Maximizing work integration in job placement of individuals facing mental health problems: Supervisor experiences

BACKGROUND: Many people confronting mental health problems are excluded from participation in paid work. Supervisor engagement is essential for successful job placement. OBJECTIVE: To elicit supervisor perspectives on the challenges involved in fostering integration to support individuals with mental health problems (trainees) in their job placement at ordinary companies. METHODS: Explorative, qualitative designed study with a phenomenological approach, based on semi-structured interviews with 15 supervisors involved in job placements for a total of 105 trainees (mean 7, min-max. 1-30, SD 8). Data analyzed using qualitative content analysis. RESULTS: Superviors experience two interrelated dilemmas concerning knowledge of the trainee and degree of preferential treatment. Challenges to obtaining successful integration were; motivational: 1) Supervisors previous experience with trainees encourages future engagement, 2) Developing a realistic picture of the situation, and 3) Disclosure and knowledge of mental health problems, and continuity challenges: 4) Sustaining trainee cooperation throughout the placement process, 5) Building and maintaining a good relationship between supervisor and trainee, and 6) Ensuring continuous cooperation with the social security system and other stakeholders. CONCLUSIONS: Supervisors experience relational dilemmas regarding pre-judgment, privacy and equality. Job placement will be maximized when the stakeholders are motivated and recognize that cooperation must be a continuous process. KEYWORDS: Work disability prevention; return to work; sick leave; supported employment; vocational rehabilitation