Employment Specialists’ Contributions of Support for People with Severe Mental Illness to be Integrated into the Workforce: A Metasynthesis

Project summary

Background: People with severe mental illness(SMI) experience substantial personal and environmental barriers to work participation, only approximately 15% are employed, however; the majority wants employment. The Individual Placement and Support (IPS) approach is currently the most effective work integration program for people with SMI. IPS includes focus on competitive employment on an early stage of recovery, without screening individuals` "work-readiness"; job support is provided by employment specialists (ES) who work close with mental health services. Studies indicate that the ES competencies are predictors of the employment outcomes for IPS clients, however, there is a lack of systematic understanding of the useful ingredients in the ES` support. Job tenure for people with SMI remains low, even with IPS; a better understanding the efficient ingredients of the ES' support is needed. Thus, the aim of this review is to identify, analyze, synthesize and summarize empirical quantitative and qualitative studies investigating the employment specialists’` and job coaches' contributions to the employment outcomes and vocational recovery for people with SMI. Method: A systematic literature review following the integrative review approach will be employed to locate, using the key search terms `employment specialist` OR `job coach` to search four databases AMED, EMBASE, Ovid MEDLINE, PsycINFO. Both quantitative and qualitative empirical research investigating this topic, sample characteristics related to adults with mental illness, published in English in peer-reviewed scientific journals from 1987 up to 2017, will be included. This 30 years will be chosen because this period represents an ideological shift in vocational services towards place-then-train approaches in job support. Empirical articles will be excluded if they did not investigate employment specialists` contribution for this population; so will reviews, theoretical articles, book reviews, letters to editors, non-peer reviewed articles, and program- descriptions. Reference lists of included articles will be reviewed for additional studies and citations searched to identify relevant new publications. Abstracts and titles will be screened, using the Rayyan QCRI App, in blinded inclusion/exclusion processes. Remaining studies will be obtained in full text and reviewed, decisions based on consensus. The quality of the included studies will evaluated, using MacMaters` critical review forms. Results from the included studies will be extracted and summarized narratively in columns, tables and text; to sort and group the data into categories and themes and integrated using thematic analytic strategies. The data analysis will include ordering, coding, categorizing, synthesizing and summarizing data into a unified and integrated conclusion about the research question; extracting data into systematic categories, facilitating the distinctions of patterns, themes, variations and relationships.  Implications: A better understanding of employment specialists` and job coaches` support can improve the possibilities for people with SMI to be integrated in the work force.