What are individuals with serious mental illness (SMI) dealing with in a competitive labor market? Two case studies

Understanding individual experiences is crucial for consumer-centered practice and policy. However, limited literature has thoroughly explored individual employment experiences outside of rehabilitation programs. The purpose of this study is to demonstrate the challenges that two individuals with severe mental illness (SMI) had experienced in competitive employment settings. Through in-depth interviews followed by an inductive qualitative analysis, the barriers that restrained them from obtaining and keeping a job were identified. Even though the two cases had dissimilar backgrounds and diagnoses, they had both been struggling with multiple problems including psychiatric symptoms, medications, and social stigma. The findings indicate that a flexible work schedule and a supportive work environment are important to their work participation. However, many competitive employment settings did not allow them to have a flexible schedule for frequent medical leaves. The stigma toward mental illness was also prevalent in various workplaces they worked at. The implications for policy and practice are discussed.