Eee4all Product 03-02-2016 Laatste Versie

EEE4ALL
FOCUS ON DISABILITY
2015 - 2016
Collaboration
Relim Beter door werk
Zuyd University of applied Science
PXL University
University of Ljubljiana
04-02-2016
Group 3
Students:
Ralf Bouten
Jelena Ilic
Jorien Keulen
Madelon van Soest
Ietje Solheid
Jeroen Trimbos
Maarten Wyndaele
Tutors:
Marike Hendriks
Barbara Pikur
Bart van Dolderen
Introduction
This report provides insights in the results of the process of working on the international module Euro
Education: employability for all (EEE4All) - with a focus on disability, in collaboration with a real
stakeholder. The purpose of this module was to aim for strategies to promote employment for those
who are in distance from the labour market. The overall aim of the project is to promote employability
and equality for everyone. It is organized by Zuyd University of Applied Science, in cooperation with
PXL and Plymouth University.
The EEE4all module consist of eight weeks of online tutorials and student collaborations through the
Blue Jeans system. For the last two weeks students are designated to work face to face at Zuyd
University in Heerlen. Each group involves participants from different countries, which makes it easier
to access all available information from different countries regarding law and legislation. Our group
consists of seven international members, of which four are from Zuyd University Heerlen, the
Netherlands. Two students are from PXL University in Hasselt, Belgium and one student is from
University of Ljubljana, Slovenia. All of them are third or fourth year Occupational Therapy students.
Supervision was provided by three tutors from Zuyd University, Bart van Dolderen, Barbara Pikur and
Marike Hendriks.
The main assignment was to create an evidence based screening tool for Relim, a regional stakeholder.
The tool has to screen companies in the Zuid-Limburg area, on being suitable for employing people
with a long distance to the labour market. Relim is a company that guides people with a long distance
to the labour market in the process of getting back to work. Nino Bellinzis, from Relim provided
supervision in creating the screening tool.
Index
Introduction............................................................................................................................................. 1
Abstract ................................................................................................................................................... 4
1. Background information...................................................................................................................... 5
1.1. Relim ............................................................................................................................................................ 5
1.2. Employability, disability and legislation ....................................................................................................... 5
1.2.1. The Netherlands .................................................................................................................................... 6
1.2.2. Slovenia ................................................................................................................................................. 6
1.2.3. Belgium ................................................................................................................................................. 6
2. Aim of the project and the assignment ............................................................................................... 7

2.1. The aim of the project .................................................................................................................................. 7
2.2. The assignment ............................................................................................................................................ 7
3. Method ................................................................................................................................................ 8
3.1. Literature study ............................................................................................................................................ 8
3.1.1. Preparation ........................................................................................................................................... 8
3.1.2. Conducting the literature search .......................................................................................................... 9
3.1.3. Analysing ............................................................................................................................................... 9
3.2. Designing a screening tool ......................................................................................................................... 10
3.2.1 Planning ................................................................................................................................................ 10
3.2.2. Design and development .................................................................................................................... 10
3.2.3. Quality Checks ..................................................................................................................................... 10
3.3. Think aloud method ................................................................................................................................... 11
3.3.1. Preparation ......................................................................................................................................... 11
3.3.2. Conducting .......................................................................................................................................... 11
3.3.3. Analysing ............................................................................................................................................. 11
4. Results ............................................................................................................................................... 12
4.1. Literature study .......................................................................................................................................... 12
4.2. Designing a screening tool ......................................................................................................................... 12
4.3. Thinking aloud ............................................................................................................................................ 12
5. Final report ........................................................................................................................................ 13

5.1. Guidelines to use the screening tool .......................................................................................................... 13
5.2. Screening tool ............................................................................................................................................ 14
6. Discussion .......................................................................................................................................... 21
6.1. Discussion ................................................................................................................................................... 21
7. Conclusion ......................................................................................................................................... 22
7.1 Conclusion ................................................................................................................................................... 22
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8. Suggestions ........................................................................................................................................ 23
Appendix ............................................................................................................................................... 24
1. Appendix Background information ................................................................................................ 24
1.1. Target group - Relim ................................................................................................................................... 24
Description and characteristics ..................................................................................................................... 24
1. Mood disorders ......................................................................................................................................... 24
2. Anxiety disorders....................................................................................................................................... 25
3. Eating disorders ......................................................................................................................................... 27
4. Personality disorders ................................................................................................................................. 27
5. Other disorders ......................................................................................................................................... 28
1.2 Methodology Relim .................................................................................................................................. 29
1.3 History of Employability .............................................................................................................................. 29
1.4 Employability and Disability ........................................................................................................................ 30
1.5 Employability and mental disorders ............................................................................................................ 31
3. Appendix Methods ......................................................................................................................... 32

3.1 Full PIOO table............................................................................................................................................. 32
3.2 Search history .............................................................................................................................................. 33
3.3 Summary of articles .................................................................................................................................... 35
3.4 Overview of specific features ...................................................................................................................... 42
3.5. Evidence based questions applied to the 7S model ................................................................................... 47
4. Appendix result............................................................................................................................... 49
4.1 List of articles .............................................................................................................................................. 49
5. Appendix Final report ..................................................................................................................... 50

5.1. Dutch version screening tool................................................................................................................... 50
References ............................................................................................................................................. 58
Abstract
Aim of the study: Aim of the study was to design a screening tool with specific features that enables a
high chance for successful employment for clients of Relim.
Method: Methods used to design the screening tool were a literature study, screening tool design and
think aloud method. All three methods are connected with each other and are used sequentially.
Result: The literature review resulted in specific features applicable to the assignment. Important key
features that were found are: supported employment, job carving, sustainability, coaches and
modification of the workplace. The result of screening tool design was a screening tool prototype.
The think aloud method resulted in feedback from two experts, tutors and the stakeholder.
Conclusion: The conclusion is that the prototype of the screening tool is usable for basic screening and
is fit to be used in practice. The final version of the screening tool is still pending due to validation
which has not been performed yet.
Keywords: employment, successful employment, mental health problems, skill development,
sustainability and vocational rehabilitation and screening tool.
1. Background information
This part of the document provides information about Relim, the module stakeholder, and
employability, disability and legislation regarding those topics in The Netherlands, Belgium and
Slovenia.
1.1. Relim
Relim is a company that helps people with a mental health issues and a long distance to the labour
market to realise their dreams and ambitions, with a main focus on work. Relim helps each individual
client by providing them with more social interaction or activation, meaningful day care and help to
develop work related competences. The aim is to facilitate individuals for finding and maintaining job
by looking at the demands, the perspective at the labour market and the individual skills, possibilities
and wishes.
Relim collaborates with many of other social- and care organizations. They support in inprove a lot of
other areas like psychosocial, practical and physical functioning, financial situation and housing. This
way they aim to improve the lives of their clients, and get their lives back on track again. When the
clients of Relim are more self-reliant and self-sufficient they will make less use of governmental help
and local help. By stimulating independence and confidence, they aim to lower the cost of
governmental and local support. This will lead to an increase of livability in the community for both
clients and residents. Relim works for local communities, social and care organizations and/or
companies.
More information about the target group is in appendix 1.1.
More information about the methodology which Relim is using is in appendix 1.2.
1.2. Employability, disability and legislation

Employment plays an important role in individuals lives. Not only does it create financial
independence, social participation and positive self-esteem, it also allows individuals to promote
personal status and identity and construction of a social network outside the family (Ronald & Collin,
2005).
The concept of employability has no single universally accepted definition. A simple definition of
employability is the quality of being employable. More broadly, it can be conceptualised as gaining,
sustaining and progressing in employment (Ronald & Collin, 2005).
For the individual, employability depends on: the knowledge and skills they posess, and their attitudes;
the way personal attributes are presented in the labour market; the environmental and social context
within which work is sought; and the economic context within which work is sought (Partnership,
2009).
Disabilities is an umbrella term, covering impairments, activity limitations, and participation
restrictions. An impairment is a problem in body function or structure; an activity limitation is a
difficulty encountered by an individual in executing a task or action; while a participation restriction is
a problem experienced by an individual in involvement in life situations (WHO, 2014).
According to World health organisation almost all jobs can be performed by someone with a disability,
and given the right environment, most people with disabilities can be productive.
People with disabilities have been among the most economically, disadvantaged politically
marginalized, and least visible members of society (O'Reilly, 2007).
People with disabilities are disadvantaged in employment sustainability. A reason for that could be a
lack of education, training or financial resources. Also workplace and employers perception of disability
could play a part.
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Stigma and misinformation about mental disabilities is a third significant barrier to employment. Many
employers underestimate the ability of those that are disabled, or fear unpredictable behaviour.
Mental health organizations
1.2.1. The Netherlands

The aim of GGZ (biggest mental health organization) Nederland and its member organisations is to
ensure the availability of high quality, accessible, affordable and sustainable mental health care
Two innovative practices deserve special attention, therefor two 2-page factsheets on eMental
Health and Transparency are avalible. (GGZNEDERLAND, 2015).
1.2.2. Slovenia
The Mental health area was neglected for a long time in Slovenia. Current efforts on the promotion
and protection of mental health are directed at strengthening, preservation and improvement of
mental health. That includes promotion, prevention, treatment, rehabilitation and long-term care.
In Slovenia, safety and health at work is the responsibility of the Ministry of Labour, Family, Social
Affairs and Equal Opportunities, and the Ministry of Health. These two ministries monitor and assess
the situation in the area mentioned above and on this basis draw up regulations and solutions for the
standardised regulation of safety and health at work (Ministrstvo za delo, n.d.).
1.2.3. Belgium
Most of the Belgian mental health organizations cooperate with the Belgium Safe Work Information
Center (BeSWIC). This center groups information about health, safety and welfare at work.
The European Agency for Safety and Health at Work provides information on how to improve mental
health promotion from a global approach to strengthen and promote the health, safety and welfare of
workers at work (FOD, n.d.)
More information about history of employability is in appendix 1.3.
More information about employability and disability is in appendix 1.4.
More information about employability and mental disorder is in appendix 1.5.
2. Aim of the project and the assignment

Short information about the project and the assignment.
2.1. The aim of the project

The aim of the project Enabling Employability for all: focus on disability is to equip us, as a future
practitioner, to work alongside those individuals who need extra support to find and maintain a job
despite their disability.
2.2. The assignment

The aim of the assignment is to find out which organisations in Zuid-Limburg match specific features
of working places offering a high chance for successful employment for clients of Relim. The
outcomes are:
1. To design a screening tool with specific features that enable high chance for successful
employment for clients of Relim.
2. Screen organizations in Zuid-Limburg if they match specific features of working places offering a
high chance for successful employment for clients of Relim.
3. Method
In the method section, three used methods (literature study, screening tool design and a think aloud
method) are described. The process contains a high level of complexity as all three methods are
connected and were used sequentially throughout the process.
3.1. Literature study

Literature review can be defined as the use of ideas in the literature to justify the particular approach
to the topic, the selection of methods, and demonstrate on that this research contributes something
new (Levy, 2006).
In this project, due to time constraint, the quick and dirty method for literature study has been
applied. All required steps of the literature review have been applied using a limited number of
relevant research papers for the review. The following main phases were used: design and search for
relevant studies, selection of studies, charting the data, and finally the ordering and summarizing of
the gathered results. The approach in this literature study is identified as a similar process as known in
scoping studies, where the appraisal and inclusion of evidence is not limited by the methodological
quality of that evidence. (Arksey, 2005)(Levac, 2010).
3.1.1. Preparation
The first step involves identifying the subject of the literature review (Coughlan, 2008). The following
research question was formulated:
What is known in literature about specific features that create a supportive work environment with
a high chance of sustainability for people with mental health problems?
Based on the research question search terms have been chosen using a PICO structure. It contains four
elements which define specific areas of research. The first element refers to the population of the
study, second element defines an intervention, the third element refers to a comparison to the first
given intervention, where the last element defines the outcome of a study. The main search terms
used were: employment, successful employment, mental health problems, skill development,
sustainability and vocational rehabilitation. A combination of MeSH terms and free terms was
applied. For search strategies the formula as portrayed in Table I was used. Keyword searches are the
most common methods of identifying literature. Another strategy is combining keywords. To help with
these combinations many databases use commands called Boolean operators. The most common
Boolean operators are AND, OR and NOT (Coughlan, 2008).
Table I: example of search terms full table is in appendix 3.1
3.1.2. Conducting the literature search

