This research adopts a critical realist methodology to gain explanatory insight into the job retention challenges faced by employees recovering from mental health problems. Methods involved a literature review of qualitative job retention research, a comparative case study approach, and service user collaboration. Occupational, resilience and mental health recovery perspectives were the major orientating concepts. One case study comprised seven employed people who were using acute mental health services. The second comparative case study comprised fourteen users of a community- based job retention project for employed people with mental health problems. All twenty- one participants took part in individual interviews following a semi-structured format. The data were analysed within a critical realist paradigm using a combination of inductive and deductive thematic and constant comparative analysis. Work mattered to people during recovery because of feelings of guilt about not working, and because some feared that work had, or could, exacerbate their mental health problems. Such fears co-existed with a strong sense that work was an important part of people's lives in terms of finance, social capital, occupational capital (a concept newly proposed in this thesis) and personal capital. These assets were under threat, but they also had the potential to be deployed to support recovery. Participants were on complex and uncertain return-to-work journeys, facing a combination of internal and external obstacles. Barriers arose from the direct impacts of mental health problems, external and internalised stigma, job demands and the workplace environment - particularly relationships with colleagues and, above all, managers. The concept of iatrogenesis here is newly applied to being on sick leave, conceived of as an otherwise necessary therapeutic measure which brings with it additional challenges, risking delay to recovery and return to work. Findings suggest that return-to-work trajectories are likely to be more successful and sustainable when such challenges are addressed. The implications for practice and policy drawn out in this research are related to keeping in touch with work; mitigating the iatrogenic effects of sick leave; maintaining work orientation and identity; return-to-work planning; and harnessing 'natural', specialist and peer supports. Broader implications were that occupational and resilience perspectives can be integrated to help understand the challenges people with mental health problems encounter when seeking to retain employment. This, in turn, lent support to a social critique which called for work to be organised in a way that is centred on people's needs and well-being, and not just economic efficiency.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:589937 |
| Date | January 2013 |
| Creators | Cameron, Josh |
| Publisher | University of Brighton |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | https://research.brighton.ac.uk/en/studentTheses/6da60c9b-d8f0-42b0-beee-82ead49f6266 |
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