title: Persisting Barriers to Employment for Recently Housed Adults with Mental Illness Who Were Homeless.
abstract: Adults with mental illness who are homeless experience multiple barriers to employment, contributing to difficulties securing and maintaining housing. Housing First programs provide quick, low-barrier access to housing and support services for this population, but their success in improving employment outcomes has been limited. Supported employment interventions may augment Housing First programs and address barriers to employment for homeless adults with mental illness. The present paper presents data from qualitative interviews to shed light on the persisting barriers to employment among people formerly homeless. Once housed, barriers to employment persisted, including the following: (1) worries about disclosing sensitive information, (2) fluctuating motivation, (3) continued substance use, and (4) fears about re-experiencing homelessness-related trauma. Nevertheless, participants reported that their experiences of homelessness helped them develop interpersonal strength and resilience. Discussing barriers with an employment specialist helps participants develop strategies to overcome them, but employment specialists must be sensitive to specific homelessness-related experiences that may not be immediately evident. Supported housing was insufficient to help people return to employment. Supported employment may help people return to work by addressing persisting barriers.
authors.affiliation: Centre for Research on Inner City Health, the Keenan Research Centre, Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Canada. Daniel.poremski@mail.mcgill.ca.|Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore. Daniel.poremski@mail.mcgill.ca.
authors.forename: Daniel
authors.initials: D
authors.lastname: Poremski
authors.affiliation: Centre for Research on Inner City Health, the Keenan Research Centre, Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Canada.
authors.forename: Julia
authors.initials: J
authors.lastname: Woodhall-Melnik
authors.affiliation: Department of Psychiatry, McGill University, Montreal, Canada.
authors.forename: Ashley J
authors.initials: AJ
authors.lastname: Lemieux
authors.affiliation: Centre for Research on Inner City Health, the Keenan Research Centre, Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Canada.|Department of Psychiatry, University of Toronto, Toronto, Canada.
authors.forename: Vicky
authors.initials: V
authors.lastname: Stergiopoulos
mesh_terms: D000328:Adult; D000368:Aged; D030881:Disclosure; D004522:Educational Status; D004651:Employment / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology* / Q000706:statistics & numerical data*; D006798:Housing / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D009042:Motivation; D036301:Qualitative Research; D055500:Resilience, Psychological; D019966:Substance-Related Disorders / Q000453:epidemiology
keywords: Homelessness; Mental illness; Supported employment; Supported housing