In conducting the literature search it is important to keep a record of the keywords and methods used
as these will need to be identified later when describing how the search was conducted. (Coughlan,
2008).
The following databases were selected to conduct the search: PubMed, Citrix, Google Scholar, OT
seeker, Psychinfo and Zuyd database (BioMed Central, CINAHL, Psychology and behavioural sciences
collection, ScienceDirect, SpringerLink, Social Science Open Access Repository)
MeSH-terms and free terms were used to conduct the literature search. The first attempt, the search
terms were a combination of terms from the PICO-structure and 7S key terms; it resulted in zero hits.
The search strategy has been modified by leaving out 7S key words. Running the second search then
lead to a hundred and fifty hits.
3.1.3. Analysing
Selection procedure
The number of reviewed results was narrowed down due to time constraints. Based on title selection,
fifty articles remained. Search history was saved through the process and is in appendix 3.2. Fourteen
articles were selected for analysis based on abstract scan. PQRS-system was used for analysis. This
method facilitates easy identification and retrieval of material particularly if a large number of
publications are being reviewed (Coughlan, 2008). Summaries were made using a format as shown in
table II. The full collection of summaries can be found in appendix 3.3.
TABLE II: Example: summary of the article Working with mental health problems: clients experiences of
IPS, vocational rehabilitations and employment. (Koletsi, 2009)
During a tutorial session the basic findings were discussed and 7S model was applied to analyse the
results of included articles in order to identify specific features. Articles were reread and specific
features were retracted from the articles. Findings were put in an overview based on the 7S model. An
example is shown in table III. The full table is in Appendix 3.4.
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Article Systems
6#
Structure
Employment
Supported
support system employment
Style Staff
Coaches
(support
person)
Strategy
Skills
Shared values
Placing client to Education of Stigma

and
work at least 8 a employers
discrimination
week
Table III: Example: overview of specific features linked to the 7S model
3.2. Designing a screening tool

It is important to understand the capacity of the tools, and adapt those to meet the requirements. This
will help ensure confidence in the quality of assessment (Authority, 2015).
The following steps have been applied to design a screening tool: planning, design & development and
quality checks.
3.2.1 Planning
An appropriate type of assessment method was chosen and identified as the questioning method
Underlying theory of the 7S model was discussed in a tutorial session and several possible strategies
for application were offered. Additional literature was read for a better understanding of the structure
used in both 7S model and methods for designing a screening tool.
3.2.2. Design and development

Designing steps were followed as mentioned in guide to developing assessment tools (Authority,
2015). The targetgroup was identified and the aim of the screening tool was described as a basic
screening of companies to gather information about their suitability for employing people with a long
distance to the labour market.
Evidence from literature review was applied to the 7S model, to create an overview of specific features
for companies. Possible questions have been formed using those features. Questions were specified
and applied to a basic screening tool format and definitions of variables were described. The definitions
can be found in the screening tool (part 5). Appropriate types of questions were chosen based on the
possible outcomes of the questions. An example of the questions is shown in table IV. The full table is
in appendix 3.5 Layout choices were based on UCD (User Centered Design) (Gulliksen, 2013).
Open questions were reformulated into closed questions in order to reach screening tool criteria.
Table IV: example of evidence based questions applied to the 7S model
3.2.3. Quality Checks

Several necessary checks were undertaken to confirm the correctness and relevance of the tool.
First, basic content was reviewed by a tutor on clarity, content accuracy, relevance and content
appropriateness. Secondly the screening tool was taken to extern companies for review on the
requirements regarding addressing all main themes, appropriate language, effective collection of
evidence and clarity of instructions. A last quality check was performed by presenting it to the
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stakeholder. A complete trial has not been conducted yet, due to time constraints. Feasibility, validity
and reproducibility have not been tested.
3.3. Think aloud method

Thinking aloud is a method that requires subjects to talk aloud while solving a problem or performing
a task, and is a unique source of information on cognitive processes: it generates direct data on the
ongoing thought processes during task performance (Jaspers, 2004).
3.3.1. Preparation
Steps conducted during the preparation were: gathering information about methodology and
possibilities regarding subjects, selecting subjects and preparation of instruction. Literature on think
aloud methodology was gathered to gain specific knowledge regarding the process. Additional
information on the method has been provided during private tutorial sessions. The selection of
subjects was based on the following methodological criteria: degree of expertise and verbalisation
skills. Appointments were set at an appropriate moment to guarantee spare time to process obtained
protocols. Before conducting, an instruction as mentioned in The think aloud method: a practical
guide to modelling cognitive processes was prepared.
3.3.2. Conducting
Practical procedures in obtaining think aloud protocols were taken into account. These procedures
were followed as mentioned in relevant literature and contain the following areas of attention:
appropriate setting, clear instructions, warming up method to start the process of thinking aloud and
prompting behaviour of the experimenter with as little interference as possible (Someren, 1994).
Recording and transcription of the protocol have not been conducted due to time constraint, thorough
notes were taken instead.
3.3.3. Analysing
Procedure on reviewing the protocol was taken into account. Separate notes were taken during the
review session. Comments and explanations that were given have been processed separately from the
think aloud protocols.
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4. Results
This section contains information about the results of the literature study, the screening tool, the design
that was used and the think aloud method.
4.1. Literature study

The review should conclude with a concise summary of the findings that describes current knowledge
and offer a rationale for conducting future research. In a review, which forms part of a study, any gaps
in knowledge that have been identified should lead logically to the purpose of the proposed study. In
some cases, it may also be possible to use the developed themes to construct a conceptual framework
that will inform the study. In all reviews, some recommendations or implications for practice,
education and research should be included (Coughlan, 2008).
The literature review resulted in specific features applicable to the assignment. Key features found are:
Supported employment, Independent placement and support, Coaches, Time management
strategy, Agreed common goals, Employer education strategy, Job carving, Flexible working
hours, Stress management, Modification of work place, Sustainability, Psychological support,
Step by step learning, Social skills, Coping strategy, Reducing risks and Vocational support.
A list of articles that contain specific features is in appendix 4.1.
4.2. Designing a screening tool

All methodological steps lead to a prototype of the screening tool. An instrument to globaly screen
companies for being suitable to employ people with long distance to the labour market. The tool is
easy to read and feasible for people involved. It provides a global view of the company and the features
it has, in relation to people with long distance to the labour market. The tool has seven topics based
on the 7s model. Every topic contains questions in relation to successful employment and the 7s model.
The gross number are closed questions. The screening tool is easy to use for organisations of any kind
even in the prototype phase.
4.3. Thinking aloud

The results of thinking aloud with Meander: Good questions, good clarity, understandable and
complete. Suggestions were given during review.
The results of thinking aloud with Zorg Aan Zet: Appropriate questions, readable and good lay out.
Suggestions were given during review.
Changes to the screening tool were made after receiving feedback from tutors, companies and
stakeholder Relim. Any misspelled sentences were corrected according to external feedback. Question
style was adjusted as a result of the think aloud protocol. A definition list was added in order to improve
feasibility and clearty. A guideline was added to improve feasibility and reproducibility.
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5. Final report
This part contains the screening tool as the companies would receive from Relim. First a guideline with
more information about the tool and the tool itself. The Dutch version of the screening tool is in
appendix 5.1.
5.1. Guidelines to use the screening tool
General
1.1 Short description
This instrument is a screening tool designed for screening companies to see if they are
suitable for placing people with a long distance to the labour market. It was designed in 2016
by a group of seven international students as an assignment provided by Zuyd Hogeschool
and Relim.
1.2 Target group
The target group of the instrument are companies of any kind.
1.3 Authors
Keulen J., Soest M., Solheid I., Ilic J., Trimbos J., Wyndaele M., Bouten R. (2016).
1.4 Aim of the screening tool
Aim of our instrument is a basic screening of companies to get information about their
suitability for employing people with a long distance to the labour market.
Screening tool information

The instrument is a questionnaire which is divided into 7 separate sections.
Section 1: Strategy (6 items)
Section 5: Staff (5items)
Section 2: Structure (4 items)
Section 6: Style (4 items)
Section 3: Systems (6 items)
Section 7: Shared Values (5 items)
Section 4: Skills (3 items)
1.5 Guidelines
The screening tool contains 34 evidence based questions which are formed in open, closed
and multiple choices type. Some questions offer the possibility of answering a sub question.
The screening tool starts with question number 1 and to finish it you need to follow
numerological order all the way to the question number 34. Specialised word are marked
and specified in the footnotes.
Feasibility
This screening tool is available in English and Dutch. To fill it out you need a pen and the tool
itself. The time needed to finish the complete screening tool is estimated between 20 and 30
minutes.
Additional information
The instrument is a pilot questionnaire which is being tested at the moment. According to the
results gained by the test runs additions and/or changes might be made.
Sometimes there is a number behind a word. This is a reference to the definition of the word
at the end of the screening tool.
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5.2. Screening tool

Strategy
The notion of strategy refers to the proposed management actions: How does the organization act
effective? What goals have been set for themselves as an organization and how do they tend to
achieve them?
1. Are you familiar with the concept of long distance to the labour market1?
Yes
No
2. What are your long distance goals for the labour market and how will you reach them (what
is the mission and vision of the organisation)?
Employing people with disabilities2
Providing supported employment
Reaching certain financial goals
Expanding the company
Gaining recognition
Other_________________________________________________________________
3. What are your goals in relation to employing people with a long distance to the labour
market?
_______% of staff are people with a long distance to the labour market
Education of regular staff3 in relation to people with a long distance to the labour
market
Training coaches to guide people with a long distance to the labour market
Design special or new workplaces for people with a long distance to the labour market
Specifying tasks for individual people with a long distance to the labour market
Other_________________________________________________________________
4. What is your view on applying PDCA4 (plan, do, check and act) circle in your organization in
relation to people with a long distance to the labour market?
PDCA is not known to us
PDCA is known, but we dont apply it
PDCA is known, we apply it, we have no information about effectiveness yet
PDCA is known, we apply it, it works out for us
5. Are company goals and PDCA known by regular staff?
Yes
No
1.
2.
3.
4.
Long distance to the labour market

The clients have a wide variety in mental health disorders. This makes finding a job harder for them. That is why we call it a long
distance to the labour market in our screening tool.
People with disabilities
People with a disability of any kind, like mental health or psychical disorders
Regular staff
Regular staff consists of every employee in the company with no disability.
PCDA (Plan, do check and act)
Plan: thinking of the plan.
Do: carry out the plan.
Check: check the plan and evaluate the process.
Act: revise or adapt the plan.
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6. What are your set goals for people with a long distance to the labour market?
Flexible working hours
Working minimum of _______ hours a week
Education strategies5
Step by step learning strategies6
Other:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Structure
Structure represents the way the organization is organized: tasks and authority decision making,
coordination, assessment, hierarchy, provision of information, line and staff functions.
7. Is it possible to divide the main task in shorter tasks?
Yes
No
8. Do people with a long distance to the labour market need to be able to complete their task
independently within your company?
Yes
No
9. Is there some kind of supervision available for the people with a long distance to the labour
market?
Yes
0 20 % of the time
20 40 % of the time
40 60 % of the time
60 80 % of the time
80 - 100 % of the time
No
10. Are there specific job functions in your company which help people with a long distance to
the labour market?
Yes
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
No
Systems
Are the processes and procedures of the company, which reveal business daily activities and how
decisions are made. Systems are the area of the firm that determines how business is done.
11. Are you familiar with the concept of Supported Employment7?
Yes
No
5.
6.
7.
Education strategies
Educating your employees with a disability about the job so they can perform it.
Step by step learning strategies
The employees with a disability get the chance to learn the job at their own pace.
Supported employment
Supported employment refers to the service provisions wherein people with disabilities, including intellectual disabilities, mental
health and traumatic brain injury, among others, are assisted with obtaining and maintaining employment
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12. Do you use a system to employ people with a long distance to the labour market?
Yes
No
Which methods do you employ to guide people with a long distance to the labour
market?
Supported Employment7
Individual Placement and Support8
Vocational Rehabilitation9
Mindful - vitality in practice10
SHARP-at work (stimulating healthy participation of workers relapse
prevention)11
Participatory supportive RTW intervention12
Other ___________________________________________________________
13. Are the methods, manuals or other aids properly used by the designated staff?
Yes, everybody applies it
Yes, ___% apply it
No
o Are the methods, manuals or other aids being monitored?
Yes
No
14. Do you use a protocol of hiring, guiding and evaluating the employment of people with a long
distance to the labour market?
Yes
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
No
o Is the protocol of hiring, guiding and evaluating being monitored?
Yes
No
7.
8. Education strategies
Educating your employees with a disability about the job so they can perform it.
9. Step by step learning strategies
The employees with a disability get the chance to learn the job at their own pace.
10. Supported employment
11. Mindful vitality in practice
This programme is an intervention to improve the work engagement and energy balance among workers. For example a method could
be social support.
12. SHARP at work (stimulating healthy participation of workers relapse prevention)
It is an intervention for people with a common mental disorder. This goes beyond return-to-work by focussing on prevention of
recurrent sickness absence.
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15. Do you use manuals or other aids regarding tasks for people with a long distance to the
labour market?
Yes
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
No
16. Are the methods and manuals that are used known by the whole staff?
Yes
No
o
Are they evidence based13?

