Function in job seekers with mental illness and drug and alcohol problems who access community based disability employment services

Abstract

Purpose: This study identified functioning, health, and social needs in jobseekers with mental disorders independently assessed as having capacity to work and referred to disability employment services. Differences in function between jobseekers with mental illness alone and with additional drug and alcohol problems were examined with view to identifying interventions for vocational rehabilitation.

Method: A convenience sample of 116 jobseekers completed BASIS-32, CANSAS, AUDIT, DAST-10 and 6 items from the EXIT interview and were divided into two groups: mental illness only, and additional drug and alcohol issues (AUDIT total score >8 and/or DAST total score >3). Analysis of variance was used to determine group differences. Results: Jobseekers reported low-moderate problems with function. Over 40% of the sample reported unresolved psychological distress, physical health needs, and social/daytime activity needs. Thirty-five jobseekers (30%) had additional drug and alcohol problems and reported significantly greater difficulty with impulsive/addictive behavior and poorer memory and executive function than the mental illness only group. No significant differences were identified in past work functioning.

Conclusions: Screening all job seekers for psychological, physical, and social needs to identify suitable treatment and rehabilitation strategies and providing interventions that improve emotional regulation and executive function for job seekers with additional drug and alcohol problems may improve employability of job seekers accessing disability employment services.

Implications for Rehabilitation

• Many job seekers with co-existing mental illness and drug and alcohol problems who have been assessed as having the capacity to work report unresolved psychological distress, physical health needs, and social activity requirements.

• Early screening for psychological, health and social needs using a general needs measure, such as the CANSAS, will help to identify potential barriers to employment, including drug and alcohol problems.

• Vocational rehabilitation interventions that improve executive function and emotional regulation may improve employability of job seekers with additional drug and alcohol issues.

Keywords::

• Rehabilitation
• psychosocial
• psychiatric
• drug and alcohol
• mental health
• health care
• vocational
• work

Acknowledgements

The team thanks all participants who contributed to the research as well as Dr Janice Ollerton and Ms Jonine Penrose-Wall for their assistance with data collection, and the managers of Break Thru People Solution’s Research Unit, Ms Elizabeth Hudson and Mr Simon Fairall.

Declaration of Interest: This study was part of a broader collaborative research project between Break Thru People Solutions and the Faculty of Health Sciences at The University of Sydney. It was funded by the New South Wales Health Department’s Office of Mental Health and Drug and Alcohol via the Mental Health Coordinating Council and Network of Alcohol and Other Drug Agencies as part of the Non-Government Organisation Mental Health and Drug and Alcohol Research Grants Program 2007. Break Thru People Solutions’ disability employment services are funded by the Australian Government Department of Education, Employment and Workplace Relations. Authors Lynda R. Matthews, Lynne M. Harris and Gocken Bozdag report no declarations of interest. Authors Alison Jaworski and Ashraful Alam were employed by Break Thru People Solutions at the time this research was conducted.