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The meaning and experience of stress among supported employment clients with mental health problems
Author(s) -
Besse Christine,
Poremski Daniel,
Laliberté Vincent,
Latimer Eric
Publication year - 2018
Publication title -
health and social care in the community
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.984
H-Index - 68
eISSN - 1365-2524
pISSN - 0966-0410
DOI - 10.1111/hsc.12527
Subject(s) - mental health , stressor , psychology , population , coping (psychology) , meaning (existential) , grounded theory , medicine , qualitative research , psychiatry , clinical psychology , psychotherapist , sociology , environmental health , social science
Abstract Many clinicians are concerned that competitive work may cause excessive stress for people with severe mental health problems. Individual Placement and Support ( IPS ) is acknowledged as the most effective model of supported employment for this population. The manner in which IPS clients define and experience employment‐related stress is poorly understood. This qualitative study aims to explore how people with mental health problems receiving IPS services define and experience employment‐related stress. We purposively sampled and interviewed 16 clients of an IPS programme, who had been competitively employed for more than 1 month. Data were collected between September 2014 and July 2015 in Montreal, Canada. Transcripts of semi‐structured interviews were analysed using grounded theory methodology. IPS clients often defined stress similar to its common understanding: the result of experiencing prolonged or/and cumulative strains, or of an incongruence between efforts and rewards, hopes and reality. Stress experienced in this way could exacerbate psychiatric symptoms, especially depression or psychotic symptoms. However, when maintained at a more manageable level, stress stimulated learning and improved planning of tasks. Participants described different coping mechanisms, such as sharing their experiences and difficulties with others, focusing on problem resolution and avoidance. The first two of these helped IPS clients remain at work and bolstered their confidence. Work‐related stress has potentially positive as well as negative consequences for IPS clients. In order to maximise the potential beneficial effects of stress, employment specialists can help clients anticipate potential stressors and plan how they might cope with them. Further research on the most effective ways of helping clients cope with stress is needed.