Yes
No
Are they used by everyone?

Yes
No
Skills
What is the organization good at? This could be services, innovativeness, marketing, and so on. To
put it in other words; what is the distinctive knowledge and expertise.
17. Are the required competences for doing the work properly defined?
Yes
No
18. Do regular staff possess competences for working with people with a long distance to the
labour market?
Yes, the regular staff are able to cope with people that are dealing with:
Stress
Anxiety
Addiction
Personality disorders
Functional problems
Social disfunctioning
Autism
AD(H)D
Mental handicaps
Other ________________________________________________________________
No
19. Is there any regular staff with work experience with people with a long distance to the labour
market?
Yes
No
13. Evidence based

The practice of evidence-based practice means integrating individual clinical expertise with the best available external evidence from
systematic research, combined with the preferences, wishes and expectations of the patient.
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Staff
It concerns both the hard side, such as expertise, rewards, training, assessment and selection, as the
soft side, such as morale, motivation and behaviour.
20. Do you motivate people within the company to collaborate or to support each other?
Yes
No
21. Are the regular staff motivated to work with people with a long distance to the labour
market?
Yes
No
22. Do regular staff receive education to work with people with a long distance to the labour
market?
Yes, what kind?
________________________________________________________________________
________________________________________________________________________
No
o
Is your company prepared to train their staff to coach or to handle people with a
long distance to the labour market?
Yes
No
23. Does your company take into account people with a long distance to the labour market
during performance appraisal interview?
Yes
No
24. Is there a place for people with a long distance to the labour market when recruiting new
staff in your company?
Yes
No
19
Style
Style represents the way the company is managed by top-levels managers, how they interact, what
actions do they take and their symbolic value. In other words, it is the management style of
companys leaders.
25. Did your company define the leadership style which is necessary for employ people with a
Yes
No
26. Does your company practice the leadership style which is necessary for employ people with a
Yes
No
27. Does your company monitor the leadership style?
Yes
No
28. Which kind of leadership style do you use?
Supportive leadership14
Directive leadership style14
Coaching leadership style14
Delegating leadership style14
Other____________________________________________________________________
Shared Values
They are the norms and standards that guide employee behaviour and company actions and thus, are
the foundation of every organization.
29. Does your company believe and see what the values are of having people with a long
Yes
No
14. Leadership style

a. Directing leadership style
People need to be told specifically and regularly what to do. They need clear goals, role responsibilities, direction and training.
They also need to spend time with their leader.
b. Coaching leadership style
The persons may be encountering difficulties, blocks and set-backs. They still need a high degree of direction, but the amount
and nature of support they require increases significantly. They need regularly reinforcing and corrective feedback and a leader
who can constantly support and recharge them with the next steps in the plan.
c.
Supporting leadership style
The individual is becoming more confident in their ability in their task. They are also more able to decide upon what is needed
to move things forward. They still need some sort support or leadership.
d. Delegating leadership style
The leaders are able to rely upon their team members to successfully complete their tasks relatively independently.
20
30. Is there stigma or discrimination in your company, when employing people with a long
Yes
No
o
How are you dealing with this stigma or discrimination in your company?
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
31. Did your company define the work culture15 which is necessary for employ people with a long
Yes
No
32. Does your company practice the work culture which is necessary for employ people with a
Yes
No
33. Does your company monitor the work culture?
Yes
No
Final question
34. Are you willing to make changes to your company if necessary?
Yes
No
15. Work culture

Work culture is a concept which deals in the study of;
Beliefs, thought processes, attitudes of the employees.
Ideologies and principles of the organization.
21
6. Discussion
In this section, outcomes of discussions with teachers, the companies, our stakeholder and each other
regarding the screening tool, method, design, questions and results are summarised.
6.1. Discussion
Through the process of the EEE4all module the screening tool was developed. This screening tool is a
first prototype and can be used to screen companies that enable a high chance for successful
employment. The base of the product is finalised but it can still be subjected to modification and
adjustment to personal needs of a company.
The screening tool is a first step in the bigger picture for employing the clients of Relim. There is no
evidence yet that the list is complete due to a lack of validation which should be done in the near
future. The think aloud method was used to evaluate the screening tool with the help of two experts
and it resulted in a product that is appropriate for basic screening with room left for improvement in
the future.
Due to the fact that the screening tool was made by a group of international students a translation
might be the next step in the process of implementing the use of it.
The screening tool is based on the 7s model and it consists of features found in scientific literature.
At the moment the screening tool gives a view of the current situation of the company and it isnt
applicable to the future willingness of modification and improvement within specific companies.
The literature review was conducted by using the quick and dirty method due to time constraints.
An extensive search might result in many more specific features, which could be included in to the
screening tool in the future.
22
7. Conclusion
This part contains the conclusion about the aim of the study, the results, and the screening tool.
7.1 Conclusion
Aim of the study was to design a screening tool with specific features that enables a high chance for
successful employment for clients of Relim. A literature review was conducted and specific features
were found. These features have been used to make a screening tool based on the 7s model.
The result of the whole process is a screening tool, that is designed for Relim, as stated above a
literature review was conducted and the 7s model was used to create it. The screening tool is evidence
based.
The screening tool was developed in an international environment and improved according to different
views of experts. A prototype was used for a think aloud session at two separate companies to gather
valuable feedback on improving the screening tool.
Improving the screening tool could consist of starting up a validation process. The method used for
literature review was the quick and dirty method.
Overall the prototype is suitable for basic screening and can be used in practice.
23
8. Suggestions
This part of the document contains suggestions which are formulated based on think aloud sessions
and other feedback from tutors, companies and the stakeholder.
Digital or paper screening tool
The screening tool is available in a paper version, some companies might prefer a digital version
because it is an easier and faster way to fill it out.
Validating the screening tool
Due to time constraints there was no chance to validate the screening tool and to make sure it reaches
criteria.
The follow up
The conclusion of the screening tool is:
The company is suitable
The company is unsuitable
o The company doesnt want to make changes
o The company is willing to make changes.
If the company is willing to make changes an information brochure could be created. This in order to
suggest adjustment to the company for it to be more suitable to place people with a long distance to
the labour market.
The screening tool can also be an advice or plan for companies who want to change or improve.
Some examples of questions are:
Which adaptations that your company can afford, can give the people with mental illness a
chance to work in your company?
Are you prepared to change?
The stakeholder can suggest doing an experiment where an employee of Relim is placed and
monitored.
Shared values
A suggestion regarding shared values, is to form more questions about stigma and discrimination on
the work floor. More room for the companies to add writings about shared values, could be added.
Interview or measure assessment
The main point of the screening tool is to screen companies and to find out if they are suitable to
employ people with a long distance to the labour market. Now the boxes can be filled out and give it
a quantitative conclusion. It is more valuable to get in a conversation with companies about their
thoughts of guiding people with long distance to the labour market. The screening tool can be used as
a structured interview.
The message of the screening tool
In the experts opinion there is a push-mechanism at Relim and that should be adjusted. It should
formulated like this: How could we help a company be suitable for employing a client of Relim?
Formulating confronting questions
Some Ss had very confronting questions for companies. As example: Is there stigma or discrimination
in your company, when employing people with long distance to the labour market? Those questions
are really hard to fill out. A suggestion could be to modify those questions or make them open instead
of closed.
24
Appendix
1. Appendix Background information
1.1. Target group - Relim
Description and characteristics
The clients at Relim have a wide variety in mental health disorders. It is impossible to specify all
clients as they all have their own diagnosis along with their unique personality. However, to get a
clear view of the target group, weve decided to provide a brief description and some characteristics
for each common diagnostic group. That way we can compare the characteristics to one another and
identify important overlap(s) as well as specific differences between groups. This will eventually help
us to develop to our screening tool, with the target group and its specific characteristics, possibilities
and barriers taken into account.
We can roughly divide the mental health disorders into five categories:
Mood disorders
Anxiety disorders
Eating disorders
Other disorders
Each of these categories contains a number of specified disorders, which we will elaborate below.
Relim works with people with any kind of disorder, from any category, except for the 3rd. People
with eating disorders are not included in Relims target group. This is why we wont provide a detailed
description for the third category.
1. Mood disorders
I. Depression
Depression is a mood disorder that can be diagnosed through a number of core symptoms. The exact
symptoms are to be found in the DSM-IV and DSM-V. Depression is only a depression when it occurs
and stays for more than six weeks and when the depressed feelings cant be relieved by comforting.
The most important core characteristics of depression:
A bland, sad mood;
not capable of having fun of any kind;
a lot of interest;
a lack of motivation to do anything.
Apart from the core characteristics, theres a number of additional symptoms that people with
depression might have:
Cognitive symptoms
o Negative self-evaluation
o Negative future perspective
o Attention disorders
Physical symptoms
o Under eating / over eating
o Sleeping disorders
o Lack of sexual interest
Additional symptoms
o Separation anxiety
25
o
o
Suicidal thoughts
Non-specific physical complaints
II. Dysthymia
Dysthymia is a form of depression in which the characteristics and symptoms are similar to those of
depression, yet they arent there all the time and theyre less intense compared to a normal
depression. Theres a huge difference in seriousness between different patients with dysthymia.
III. Bipolar disorder
A bipolar disorder is a disorder that is characterized by episodes of depression, varied with manic
episodes, in which an upbeat mood is common.
Characteristics:
Low self-esteem / High self esteem
Avoiding social contact
Not feeling any emotions
Throwing fits
Hallucinating
No/low conscience
No structure in daily activities
Constant contradistinction
2. Anxiety disorders
IV. Panic disorder
A panic disorder is (the fear of) having a panic attack at random moments.
The characteristics of a panic disorder:
Cant be planned
Happens more often when clients start avoiding situations
The constant fear of having a panic attack
The fear of going crazy and losing control
Often goes hand in hand with the development of agoraphobia
Symptoms of a panic attack:
Shivers;
Heart poundings;
Sweating;
Hyperventilating;
Chest pains;
Nausea;
Stomach ache;
The feeling of passing out;
Dizziness;
Temperature regulation problems;
V. Social phobia
A social phobia is basically the fear of (having to act in) social situations. Most importantly the
situations in which the person could be judged by others.
This fear leads to avoiding any social situation and will most likely make matters worse.
26
The characteristics of a social phobia:
Avoiding social contact;
Fear of presenting oneself;
Avoiding talking to strangers;
The symptoms of a social phobia are similar to those mentioned in the panic disorder. Once a person
is forced into being social in any form, physical and cognitive symptoms of fear show: shivers, heart
poundings, sweating, nausea, dizziness, etc.
VI. Obsessive Compulsive Disorder (OCD)
OCD is an anxiety disorder that is a little different from other disorders. Obsessions cause the fear,
instead of specific situations.
Characteristics of OCD:
Compulsive movements
Compulsive patterns
Compulsive need to control situations
Fear occurs when compulsive movements and patterns cant be conducted
Irrational thoughts are identified but cant be reshaped
VII. Generalized anxiety disorder
A generalized anxiety disorder is diagnosed when someone is basically concerned and afraid of
anything, all the time.
Characteristics of a generalized anxiety disorder:
Afraid of everything;
Concerned about everything;
No clear recollection of what caused the fear;
Symptoms of a generalized anxiety disorder:
Feeling tensed all the time;
Depressed feelings;
Tiredness;
Attention deficit;
Headaches;
Dizziness;
Respiratory troubles;
Nausea;
Stomach ache;
Sleeping disorders;
VIII. Post-Traumatic Stress disorder (PTS)
PTS occurs after trauma and is divided into two groups of PTS. Type I is the acute trauma, that occurs
after an accident, rape, etc. Type II is the chronic type that occurs after more traumatizing
experiences of the same kind, like abuse etc.
Characteristics:
Reliving the experience
Avoiding situations that are similar to traumatic experience
Overreacting to normal stimuli
Symptoms:
Fear, with all symptoms mentioned above (in phobias)
Sleeping disorders
27
Attention deficit
Crying
IX. Specific phobia

