Persons with brain injury and employment supports: Long-term employment outcomes and use of community-based services

ABSTRACT

Objectives: To understand how employment services (ES) are provided to persons with brain injuries (PWBIs) in Ontario, Canada, and the impact service delivery has on competitive-employment outcomes.

Design and methods: A mixed-method case study of one community-based agency that provides specialized services to PWBIs. Relationships between demographic, service-related variables and employment outcomes (2009–2014) were analysed using chi-squares and analyses of variance. In addition, 14 interviews were conducted and analysed using thematic analysis.

Results: PWBIs accessed services on average of 16 years post injury; 64% secured at least one competitive-employment job, which was how employment success was defined in this study. Average job tenure was 368 days, and average job intensity was 3.8 hours/day. Employment success was significantly associated (p < 0.05) with use of job development, job coaching, case management and job retention services. Interviews revealed that PWBIs were provided five services: job goal(s) identification, assessment of work-related abilities/skills, job development, on-the-job supports and job retention assistance. Challenges to ES delivery included lack of suitable jobs and hiring incentives, and difficulties in establishing natural supports at the workplace.

Conclusions: PWBIs’ employment outcomes may be supported through provision of ES to assist with: the development of realistic job goals and job-finding skills, securing work, on-the-job coaching and advocacy with employers.

KEYWORDS:

• Acquired brain injury
• community integration
• community-based rehabilitation
• work
• mixed method

Declaration of Interest

The authors have no conflicts of interest to declare. The authors alone are solely responsible for the content and writing of this paper. This work was supported by a Partnership Team grant from the Ontario Neurotrauama Foundation and Réseau Provincial de Recherche en Adaptation-Réadaptation.