of 16 clients of an IPS program who had recently been competitively employed. Grounded theory was used to structure the analysis.

Results: Most participants reported that their stress level decreased once they found work. Stress following work was associated with fear of failure, pressure to perform and uncertainty. The support that people perceived in their return-to-work project, and where they were on their recovery journey, modulated their perception of stress. Many cited IPS as a source of support.

Conclusions: Competitive work changed the nature of stress and was mostly associated with a decrease in stress level. Adjunctive interventions aiming to buffer self-stigma or help participants use more adaptive coping mechanisms may merit investigation.

Keywords:

• Stress
• coping
• severe mental illness
• work
• supported employment
• individual placement and support
• IPS

Declaration of interest

This research was supported by two non-profit Foundations: SICPA and Fondation du 450ème anniversaire de l’UniL. The funding organizations played no role in either the design and execution of the study or in the interpretation of its findings. The authors report neither financial nor personal conflict of interest.

This study was designed and data were collected at the Douglas Mental Health University Institute, Centre Intégré Universitaire en Santé et Services sociaux de l’Ouest-de-l’Ile-de-Montréal, 6875 LaSalle Blvd, Verdun, QC, Canada, H4H 1R3. All authors participated in data analysis and/or interpretation as well as writing of the manuscript from their various locations.