A specific phobia is basically a phobia for one particular thing. The characteristics are the same as
other phobias, yet it just occurs when the person is subjected to the feared object.
Characteristics:
Avoiding the feared object
Avoiding surroundings where the feared object could occur
Avoiding going out
The symptoms of a specific phobia are similar to those mentioned in the panic disorder. Once a
person is forced into being social in any form, physical and cognitive symptoms of fear show: shivers,
heart poundings, sweating, nausea, dizziness, etc.
3. Eating disorders
As eating disorders dont apply to our target group, this disorders dont need any further clarification
regarding characteristics of clients suffering from either anorexia nervosa or bulimia nervosa.
4. Personality disorders
The anti-social personality disorder and the borderline personality disorder are part of the
personality disorders is cluster B. One of the main characteristics of personality disorders in cluster B
is a distorting effect on the social environment.
X. Anti-social personality disorder
Central feature of an anti-social personality disorder is the instability of thinking, feeling and
behaviour. This may result in fluctuating moods, unstable relations with others, impulsiveness and
the pursuit of short-term needs widening.
Symptoms:
Disregarding for right and wrong
Persistent lying or deceit to exploit others
Intense egocentrism, sense of superiority and exhibitionism
Poor or abusive relationships
Irresponsible work behaviour
Unnecessary risk-taking or dangerous behaviours
XI. Borderline personality disorder
Borderline personality disorder is when a person has a pervasive pattern of instability of
interpersonal relationships, self-image and emotions, clear impulsivity beginning by early adulthood
and present in a variety of situations.
Symptoms:
Frantic efforts to avoid real or imagined abandonment
A pattern of unstable and intense interpersonal relationships
Identity disturbance
Impulsivity
Recurring suicidal behaviour
Chronical feeling of emptiness
28
5. Other disorders
XII. Schizophrenia
Schizophrenia is a brain disorder that affects the way a person behaves, thinks, and sees the world.
People with schizophrenia often have an altered perception of reality. It is a chronic disorder. With
support, medication and therapy, many people with schizophrenia are able to function independent
and live fulfilling lives.
It is difficult to:
Distinguish between what is real and unreal
Think clearly
Manage emotions
Relate to others
Symptoms:
See and hear things that dont exist
Speak in strange or confusing ways
Believes that others are trying to harm them
Feeling of constantly being watched
XIII. Dementia
Dementia is caused when the brain is damaged by diseases, such as Alzheimers disease or a series of
strokes. There are a couple of other causes for getting dementia, like heavy drinking (Korsakoffs
syndrome) or infectious agents that attack the central nervous system and then invade the brain
(Creuzfeldt-Jakob disease).
Symptoms & difficulty with:
Thinking
Problem-solving
Language
Memory loss
XIV. Autism
Autism presents as a disorder of profound social disconnect rooted in early brain development.
Characterized by:
Appear unaware of surroundings
Fail to respond to the sights and sounds of a social world.
Limited speech and language skills
Restricted, repetitive pattern of behavior and interests
XV. Attention Deficit (Hyperactivity) Disorder (AD(H)D)
One of the hallmarks of ADHD is having difficulty keeping your mind on the task at hand. Adults with
ADHD may have trouble prioritizing, starting, and finishing tasks. They tend to be disorganized,
restless, and easily distracted. Some people with ADHD have trouble concentrating while reading.
The inability to stay focused and follow through on task can derail careers, ambitions and
relationships.
The main symptoms of ADHD are:
Inattention
Hyperactivity
Impulsivity
29
1.2 Methodology Relim

To make sure that the information described above can be carried out Relim developed a method
that they use.
This so called Relim-method makes sure that the client enhances their ability to use empowerment
and that they are able to increase their level of independence.
Step by step the clients are encouraged to take control of their own lives, by working and learning.
Relim doesnt force their clients to work, they can take the steps at their own pace. There is always
the possibility to take a step back if it proves to be too much. This approach makes our method
unique and successful.
Within the Relim method there are two courses: a rehabilitation course which focusses on getting
back onto the labour market and a rehabilitation course which focusses on getting back to
functioning well in society as a whole.
The following parts make our method so unique and successful:
Work is the most important tool. Working doesnt only keep you busy and give you a
steady and fair income. It also provides our clients with a solid structure, social
interaction and contact and an identity.
We look for the possibilities instead of the barriers and restraints in our clients. This
helps Relim get the best out of the clients.
It is about what you are ready for and what you are actually up for. In other words: What
can you do and what do you want to do?
Working is our only focus point. In all aspects of life you need to make progress. This is
why we collaborate intensively with social and care organizations.
Our approach is divided into structured stages. Checklists and support instructions are
our main tools within this approach.
We use a patient wise to workwise and a streetwise to workwise approach. This way the
pattern, in which youve probably been moving for years, can be permeated.
A personal relationship based on trust between the client and their coaches is a key
element. Support is individual, close and consistent, stimulating and supporting.
The coaches of the clients exchange experiences regarding the client. This way they know
how the client is doing and at what pace the client is making progress.
The client is offered a safe environment and a fair amount of time to adjust to the new
circumstances. There for, any impulses will stay within the boundaries of the clients own
load bearing capacities. This offers the client the possibility to orientate on different
routes and will also prevent the client from any further harm and negative experiences.
The feeling of belonging is stimulated by for example: wearing Relim work clothing, being
able to build social contacts on the work floor, doing activities with a social purpose, real
stakeholders and external workplaces (when possible).
Relim offers the client flexibility and customized work, so that activities will fit their
clients.
1.3 History of Employability

The historical antecedents of the current employability debate can be traced back at least a century.
In our research we followed Gaziers work on employability which provides a useful overview of the
concepts development towards currently accepted definitions (Ronald & Collin, 2005)
First, dichotomic concept of employability was developed in beginning of the 20th century. It resulted
in two following concepts of employable (individuals who were able and willing to work) and
unemployable (individuals who were unable to work). Socio-medical employability was developed
30
before the 1950s and was referring to the distance between the existing work abilities of socially,
physically or mentally disadvantaged people and the work requirements of employment. Then, in the
1960s the concept of manpower policy employability emerged, which expanded the notion of sociomedical employability to other socially disadvantaged groups, with the emphasis again on the distance
between the existing work abilities of the disadvantaged and the work requirements of employment.
Unlike other concepts (focusing on characteristics of disadvantaged people and their deficiencies
relative to what was required to be employable), flow employability was focusing on accessibility of
employment within local and national economies, with employability defined as the objective
expectation or high probability, that a person looking for a job can find one (Ronald & Collin, 2005)
The concept of labour market performance employability, dating from the 1970s, focused on the
labour market outcomes achieved by policy interventions, measurable in terms of days employed,
hours worked and payment rates, and other labour market outcomes for individuals participating in
employability.related programmes. According to literature, employability emerging in the late 1980s
was caled initiative employability. It was reflecting an acceptance that successful career development
requires the development of skills that are transferable and the flexibility to move between job roles.
The focus is on the individual, to develop his skills and networks in the workplace. Last one to develop
was interactive employability in 1980s, with focuse on maintaining the emphasis on individual
initiative, while also acknowledging that the employability of the individual is relative to the
employability of others and the opportunities, institutions and rules that govern the labour market.
This can be seen as implying the importance of the role of employers and labour demand in
determining a person employability.
1.4 Employability and Disability

Disabilities is an umbrella term, covering impairments, activity limitations, and participation
restrictions. An impairment is a problem in body function or structure; an activity limitation is a
difficulty encountered by an individual in executing a task or action; while a participation restriction is
a problem experienced by an individual in involvement in life situations (WHO, 2014).
Historically, people with disabilities have been among the most economically impoverished, politically
marginalized, and least visible members of society. Yet this group represents more than 650 million
people, of whom 470 million are of working age. This includes people with physical, sensory,
intellectual and psycho-social disabilities. Their opportunities for employment are limited in many
cases by the lack of enabling legislation to promote their access to skills development (including life
skills, technical skills and entrepreneurship skills) and employment opportunities; and the weak
implementation and enforcement measures, where such legislation is in place (O'Reilly, 2007).
According to World health organisation (WHO, 2014) almost all jobs can be performed by someone
with a disability, and given the right environment, most people with disabilities can be productive.
Eurostat Information from 2014 shows that employment rate of EU people with basic activity
difficulties (such as sight, hearing, walking, communicating disabilities) was in 2011 around 47.3 %
which is almost 20 percentage points below then people without such difficulties. At country level, the
greatest gaps in employment rate were observed in the Netherlands (43 % and 80 % respectively) and
Hungary (24 % and 61 %), with differences of more than 37 percentage points between the groups.
This contrasts sharply with the situation in Luxembourg, where the smallest variation was observed (2
percentage points).
The World report on disability from 2011 (WHO, 2014) had stated that people with disabilities have
poorer health outcomes, lower education achievements, less economic participation and higher rates
of poverty than people without disabilities. This is partly because people with disabilities experience
31
barriers in accessing services that many of us have long taken for granted, including health, education,
employment, and transport as well as information.
People with disabilities are disadvantaged in the labour market. One of the reasons for that can be
their lack of education, training or financial resources. On the other side disadvantage in the labour
market can also be consequence of workplace or employers perceptions of disability and disabled
people. On global and national levels people with disabilities must be empower for removing the
barriers which prevent them participating in their communities; getting a quality education, finding
decent work, and having their voices heard.
1.5 Employability and mental disorders

According to systematic review of data and statistic from community studies in European Union (EU)
countries 27% of the adult population had experienced at le.
st one of a series of mental disorder in the past year (this included problems arising from substance
use, psychoses, depression, anxiety and eating disorders) (WHO, 2014).
Mental disorders comprise a broad range of problems, with different symptoms. It mostly affects
individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the
psychological, biological, or developmental processes underlying mental functioning. However, they
are generally characterized by some combination of abnormal thoughts, emotions, behavior and
relationships with others. Examples are schizophrenia, depression, intellectual disabilities and
disorders due to drug or alcohol abuse (WHO, 2014).
People with mental health problems experience difficulties in finding and maintaining work and this
contributes to poverty and income inequality. Comparative work is highly valued in Western
societies, but people who suffer from mental illness are a disadvantaged group in this respect.
According to literature a majority of individuals with psychiatric disability desire competitive work
but only between 10 and 20% of them are employed. Numerous studies over many years have
shown that people with disabilities have high unemployment rates and people with serious mental
illnesses have the highest unemployment rate of any group with disabilities, despite the fact that
most of these people have both the desire and the capacity to work (Partnership, 2009).
In the 2004 report for the Social Exclusion Unit entitled Mental Health and Social Exclusion it was
stated that only 24% of adults with long term mental health problems are in work relationship. Next
to that they are at more than double the risk of losing their job than those without mental illness.
Stigma and misinformation about mental disabilities is a significant barrier to employment. Many
employers underestimate their ability or fear unpredictable behaviour. Employers may be concerned
that individuals with serious mental illnesses will have poor attendance, problems with performance,
or will need accommodations that will be too expensive. For example, accommodations commonly
sought by individuals with serious mental illnesses such as telecommuting, flexible work schedules
and intermittent breaks during work hours often have no cost, such as telecommuting options,
flexible work schedules and intermittent breaks during work hours.
In general employment has a beneficial effect in persons with mental illness. For the vast majority of
workers, and under most circumstances, it is reasonable to suggest that active participation in work
is therapeutic and beneficial (O'Reilly, 2007).
32
3. Appendix Methods
3.1 Full PIOO table
P
Mood disorders
OR
Schizophrenia
OR
ADHD/ ADD Attention
Deficit
(Hyperactivity)
Disorder
OR
OR
Mental health disorder
OR
Mental Illness
OR
Anxiety disorder
OR
Addiction
OR
Psychological disabilities
OR
Psychiatric disabilities
OR
Autistic spectrum disorder
OR
Antisocial behaviour
I
AND
OR
OR
OR
OR
OR
OR
OR
OR
OR
OR
OR
OR
O
Employee engagement
AND
Employability
Development of skills
Ongoing support
Rehabilitation
Health promotion
Education
Modification
environment
Strategy
Structure
Systems
Staff
Style
of
work
OR
OR
OR
OR
OR
OR
OR
O (Result)
Skills
AND
Shared values
Successful employment
Specific features
Meaningful employment
Matching organizations
Partner organization
Sustainability
Screening tool
OR
Assessment
OR
Checklist
33
Questions based on PICO table, containing P I O in each question
1. How can modification of work environment lead to successful employment in people with
mental health problems?
2. How can employee engagement lead to sustainability on the labour market in people with
psychosocial problems?
3. How can education of employers lead to successful employment of people with mental health
problems?
4. How does meaningful employment relate to stress related issues in people with mental health
problems?
5. How does a supportive work environment lead to sustainability in people with mental health
problems?
6. What are specific features of the work environment that lead to successful employment of
people with mental health problems?
7. How does development of skills relate to meaningful employment in people with mental
health problems?
8. How can a screening assessment improve the level of successful employment in people with
9. What are specific features that lead to sustainability of employment in people with mental
health problems?
10. How can individual placement and support lead to successful employment in people with
3.2 Search history

This search was conducted via Scholar.Google
Search
Query
#1
#2
#3
Mental health AND employability AND skills

Mental health AND employability AND sustainability
Mental health disorder AND modification of work environment AND successful
employment
Psychological disabilities AND strategy AND successful employment
#4
Items
found
1
1
1
1
This search was conducted via the database American journal of occupational therapy
Search
Query
#1
#2
Employment
Employment -> By screening the titel and abstract ->
Items
found
6
1
This search was conducted via the database Canadian journal of occupational therapy
Search
Query
#1
#2
Employment AND psychiatric disorders

Employment AND psychiatric disorders -> By screening the titel and abstract ->
Items
found
37
1
This search was conducted via the database Pubmed

Search
Query / Terms
#1
#2
((''Modification of workplace'') AND ''Health disorders'') AND ''Sustainability''

((""Job Application""[Mesh]) AND ""Workplace""[Mesh]) AND ""Mental
Disorders""[Mesh]"
Systems
#5
Items
found
0
4
868213
34
#7
#9
#10
#12
#14
#17
#19
#22
#23
#25
#26
#27
#31
#34
#37
#39
#42
Employability
Matching organizations
Screening tool
Education
Development of skills
Schizophrenia
Addiction
Psychiatic disabilites
Antisocial behaviour
((((((((((((((antisocial behaviour) OR psychiatric disabilities) OR addiction) OR
schizophrenia) OR mental health disorders) AND systems) OR education) OR
development of skills) OR supported employment) OR modification of work
environment) AND sustainability) OR matching organizations) OR shared values) OR
succesful employment) AND screening too
((mental health disorders) AND modification of workplace) AND sustainability
(mental health disorders) AND supported employment)
((mental health disorders) AND supported employment) AND specific features
(((((((mental health disorders) AND supported employment) AND specific features))
AND succesful employment) OR sustainability) OR shared values) OR skills) OR partner
organization
(((mental health disorders) AND supported employment)) AND successful
employment
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search
Query/terms
Items
found
112478
#3
((""mental health""[MeSH Terms] OR Mental health[Text Word]) AND problems[All

Fields]) OR ((""mental health""[MeSH Terms] OR mental health[Text Word]) AND
(""disease""[MeSH Terms] OR disorders[Text Word])) OR (psychosocial[All Fields]
AND (""disease""[MeSH Terms] OR disorders[Text Word])) OR (""personality
disorders""[MeSH Terms] OR personality disorders[Text Word])"
#9
((""mental health""[MeSH Terms] OR Mental health[Text Word]) AND problems[All

Fields]) OR ((""mental health""[MeSH Terms] OR mental health[Text Word]) AND
(""disease""[MeSH Terms] OR disorders[Text Word])) OR (psychosocial[All Fields]
AND (""disease""[MeSH Terms] OR disorders[Text Word])) OR (""personality
disorders""[MeSH Terms] OR personality disorders[Text Word]) AND
(""employment""[MeSH Terms] OR employment[Text Word]) OR sustainability[All
Fields] OR (""rehabilitation""[Subheading] OR ""rehabilitation""[MeSH Terms] OR
Rehabilitation[Text Word]) AND checklist OR screening tool OR assessment"
1061798
#10
mental health disorders OR mental health problems OR personality disorders OR

psychosocial disorders AND employability OR sustainability OR Rehabilitation OR
successful employment AND specific features AND checklist OR screening tool OR
assessment"
1060818
#12
Mental health disorders AND specific features AND succesful employment AND
assessment"
#13
Mental health disorders AND specific features AND succesful employment AND
assessment Schema: all"
#14
Mental health disorders AND specific features AND succesful employment"
35
#15
Mental health disorders AND specific features AND succesful employment Schema:
all",

Search
Query
#16
#17
#18
#19
#21
#22
#23
#24
#25
#26
Mental health disorders AND specific features AND employability

Mental health disorders AND specific features AND employability schema: all
Mental health disorders AND employability AND assessment
Mental health disorders AND employability AND systems
Psychiatric disabilities AND employability AND staff
Psychiatric disabilities AND employability AND staff schema: all
Psychiatric disabilities AND employability AND shared values schema: all
Psychiatric disabilities AND employability AND shared values
Psychiatrich disabilities AND employability
Mental health AND employability
Items
found
0
0
5
2
0
0
0
0
4
52
3.3 Summary of articles

Article #1:
PICO question:
Aim of study:
Background:
Method:
Conclusion:
Occupational Therapy Interventions for Employment and Education for Adults With Serious Mental Illness
1. How can modification of work environment lead to successful employment in people with mental health
problems?
3. How can education of employers lead to successful employment of people with mental health problems?
5. How does a supportive work environment lead to sustainability in people with mental health problems?
10. How can individual placement and support lead to successful employment in people with mental health
problems?
In this research the researchers were evaluating the effectiveness of occupational therapy interventions
focusing on participation and performance in occupations related to paid and unpaid employment and
education for people with serious mental illness. They were evaluating the interventions Supported
Employment and Individual Placement and Support and other occupation- activity based interventions.
People with serious mental illness have the lowest employment rate, lower than other people with
disabilities. For people with serious mental illness developing the skills and obtaining the supports necessary
for productive living are of particular importance to participating in the employment. Work is any productive
activity, whether paid or unpaid, that contributes to the maintenance or advancement of society as well as
to the individuals own survival or development.
Qualitative research by Honey (2004) in Australia reported that people with mental illness weighed the
benefits and drawbacks of employment on the basis of contextual factors such as the perceived status of
employment in society, type of job available, support and expectation of the social network, individual
factors of mental illness, level of comfort with disclosing ones mental health status to a potential employer,
and perceived alternatives to employment.
The AOTA set up this systematic review. Three EKU graduate students, one faculty advisor, and AOTA staff
and consultant were involved. They developed a search strategy and key search terms based on population,
interventions and outcomes. They operationalized the term serious mental illness. Other criteria were:
English-language articles, participants between the age of 18-6 and interventions within the scope of
occupational therapy practice. They only used studies from level I (SR, Meta-analyses) II (non-RCTS) and III
(pretest-posttest). There were 37 Level I studies, 5 Level II, and 4 were Level III.
Work Programs: SE and Vocational Rehabilitation
Evidence for the efficacy of SE and IPS is strong. Another review shows that SE with prevocational training
found that those in SE programs earned significantly more and worked more hours per month than clients
in prevocational training The results indicate higher rates of employment, shorter length of time to find a
36
job, and longer job duration: Two-thirds of the study participants in the IPS condition worked 20 Hr/week
compared with 23% for those in the control conditions. SE is more effective than Vocational Rehabilitation.
Supported Education Programs
The effective is good. The skills were increasing in enrollment in school or vocational education.
SE Plus Cognitive or Social Skills Training
Neurocognitive enhancement therapy (NET) in combination with work therapy (WT). At 2- to
3-yr follow-up, the results indicate that participants in SE and cognitive training were more likely to work, to
be employed for more hours, to be working over a longer period of time, and to earn more than those in
the SE-alone program.
Programs Related to Homemaking, Parenting, and Environmental Supports
Two Level I studies (Velligan et al., 2000, 2006) showed good evidence of the efficacy of using environmental
supports provided through cognitive adaptation training, a manual-driven series of compensatory strategies
based on neuropsychological, occupational therapy, and behavioral principles.
Increasing evidence has shown that the results for the IPS model are stronger when paired with social skills
training or cognitive skills training.
Article #2
PICO-question
Aim of study
Background
Method
Results
Conclusion
Article #3
PICO-question
Aim of study
Background
Work-focused cognitivebehavioural therapy and individual job support to increase work participation
in common mental disorders: a randomised controlled multicentre trial
problems?
6. What are specific features of the work environment that lead to successful employment of people with
The aim of this study was to evaluate the effectiveness of work-focused cognitive behavioural therapy
(CBT) and individual job support for people struggling with work participation due to CMDs (Common
Mental Disorders).
Labour force participation of people with mental disorders varies according to the nature of their disorder.
Research that compares function and psychosocial need in job-seekers with different mental disorders,
however, is scant especially in the Australian setting. Identifying rehabilitation needs of job-seekers with
mental disorders receiving employment services is of interest to providers of disability employment
services in Australia
A randomised controlled multicentre trial (RCT) including 1193 participants was conducted. Participants
were on sick leave, at risk of going on sick leave or on long-term benefits. The intervention integrated
work-focused CBT with individual job support. The control group received usual care.
The main outcome was objectively ascertained work participation at 12 months follow-up, with changes in
mental health and health-related quality of life as secondary outcomes. Results a larger proportion of
participants in the intervention group had increased or maintained their work participation at follow-up
compared to the control group (44.2% vs 37.2%, p=0.015). The difference remained significant after 18
months (difference 7.8% p=0.018), and was even stronger for those on long-term benefits (difference
12.2%, p=0.007). The intervention also reduced depression (t=3.23, p<0.001) and anxiety symptoms
(t=2.52. p=0.012) and increased health related quality of life (t=2.24, p=0.026) more than usual care.
A work-focused CBT and individual job support was more effective than usual care in increasing or
maintaining work participation for people with CMDs. The effects were profound for people on long-term
benefits. This is the first large-scale RCT to demonstrate an effect of a behavioural intervention on work
participation for the large group of workers with CMDs
Function, health and psychosocial needs in job-seekers with anxiety, mood, and psychotic disorders who
access disability employment.
Wat are the specific needs for sustainable employment in people with mental health problems.
The study sought to identify differences in health, social needs and function in people with anxiety, mood
or psychotic disorders accessing disability employment services. This to inform disability service providers
of vocational rehabilitation interventions.
Labour force participation of people with mental disorders varies according tot he nature of their disorder.
Research that compeares function an psychosocial need in job-seekers with different mental disorders,
however, is scant especially in the Australian setting. Identifying rehabilitation needs of job-seekers with
37
Method
Results
Conclusion
mental disorders receiving employment services is of interest to providers of disability employment

services in Australia
Self-report measures and the Executive Interview (EXIT) were used to document function. Differences
between disorders were determined using one way analysis of variance.
Significantly better estimates of social functioning as measured by the Behaviour and Symptom
Identification Scale (BASIS-32) were reported by job-seekers with psychotic disorders compared to those
with anxiety or mood disorders. However, job-seekers with psychotic disorders reported longer periods of
unemployment compared to those with mood disorders and longer estimates of the time it would take to
obtain work compared to both the other groups.
Perceived psychosocial problems, such as poor social function in job-seekers with anxiety and mood
disorders and perceptions of poor employability in those with psychotic disorders, should be considered
when developing vocational rehabilitation interventions, or where additional support me be required once
employment is obtained.
Poor insight to own skill levels (psychosis)
Overconfidence in own judgement about experiences (psychosis)
overconfidence in self-judgements about experiences of positive symptoms
Social function is central to key employability skills.
Additional support may be required once employment is obtained
Fostering natural co-worker supports may be an important strategy for job-seekers with anxiety.
For job-seekers with psychotic disorders, strategies for management and disclosure of personal
information using a stregths based approach may be useful for mitigating self-stigma
Article #5
PICO-question
Aim of study
Background
Method
Results
Conclusion
Article #6
PICO question
Aim of study
Occupations, work characteristics and common mental disorder (2012)

9. What are specific features that lead to sustainability of employment in people with mental health
problems?
To assess the prevalence of common mental disorders (CMD) by occupation.
To examine whether the increased risk of CMD in some occupations could be explained by work
characteristics.
Work characteristics have not previously been studied as an explanation of the differing rates of CMD
between occupations.
Cross-sectional design:
they take a sample of 3425 respondents from the Asult Psychiatric Morbidity Survey 2007.
Occupations were classified by the Standard Occupational Classification group.
CMD were measured by the Revised Clinical Interview Schedule.
Job characteristics were measured by questionnaire.
Personal service occupations had the highest prevalence of CMD. Process, plant an machine operatives the
lowest.
Work characteristics did NOT explain the increased risk of CMD.
Psychosocial work characteristics could not explain the high rates of CMD in particular occupations in the
UK.
Perspectives on barriers to employment for job seekers with mental illness

and additional substance-use problems
What are the barriers for employing people with mental illness?
How can employers modify work place for people with mental illness?
How can education of employers lead to successful employment of people with
This study examines the barriers to employment faced by job seekers with mental illness and additional
substance-use issues. Next to that strategies to improve employment
outcomes were conducted with stakeholders associated with an
employment service provider specialising in mental illness.
38
Background
Method
Results
Conclusion
Article #7
PICO question
Aim of study
Background
Method
Results
Conclusion
Article #8:
PICO question
Despite the recognised benefits of employment, mental illness is generally associated with lower rates of
workforce participation and higher rates of unemployment overall, and with employment in occupations
that are relatively lower skilled or lower income-earning than would be expected based on
qualifications. People with mental illness, such as anxiety disorders, mood disorders and psychosis, who also
have problems with substance use have especially low employment rate.
Semi-structured interviews were used to collect data about barriers to employment for job seekers with
mental illness and substance-use problems. Data were collected between May and August 2009 at the
premises of the employment service provider in metropolitan Sydney. Thematic analysis
of transcribed interview data was conducted to develop a meaningful data framework.
The barriers to employment for job seekers with mental illness and current or previous substanceuse
problems depend on: personal history of the job seeker, the job seeker symptoms, attitudes and
interpersonal function, the attitudes of the broader community to mental illness and to substanceuse
probllems and systemic factors, including policy settings that impact access to
and availability of services for the individual and characteristics of organisational culture.
Nationally and internationally, employment services have moved towards a recovery approach to service
delivery that aims at empowering consumers to work in competitive employment settings. These findings
highlight the additional barriers to employment associated with substance-use problems for those with
other mental illness, particularly restrictions in the environments where JS could be employed and poor
motivation.
The aspirations of JS and ES interviewed here concerning employment were not
well matched, implying limitations in the support
that JS receive to meet their individual goals. Meeting the challenges presented by these findings requires a
reorientation of the employment service-delivery model.
Working with mental health problems: clients experiences of IPS, vocational rehabilitations and employment.
problems?
10. How can individual placement and support lead to successful employment in people with mental health
problems?
This is a qualitative study aimed to explore clients views of the difficulties of obtaining and maintaining
employment, their experiences of the support received from their IPS (individual placement and support) or
Vocational Service workers and the perceived impact of work on clients live.
The effectiveness of IPS has been well established, little is known about clients perception of the model
compared to usual vocational rehabilitation, nor about their experiences of searching for and returning to
work with this kind of support.
Semi-structured interviews were conducted with 48 people with psychotic disorders participating in a sixcentre international randomized controlled trial of IPS compared to usual vocational rehabilitation. To assess
their experiences of the services and the perceived effects of working, two IPS and two Vocational Service
clients at each centre who had found work during the study period were interviewed, along with two IPS
and two Vocational Services clients at each centre who had not
IPS clients reported having received more help seeking and maintaining employment, whereas Vocational
Services clients reported having received more help in finding sheltered employment or placements. Clients
who had worked associated this with financial stability, improved social lives, increased self-esteem,
integration into society and amelioration of their symptoms, as well as reduced feelings of boredom and
isolation, but also reported increased levels of stress. IPS clients as well as Vocational Service ones reported
not receiving enough follow-up support, despite this being proposed as a key feature of the model.
Findings from the in depth interviews reflect differences in service models that have also been tested
quantitatively but further work in disaggregating the IPS model and assessing the impact of each component
would be valuable.
Individual and environmental factors related to job satisfaction in people with severe mental illness employed in
social enterprises.
problems?
39
Aim of study:
Background:
Method:
Results:
Conclusion:
Article #9
PICO-question
Aim of study
Background
6. What are specific features of the work environment that lead to successful employment of people with
problems?
The study was to enhance the understanding of the impact of individual and the environmental variables on
job satisfaction among people with severe mental illness employed in social enterprises.
Job satisfaction has been shown to impact on an individuals mental and physical health and overall
satisfaction with life. Yet the employment rates for people with severe mental illness are extremely low.
The biggest barrier remains their limited access to a supportive and non-discriminatory workplace.
Research pointed out that environmental factors of the workplace (workplace accommodations, support
from co-workers, ) have a greater impact on employment than external factors (support from family, )
They used logistic regression to analyse job satisfaction. A model with job satisfaction as the dependent
variable, and both individual (occupational self-efficacy and severity of symptoms perceived) and
environmental (workplace) factors (provision of workplace accommodations, social support from coworkers, organizational constraints) as well as external factors (family support) as predictors, was tested on
the entire sample.
The data used for this study came from a broader research project in Italy.
The study highlights that the implementation of workplace accommodations and the possibility to work in
an environment that is highly supportive have the impact of increasing the likelihood of being highly satisfied
with the job.
The participants job satisfaction appears to involve a complex mix of factors. The person who felt able and
confident about the ability to meet the demands of the job were found to be more satisfied with the job
than those who felt they could not meet these demands or were barely able to do so.
The more accepted and supported people felt by their work environment, the more satisfied they were with
their job and the more adamant about not wanting to change it.
By contrast, the obstacles they faced in their job activities were found to negatively impact their level of job
satisfaction. External support, such as that provided by family, was not found to significantly predict job
satisfaction in our study
All findings across the study suggest a significant positive impact of both individual and environmental
factors on job satisfaction. People with higher occupational self-efficacy who were provided with workplace
accommodations and received greater social support were more likely to experience greater job satisfaction.
These results suggest that certain features of social enterprises, such as workplace accommodations, are
important in promoting job satisfaction in people with severe mental illness. Further studies are warranted
to expand knowledge of the workplace features that support employees with severe mental illness in their
work integration process.
A qualitative investigation of individual and contextual factors associated with vocational recovery
among people with serious mental illness.
problems?
3. How can education of employers lead to successful employment of people with mental health
problems?
5. How does a supportive work environment lead to sustainability in people with mental health problems?
7. How does development of skills relate to meaningful employment in people with mental health
problems?
The aim of this study is to investigate ways to enhance vocational recovery or the processes through
which people with serious mental illness (SMI) regain their role as workers and reintegrate into the
workforce. Most people with SMI experience difficulty in fulfilling a vocational role, with many being
unemployed or underemployed.
Between 3.5% and 6.2% of adults in the United States have a SMI that result in functional impairment or
role incapacity in one or more life domains, including vocational functioning. The disruption in vocational
functioning among people with SMI is very high. Approximately 85% of people with SMI are unemployed,
and those wo are working tend to be underemployed and have poor job retention. This level of work
impairment has enormous social costs and reduces the quality of life and satisfaction with daily activities
to such an extent that Boardman, Grove, Perkins and Shepherd asserted that enabling people to retain or
40
Method
Results
Conclusion
Article 12#
PICO question
Aim of study
Background
Method
Results
gain employment has a profound effect on more life domains than almost any other medical or social
intervention.
The sampling strategy of the recovery or parent study involved purposeful, criterion-based and maximum
variation sampling. Informants were sought who could provide in-depth and rich information about the
process of recovery from SMI. Inclusion criteria were used.
Two researchers, who were trained clinicians and skilled in qualitative interviewing, screened respondents
by phone to determine whether they met they study criteria.
The two researchers conducted the semi-structured in-depth interviews. The interviews were audio taped,
lasted approximately 90 mins, and mainly occurred in the participants home.
The recovery study used a grounded theory approach for its data collection and analysis strategy.
In talking about their employment histories and the relationship between their work experiences and
recovery, participants noted numerous factors that helped them return to work or remain employed both
during and after the onset of their psychiatric condition. Our qualitative analyses of their stories revealed
seven themes that conceptually fell into two categories: individual and contextual facilitators of vocational
recovery. Individual factors included feelings, attitudes, assets and strategies such as having confidence to
work, having the motivation to work, possessing work-related skills, assessing person-job fit and being able
to create work opportunities. Contextual factors included receiving social support and having access to
consumer-oriented programs and services.
The findings of this study support existing evidence about vocational recovery, or the ability of people with
SMI to return to work or remain employed following the onset of SMI. The themes that emerged from our
analyses are consistent with findings that self-confidence and self-esteem, motivation and skills are
important in helping people with SMI return to work and maintain their employment.
Promoting mental health through employment and developing healthy workplaces: the potential of natural
supports at work
Searching which service users are most likely to benefit from vocational interventions and, more recently, on
models of vocational support.
The NSF wants to reduce discrimination and social exclusion amongst people with mental health problems
and increasing employment opportunities. There are few studies that examined the specific needs in the
workplace of people with mental health problems. In this article the researchers focused on clients accounts
of workplace factors that had helped or hindered them in keeping their job.
X
Difficulties were high anxiety, restlessness, mood changings, etc.
Conclusion
Use forms like team building

Routine workplace practice
Getting supervision
No multi-tasking
Learning step by step
Employeers need to be educated for helping
Article 13#
PICO question
An Update on Supported Employment for People With Severe Mental Illness

What are specific features that lead to sustainability of employment in people with mental health problems?
How does a supportive work environment lead to sustainability in people with mental health problems?
What are specific features of the work environment that lead to successful employment of
people with mental health problems?
The review examines the effectiveness of supported employment for people with severe mental illness.
The psychiatric rehabilitation field has not reached consensus on the essential components of supported
employment for persons with severe mental illness. Howevei; the following components appear to be
common across many supported employment program: a goal of permanent competitive employment,
minimal screening for employability, avoidance of prevocational training, individualized placement instead
Aim of study
Background
41
Method
Results
Conclusion
of placement in enclaves or mobile work crews, time-unlimited support, and

consideration of client preferences.
A comprehensive search was made for quantitative studies, primarily in the published literature. of
Vocational programs offering supported employment, regardless of specific program features, provided that
quantitative employment outcome data for people with severe mental illness were reported.
Seven descriptive studies, three surveys, one quasi-experimental study, and six experimental studies were
found. All studies suggested significant gains in obtaining employment for persons enrolled in supported
employment programs. 58 percent of clients in supported employment programs achieved competitive
employment, compared with 21 percent for control subjects, who typically received traditional vocational
services. Employment outcomes relating to time employed and employment
earnings also favored clients in supported employment over control subjects. Two features of many
supported employment programs have the most empirical support: integration of mental health and
vocational services within a single service team and the avoidance of preplacement training.
Supported employment appears to be a promising approach for people with severe mental illness, but more
studies are needed, with close atand long-term follow-up. Reasearch has identified key principles of
supported employment programs. Initial findings indicate the importance of an explicit focus on
competitive employment outcomes, of direct placement, and of the integration of vocational amid clinical
services.
42
3.4 Overview of specific features

Article
Systems
#1
Supported
employment
Individual
Placement and
Support
#2
Supported
employment.
Work-focused
cognitive
behavioural
therapy and
individual job
support
#3
#4
Structure
Style
Staff
Strategy
Support and
Using Supported
expectation of the employment or
social network
IPS: shorter
length of time to
find a job and
longer job
duration.
Therapists that
guided the
particpants
Skills
Shared values
Type of job
available
The perceived
status of
employment in
society
Individual factors
of mental illness
Developing skills
are of particular
importance to
participating in
the employment
Participants
receiving
cognitive
behavioural
therapy with
individual job
support resulting
in maintaining
their work
participation
Not relevant
Stress
management
programmes
Interventions
which reduce
psychosocial
distress
43
#5
#6
the article is
about which
occupation can be
responsibel to
develop a mantal
disorder. They
give a list of wich
occupations are
at risk and then
they give a list of
wich charaterics
are reqponsibel
for it. does this
fit in the 7s
model?
Employment
support system
(working in
environment
where they use
drugs, alcohol
and,
pharmaceuticals)
Supported
employment
(coaches),
particularly
independent
placement and
support,
integrated
treatment for
people with
coexisting
substance-use
problems
Coaches (support
person)
Placing client to
work at least 8
hours per week,
time
management
strategies
(flexibility),
employer
education
strategies by
service providers,
clear
communication,
co-operation and
agreed common
goals during
vocational
rehabilitation
Education of
employeers
Stigma and
discrimination
44
#7
Right
program/people
to Support
emplogees with a
ps. Disorder
Individual
placement and
support IPS
Appresiation
Good/ fair wages

Job security
Vocational
Support
Skills to work with

People with a
psycotic disorder
-comunication
People with a
psycotic disorder
Get back to work
Or start to work
Cope with Social

and economic
pressure
Succesful
integration in
labour market
Interesting work
#8
Environmental
factors have a
greater inpact
than patient
characteristics
Workplace
accomodations
(individual
solutions that
enable people
with disabilities to
attain and
maintain
employment) are
to level the the
playing field so
that employees
with disabilities
can succesfully
perform the
Support within
and beyond the
workplace
Supportive and
nondiscriminating
(can also be skills)
Supervisors who
provide feedback,
communicate
openly and are
fair, supportive
and encouuraging
are seen as great
facilitators of
employment
succes
Level of selfefficacy of the

employee
Employee must
feel able and
confidant to meet
the demands of
the job
45
essential
functions of the
job or enjoy equal
benefits and
privileges of
employment.
#9
Supported
employment;
vocational
recovery
# 10
Model of
supported
emploment.
(IPS) Individual
placement and
support.
#11
Not relevant
Individual and
contextual factors
are necessary for
vocational succes
depends on
company
structure aswell
Psychological
support
Clients helped
within 2 6
months better
results for time
worked
Ips workers were

trained no
specific
explanation
Access to
consumeroriented
programs and
services
Therapeutic
relationships
(if the worker has
to identify hisself
as wishing to
work, his personal
circumstances
and his
experiences of
clinical services,
this may be
demotivating
factors is
seekening
competitive
employment)
Increasing of
work-related
skills.
Self-confidence
and self-esteem,
motivation and
skills
development.
46
#12
#13
Forms of
teambuilding
Routine
workplace
No multitasking
Employeers need
to be educated
for helping
Getting
supervision
Coaches
Job coach model

IPS (supported
employment
model)
Multidisciplinary
team
Is company
allowing client to
be accomplish to
job interview
# 14
Company
structure
Ranking and the
impact/ influence
of the ranking on
the employee
Hierarchie
Leading style of
supervisor/
employer
Control options
Learning step by
step
Self-directed
strategies, such as
the
job club, (that
require clients to
as
sume most of the
responsibility for
searching for
jobs)
Reducing Risks
-Bullying
-Agression
-Accidents
Social and job

skills education
Social skills
-supervisor
- employee
Cope witte stress
Reaction of
supervisor/
employer to
employee in a
critical situation
Cope with fear

performance
pressure
Right skills for the
tasks you have to
manage
depents on work
Importantsy of
work / Job
Prevent
Unemployment
-Bad for health
47
3.5. Evidence based questions applied to the 7S model

7S
Question #
Shared Values
Structure
Systems
Strategy
Style
Staff
Skills
Does
your
company
believe and see what the
values are of having
people with a long distance
to the labour market?
Is
there
stigma
or
discrimination in your
company, when employing
from the labour market?
How are the tasks

divided in the company?
Which methods are

used to guide people
with a long distance to
the labour market?
How many layers of

management are there
within the company?
How
can
current
methods be improved?
Did your company define

the work culture which is
necessary
for
employ
to the labour market?
Are there rules of the

layout of presentations
of documents?
Which models are used

to
support
your
employees?
Do you apply PDCA (plan,

do, check, act) circle in your
organization in relation to
your employees with a long
distance to the labour
market?
What
kind
of
management style is
used in the company?
Does
your
company
practice the work culture
which is necessary for
employ people with a long
market?
Is it possible to divide the

main task in shorter
tasks?
How can the current

models be improved?
Is this style supportive

for employees of all
kinds?
Does the job require that

the
employee
can
function on itself or is
there a person who is
supervising him/her?
Do you use a particular

system which all your
employees must use?
Are there specific goals for

individuals?
Example:
flexible
working
time,
working minimum 8 hours
per
week,
education
strategies, learning step by
step
Are goals and PDCA known
by individuals?
Do
you
motivate
people
within
the
company
to
collaborate/
or
to
support each other?
Are the employees
motivated to work with
people with a long
distance
from
the
labour
market/disabilities?
Is
the
company
prepared to train their
staff to coach/or to
handle people with a
long distance from the
labour
market/disabilities?
Are
there
staff
members who possess
the competence to
support people within
the operation of the
company?
Do the employees need

certificates to work in
the business?
Are there already some

accommodations
available
in
your
company?
What are your long distance

goals for labour market and
how will you reach them
(what is mission and vision
of the organisation)?
Does the organisation have
goals to employ people with
long distance to the labour
market?
Example:
supported employment
Is there a possibility to
increase work-related
skills at the business?
Can there be guidelines

of how to do the
assignments?
Is there a way to
improve that system or
are
there
better
working systems?
Which
processes
are
involved when you use your
current system? Do they
support each other? Is the
system strengthened by the
processes?
How visible are the

managers/chefs on the
work floor?
Is there a education
profile of the staff? Are
there
requirements?
Must
they
first
achieved
certain
competences?
Is there attention paid
to
training
or
education? Where do
they focus on?
How is the hierarchy?

Are there a lot of bosses
who the employee needs
to ask permission from?
Do you have a system

to employ people and
keep them employed?
Who are involved if you

look at the processes?
Are
there
any
additional
(informal)
gatherings outside the
Are there tasks that

take a lot of time
whereby the employee
his competences are
Are there tasks that can

evoke
fear
among
workers?
Is it possible for
employees to speak to
the chef directly?
Are
there
any
possibilities to have
your own/new ideas
regarding work and
leadership discussed?
Are there concrete

special competences
needed for the tasks in
the business?
Which education is
appropriate for the job?
Which jobs are now

available?
Should an employee be
stress resistant?
48
(supported
employment)
formal time spent on

the job?
not fully exploited?

Can you use people
with a long distance
from the labour market
for this tasks?
Are
there
career
opportunities or career
paths?
Are
there
specific
functions to help people
with a long distance to
the labour market? Like a
job coach.
Do you use methods

when
employing
people with longer
market like: supported
employment, coaches,
educating staff.
Are the processes

systems effective?
and
Are
there
any
periodical
meetings
between employer and
employee in which
general functioning of
employee and vice
versa are discussed?
What structure is there in

your company?
Are they known?

Are they used?
Are
they
evidence
based?
Looking at your current

system are there any risks
involved while using it?
How do employers and

employees stay in
touch
during
the
week?
How is the
structure?
10
Do you practice job

carving, in dividing tasks
for employees with long
market.
Does your system have an

added
value
to
your
company?
How much time do

employers spend on
their
employees
wellbeing?
Do
they
use
tools/scales to get an
idea of collaboration or
motivation within the
company?
11
Are
there
regular
functions which contain
the specific tasks to
guide other people?
Do you have a protocol

of hiring, guiding and
evaluating
the
employment of people
with long distance to
the labour market.
Do you use manuals or
other aids regarding
tasks for employees
with long distance to
the labour market?
Does everybody knows

about it (year plan, each
team concrete plan) ?
Example: agreed common
goals?
How are problems

between
different
employees within the
company adressed?
Is
there
a
programme/service for
employees
how
experience problems
at work?
Tools to search new
staff?
12
13
14
15
How are individual

problems
of
employees
approached?
Is the company willing
to
make
changes
regarding support to
employees with mental
health problems?
What is the maximum
support the company
can offer to employees
with mental health
issues?
How
would
that
maximum support be
shaped on the work
floor itself?
staff
Do you use these tools

for placing people with
long distance to the
labour market.
Is there a performance
conversation
before
the
employee
is
recruited?
Do employees have the

competences
/
education to work with
people with a psychotic
disorder?
How does this vary with
individual factors of
mental illness?
How
do
employees
self-efficacy?
your
support
How do you train /

educate employees to
work with people with a
psychotic disorder?
How do you select
employees?
49
4. Appendix result
4.1 List of articles
50
5. Appendix Final report

5.1. Dutch version screening tool
Richtlijn
Algemeen
1.1 Korte beschrijving
Dit instrument is een screening tool, ontworpen om bedrijven te screenen om te kijken of
ze geschikt zijn voor het plaatsen van mensen met een functiebeperking. Het werd
ontworpen in 2016, door een groep van zeven internationale studenten als opdracht
verstrekt door de Hogeschool Zuyd en Relim.
1.2 Doelgroep
De doelgroep van de screening tool zijn bedrijven.
1.3 Auteurs
Keulen J., Soest M., Solheid I., Ilic J., Trimbos J., Wyndaele M., Bouten R. (2016).
1.4 Doel van de screening tool
Het doel van het instrument is de basisscreening van bedrijven om zo informatie te
verzamelen over hun geschiktheid om mensen met een beperking in dienst te nemen.
Screening tool informatie

Het instrument is een vragenlijst en onderverdeeld in zeven aparte delen.
Deel een is strategie (zes vragen)
Deel vijf is personeel (vijf vragen)
Deel twee is structuur (vier vragen)
Deel zes is stijl (vijf vragen)
Deel drie is systemen (zes vragen)
Deel vier is vaardigheden (drie vragen)
Deel zeven is gedeelde waarden (vijf

vragen)
2.1 Richtlijnen
De screening tool bestaat uit 34 evidence based vragen, gesteld als open, gesloten en
meerkeuze vragen. Bij sommige vragen is een subvraag geformuleerd. De screening tool
begint met vraag 1 en om te eindigen moet je de vragen in de numerieke volgorde volgen tot
aan vraag 34. Gespecialiseerde woorden zijn gemarkeerd met een nummer en worden
gedefinieerd in de voetnoten.
Haalbaarheid
De screening tool is beschikbaar is het Engels en in het Nederlands. Om deze in te vullen heb
je een pen en de tool zelf nodig. De benodigde tijd om het volledig in te vullen is ongeveer 20
tot 30 minuten.
Bijkomende informatie
Het instrument is een vragenlijst die momenteel wordt getest. Naargelang de resultaten die
worden verzameld gedurende de test is het mogelijk dat er aanpassingen gebeuren aan de
screening tool.
51
Strategie
Het begrip strategie duidt op de voorgenomen acties van het management: op welke wijze wil de
organisatie doeltreffend zijn? Welke doelen heeft men zich gesteld en hoe denkt men die te bereiken?
1. Bent u bekend met het concept: grote afstand tot de arbeidsmarkt1?
Ja
Nee
2. Wat zijn uw doelen in relatie tot de tewerkstelling van mensen met een grote afstand tot de
arbeidsmarkt en hoe bereik je deze (wat is de missie en visie van het bedrijf)?
Tewerkstellen van mensen met een beperking2
Voorzien van supported emploment
Financile doelen bereiken
Uitbreiden van het bedrijf
Het verkrijgen van erkenning
Andere__________________________________________________________________
3. Wat zijn uw doelen in relatie tot de tewerkstelling van mensen met een grote afstand tot de
arbeidsmarkt?
______% van de werknemers zijn mensen die een grote afstand hebben tot de
arbeidsmarkt
Reguliere werknemers3 onderwijzen over het begrip: grote afstand tot de arbeidsmarkt
Coaches trainen om mensen met een grote afstand tot de arbeidsmarkt te begeleiden
Nieuwe werkplekken ontwikkelen voor mensen met een grote afstand tot de
arbeidsmarkt
Taken eenvoudig maken voor mensen met een grote afstand tot de arbeidsmarkt
Andere__________________________________________________________________
4. Wat is uw visie op het toepassen van PDCA4 (plan, do, check, act) cyclus in uw organisatie in
relatie tot de werknemers met een grote afstand tot de arbeidsmarkt?
PDCA is niet gekend
PDCA is gekend, maar wordt niet gebruikt
PDCA is gekend, we gebruiken het, maar we hebben geen informatie over de
effectiviteit
PDCA is gekend, we gebruiken het, het is effectief
5. Zijn de doelen en de PDCA-cyclus gekend bij de werknemers?
Ja
Nee
1.
2.
3.
4.
Grote afstand tot de arbeidsmarkt

De clinten hebben een grote variteit in geestelijke problemen. Dit zorgt ervoor dat ze moeilijker werk vinden. Dit benoemen wij
een grote afstand tot de arbeidsmarkt in onze screening tool.
Mensen met beperkingen
Personen met een beperking, zoals aan mentale beperking of een fysieke beperking.
Reguliere werknemers
Reguliere werknemers zijn de werknemers zonder een beperking.
PDCA
Plan: het plan bedenken
Do: het plan uitvoeren
Check: het plan nakijken en evalueren
Act: Het plan aanpassen
52
6. Wat zijn de vooropgestelde doelen voor mensen met een grote afstand tot de arbeidsmarkt?
Flexibele werkuren
Minimum ______ werkuren per week
Opleiding strategien5
Stap voor stap leren6
Andere
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Structuur
Structuur wijst op de inrichting van de organisatie: taakverdeling, cordinatie, hirarchie,
informatievoorziening, lijn- en staffuncties.
7. Is er de mogelijkheid om de hoofdtaak op te delen in kortere, kleinere deeltaken?
Ja
Nee
8. Moet de werknemer met een grote afstand tot de arbeidsmarkt geheel zelfstandig kunnen
functioneren?
Ja
Nee
9. Is er een soort van supervisie voor de werknemer met een grote afstand tot de
arbeidsmarkt?
Ja
0 20 % van de tijd
20 40 % van de tijd
40 60 % van de tijd
60 80 % van de tijd
80 100 % van de tijd
Nee
10. Zijn er specifieke functies binnen uw bedrijf om de mensen met een grote afstand tot de
arbeidsmarkt te helpen?
Ja
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Nee
5.
Opleidingsstrategien
De werknemers met een beperking opleiden over het werk zodat ze het kunnen uitvoeren
6.
Stap voor stap leren

De werknemers met een beperking krijgen de kans om op hun eigen tempo te leren.
53
Systemen
Het gaat hierbij om alle formele en informele procedures, regelingen en afspraken binnen de
organisatie. Bv.: administratie-, budgetteringssystemen, orderafwikkeling, klachtenbehandeling,
planning en prioriteitsstelling, beoordelingssystemen, promotielijnen, enz.
11. Bent u bekend met het concept supported employment7?
Ja
Nee
12. Maakt u gebruik van een systeem om mensen met grote afstand tot de arbeidsmarkt te werk
te stellen?
Ja
Nee
Welke methode gebruikt u om deze mensen te begeleiden?
Supported employment7
Individual placement and support8
Vocational rehabilitation9
Mindful vitality in practice10
SHARP-at work (stimulating healthy participation of workers relapse
prevention)11
Participatory supportive RTW intervention12
Andere________________________________________________________
13. Zijn de methodes, handleidingen of andere hulpmiddelen op een goede wijze gebruikt door
al het personeel?
Ja, iedereen gebruikt het
Ja, ______% gebruikt het
Nee
o Zijn de methodes, handleidingen of andere hulpmiddelen begeleid?
Ja
Nee
7.
Supported employment verwijst naar service waarbij mensen met een beperking, inclusief intellectuele beperkingen, mentale
beperkingen en traumatische hersenletsels, worden geholpen met het bekomen en behouden van werk.
8.
Individual placement and support (IPS)
IPS supported employment is een evidence-based benadering van begeleid werken voor mensen met een ernstige psychische
aandoening. IPS ondersteunt mensen in hun pogingen om vast werk te bereiken, part-time of full time.. Dit is tegenstelling tot
andere beroepsrevalidatie benaderingen die mensen tewerkstelt in sociale of beschermde werkplaatsen.
9. Vocational rehabilitation
Vocational rehabilitation is een proces dat mensen met een functionele, psychologische, ontwikkelings-, cognitieve en emotionele
stoornissen of gezondheidsproblemen helpt om de belemmeringen te overwinnen voor het bereiken, behouden of terug gaan te
werken of een ander nuttige bezigheid.
10. Mindful vitality in practice
Dit is een interventie om de werkmotivatie en energiebalans te verbeteren van de werknemers. Een voorbeeld van een method is
social support.
11. SHARP at work (stimulating healthy participation of workers relapse prevention)
Dit is een interventie voor mensen met een psychische stoornis. Dit gaat verder dan Return-to-work door het focussen op de
preventie van terugkerende afwezigheid door de ziekte.
12. Participatory supportive RTW intervention
Return to work interventie voor werknemers met een ziekte zonder vast werk die beperkingen ervaren in het werk door een
psychische stoornis. Kernpunten in de interventie zijn een actieve deelname en een sterke betrokkenheid.
54
14. Heeft u een protocol voor het aannemen, begeleiden en evalueren van de tewerkstelling van
mensen met een grote afstand tot de arbeidsmarkt?
Ja
________________________________________________________________________
________________________________________________________________________
_______________________________________________________________________
Nee
o Is het protocol voor het aannemen, begeleiden en evalueren begeleid?
Ja
Nee
15. Gebruikt u handleidingen of andere hulpmiddelen met betrekking tot de taken van mensen
met een grote afstand tot de arbeidsmarkt?
Ja
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Nee
16. Zijn de methodes en handleidingen die worden gebruikt gekend door al het personeel?
Ja
Nee
o
Zijn deze evidence based13? (Heeft u gezocht naar de evidence?)

Ja
Nee
Worden deze door iedereen gebruikt?

Ja
Nee
Skills
Wat kan de organisatie goed, waarin blinkt zij uit? Dat kan dienstverlening zijn, innovatievermogen,
marketing, degelijkheid, productietechnologie enz. Anders gezegd: wat is de kenmerkende kennis en
kunde?
17. Zijn er speciale competenties gedefinieerd om het werk te kunnen doen?
Ja
Nee
13. Evidence based

De toepassing van evidence-based practice betekent de integratie van individuele klinische ervaring met het beste voorhanden
bewijs van systematisch onderzoek, gecombineerd met de voorkeuren, wensen en verwachtingen van de patint.
55
18. Bezit de reguliere werknemers competenties om te kunnen werken met mensen met een
grote afstand tot de arbeidsmarkt?
Ja, de reguliere werknemers zijn in staat om te gaan met mensen die te maken hebben
met:
Stress
Angst
Verslaving
Persoonlijkheidsstoornis
Functionele problemen
Autisme
AD(H)D
Geestelijke beperking
Andere _______________________________________________________________
Nee
19. Zijn er reguliere werknemers met werkervaring met mensen met een grote afstand tot de
arbeidsmarkt?
Ja
Nee
Personeel
Het betreft hier zowel de harde kant, zoals vakkennis, beloning, opleiding, beoordeling en selectie,
als de zachte kant, zoals moreel, motivatie en gedrag.
20. Motiveert u de medewerkers binnen het bedrijf aan om samen te werken of elkaar te
steunen?
Ja
Nee
21. Zijn de reguliere werknemers gemotiveerd om te werken met mensen met een grote afstand
tot de arbeidsmarkt?
Ja
Nee
22. Krijgen reguliere werknemers een opleiding over hoe ze moeten werken en omgaan met
Ja, welke?
________________________________________________________________________
________________________________________________________________________
Nee
o
Is uw bedrijf bereidt om uw reguliere werknemers te trainen over hoe ze mensen

met een grote afstand tot de arbeidsmarkt moeten coachen?
Ja
Nee
56
23. Houdt u bedrijf rekening met mensen met een grote afstand tot de arbeidsmarkt tijdens het
functioneringsgesprek?
Ja
Nee
24. Is er plaats voor mensen met een grote afstand tot de arbeidsmarkt in uw bedrijf tijdens het
zoeken naar nieuwe werknemers?
Ja
Nee
Stijl
De stijl komt tot uiting in het gedrag van management en medewerkers. Het is de manier van
(samen)werken die kenmerkend is voor de organisatie, zich uitend in kleine en grote dingen, bv.:
Snel aanpakken van mogelijkheden of eerst alle risicos doorrekenen
Duur, goed verzorgd meubilair of een sobere inrichting.
25. Heeft uw bedrijf een stijl van leidinggeven beschreven die noodzakelijk is voor het
tewerkstellen van mensen met een grote afstand tot de arbeidsmarkt?
Ja
Nee
26. Voert uw bedrijf de stijl van leidinggeven uit die noodzakelijk is om mensen met een grote
afstand tot de arbeidsmarkt te tewerkstellen?
Ja
Nee
27. Houdt uw bedrijf toezicht op de uitvoering van de leiderschapsstijl?
Ja
Nee
28. Welke stijl van leidinggeven14 gebruikt u?
Ondersteunend leidinggeven14
Direct leidinggeven14
Coachend leidinggeven14
Delegerend leidinggeven14
Andere __________________________________________________________________
14. Stijl van leidinggeven

a. Direct leidinggeven
De werknemers worden specifiek en regelmatig verteld wat ze moeten doen. Ze hebben nood aan duidelijke doelen,
verantwoordelijkheden, sturing en training. Ze moeten ook tijd doorbrengen met hun leidinggevende.
b. Coachend leidinggeven
De personen kunnen problemen en tegenslagen ondervinden. Ze hebben veel nood aan sturing maar de hoeveelheid en
natuur van de ondersteuning die ze nodig hebben stijgt sterk. Ze hebben regelmatig ondersteunende en corrigerende
feedback nodig en een leidinggevende die constant kan ondersteunen en hen de leiding kan geven over de volgende stappen
in het plan.
c.
Ondersteunend leidinggeven
Het individu wordt meer zeker over de eigen mogelijkheden in het werk. Ze zijn ook meer in staat om te beslissen wat nodig is
om voor uit te gaan. Ze hebben nog wel nood aan ondersteuning.
d. Delegerend leidinggeven
De leidinggevende kunnen vertrouwen op dat hun teamleden hun taken succesvol en zelfstandig kunnen afronden.
57
Waarden, normen, werkcultuur

Het gaat hier om binnen de organisatie door ieder gedeelde waarden. Een kernachtige aanduiding
voor: wat wil de organisatie? Waar staat de organisatie voor?
29. Gelooft en ziet uw bedrijf wat de waardes zijn van het aannemen van mensen met een grote
afstand tot de arbeidsmarkt?
Ja
Nee
30. Is er stigma of discriminatie in uw bedrijf wanneer er mensen met een grote afstand tot de
arbeidsmarkt zijn tewerkgesteld?
Ja
Nee
o
Hoe gaat u om met dit stigma of discriminatie in uw bedrijf?

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
31. Heeft uw bedrijf de werkcultuur15 gedefinieerd die noodzakelijk is voor het tewerkstellen van
Ja
Nee
32. Past uw bedrijf de werkcultuur toe die noodzakelijk is voor mensen met een grote afstand tot
de arbeidsmarkt? (Die u eventueel heeft gedefinieerd)
Ja
Nee
33. Heeft uw bedrijf toezicht op de werkcultuur?
Ja
Nee
Laatste vraag
34. Bent u bereidt om aanpassingen uit te voeren aan uw bedrijf indien het noodzakelijk is?
Ja
Nee
15. Werkcultuur
Werkcultuur is een concept dat zich bezig houdt met de studie van:
58
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2. Aim of the project and the assignment ............................................................................................... 7

5. Final report ........................................................................................................................................ 13

3. Appendix Methods ......................................................................................................................... 32

5. Appendix Final report ..................................................................................................................... 50

1.2. Employability, disability and legislation

1.2.1. The Netherlands

2. Aim of the project and the assignment

2.1. The aim of the project

2.2. The assignment

3.1. Literature study

Table I: example of search terms full table is in appendix 3.1

3.1.2. Conducting the literature search

Placing client to Education of Stigma

Table III: Example: overview of specific features linked to the 7S model

3.2. Designing a screening tool

3.2.2. Design and development

Table IV: example of evidence based questions applied to the 7S model

3.2.3. Quality Checks

3.3. Think aloud method

4.1. Literature study

4.2. Designing a screening tool

4.3. Thinking aloud

5.1. Guidelines to use the screening tool

Screening tool information

Section 1: Strategy (6 items)

Section 5: Staff (5items)

Section 2: Structure (4 items)

Section 6: Style (4 items)

Section 3: Systems (6 items)

Section 7: Shared Values (5 items)

Section 4: Skills (3 items)

5.2. Screening tool

Long distance to the labour market

Are they evidence based13?

Are they used by everyone?

13. Evidence based

14. Leadership style

15. Work culture

Beliefs, thought processes, attitudes of the employees.

Ideologies and principles of the organization.

IX. Specific phobia

1.2 Methodology Relim

1.3 History of Employability

1.4 Employability and Disability

1.5 Employability and mental disorders

3.2 Search history

Mental health AND employability AND skills

Employment AND psychiatric disorders

This search was conducted via the database Pubmed

((''Modification of workplace'') AND ''Health disorders'') AND ''Sustainability''

This search was conducted via the database Pubmed

((""mental health""[MeSH Terms] OR Mental health[Text Word]) AND problems[All

((""mental health""[MeSH Terms] OR Mental health[Text Word]) AND problems[All

mental health disorders OR mental health problems OR personality disorders OR

Mental health disorders AND specific features AND succesful employment"

This search was conducted via the database Pubmed

Mental health disorders AND specific features AND employability

3.3 Summary of articles

mental disorders receiving employment services is of interest to providers of disability employment

Occupations, work characteristics and common mental disorder (2012)

Perspectives on barriers to employment for job seekers with mental illness