In the psychosocial rehabilitation of people with severe mental illness (SMI), employment is an ingredient in the process of recovery and human rights, given the numerous benefits generated in each of the personal and social dimensions. Existing research has tried to determine the variables that favour or hinder access to the labour market by studying the experiences reported by people with SMI in ordinary employment. However, the results obtained do not allow us to reach a clear consensus on the variables that determine the success of the employment experience. The job satisfaction is presented as a variable to be studied in depth due to the few studies on this topic. We must insist on this issue because of its predictive nature. This paper provides a review of studies on job satisfaction as a predictor of success in the regular employment of people with TMG, for which different databases were consulted from 2010 to 2021.

Keywords: severe mental illness, employment, employment success, job satisfaction

Unemployed people with severe mental illness are on the path of social marginalization,¹ will depend on the family or social protection systems. For this reason, labor integration is a precedent for social integration and constitutes one of the most important objectives of psychosocial rehabilitation programs, for people with severe mental illness, given its positive effect on social functioning, the degree of satisfaction, personal autonomy, self-esteem, and ultimately, on the quality of life of these people.²

One of the main difficulties of occupational rehabilitation professionals, of people with SMI, is to define the predictors that differentiate which are good results of the rehabilitation process and which are not.³ For this reason, to analyze the existing studies on the variables that influence access and maintenance of employment for people with SMI, there are no definitive conclusions to obtain a consensus on the scientific evidence found.

Generally, research in relation to the employment of people with SMI has focused on the study of vocational outcomes (number of people who find a competitive job, hours of work, salary, duration of employment, retention rate, loss of employment and long-term effects). Currently there is little research on non-vocational outcomes (symptoms and hospitalization, self-esteem, cognitive functioning, quality of life, social contact, satisfaction, preferences, and social support), in relation to employment and the study population.⁴

Studies of job satisfaction are scarce but the data show that it is a variable with an important effect on access to and job tenure for people with mental illness.⁵ The coincidence between employment and personal preferences makes it possible to achieve high levels of satisfaction and longer-lasting jobs than in those cases in which the jobs do not coincide with personal preferences.⁶ Likewise, in a study by Resnick and Bond, 2001, job satisfaction measured during the first 3 months of a job was significantly associated with job tenure. Overall, the findings support the utility of job satisfaction as a tool in vocational rehabilitation.⁷

The electronic databases MEDLINE, Scopus, PubMed, EBSCOhost EJS, PsycINFo, PsycArticles were searched from 2010 to July 2021. The keywords used were: employment, severe mental illness and job satisfaction. Peer-reviewed journals and studies in English and Spanish were selected. The amount of 155 references were obtained 5 references that conformed to the subject of study were selected; articles that relate job satisfaction with job results of people with SMI. In the search process, the inclusion and exclusion criteria were defined for the search of the relevant published articles. Once the titles and abstracts had been selected, the full articles were reviewed. Two reviewers carried out the selection of studies and the analysis and synthesis of the information.

Individual factors and environmental factors related to job satisfaction of people with mental illness indicate that there is a significant impact of individual (self-efficacy and perceived severity of symptoms) and environmental (workplace) factors on job satisfaction. People who experienced more job satisfaction also expressed high self-efficacy and received workplace accommodations and employment support.⁸

Social enterprises (known in Greece as KoiSPE) are one of the sources of job opportunities for people with mental illness. A study investigated the job satisfaction of employees with mental illness and associated factors.

People with severe mental illness reported satisfaction with working conditions, the job itself, the organization as a whole, and the supervision provided, while they were dissatisfied with salary and their prospects for promotion. Higher-earning employees were significantly more satisfied with their work, and women were significantly more satisfied than men with the organization as a whole.The high level of job satisfaction with most of the work factors confirms the importance of employment for mentally ill people. The employment provided should correspond to the particular needs of this group of people.⁹

In Malaysia, 2014, examined the rate and predictors of successful employment at 3 months after enrollment in an employment program among patients with severe mental illness. Results showed a high employment rate among SMI patients. Significant predictors of employment were having a good work history and landing a preferred job. Other factors associated with successful employment were having a work history, good family support, lower number of psychiatric admissions, good compliance with medicine, good interest in work, being motivated to work, satisfied with the job or salary, getting a preferred job , have competitive or supported employment, and have higher PANNS scores in positive, negative, and general psychopathology.¹⁰

Cook and Miller, 2015, explored the relative effects of adverse working conditions, job satisfaction, wages, worker characteristics, and local labor markets by explaining voluntary job separations (resignations) among employed workers with psychiatric disabilities.

In multivariable analysis, workers were more likely to quit positions at which they were employed for 20 h/wk or less, those with which they were dissatisfied, low-wage jobs, non-temporary positions, and jobs in the structural (construction) occupations. Voluntary separation was less likely for older workers, members of racial and ethnic minority groups, and those residing in regions with lower unemployment rates. Patterns of job separations for workers with psychiatric disabilities mirrored some findings regarding job leaving in the general labor force but contradicted others. Job separation antecedents reflect the concentration of jobs for workers with psychiatric disabilities in the secondary labor market, characterized by low-salaried, temporary, and part-time employment.¹¹

Although the idea that employment is beneficial for recovery is valid, it must be qualified by the personal meanings attributed to these experiences, and the cultural and economic factors specific to each context. The meanings of work experience in people diagnosed with severe mental illness in Andalusia (Spain), a region with a high unemployment rate, show through narratives about work experience that certain obstacles to recovery. For example, participants mentioned personal conflict and stress, job insecurity, and meaningless jobs.¹²

Employment is very important in the lives of people with Serious Mental Illness and as a productive activity it favors cognitive development, interpersonal relationships and is an organizer of daily life.^13,14 Employment as retributive activity allows autonomy and active social role,^15,2 increases self-esteem through the role of worker and social recognition.^16,17

Most people with SMI want to have a competitive job¹⁸ but most of them lose it within six months on average.⁷

The scientific literature provides information on the predictive variables of success in the employment of people with SMI. Based on a systematic review of 22 qualitative studies published between 2000 and 2018, a series of facilitators for the access to employment of people with SMI was defined: personal factors (personality, adaptation, social skills, competences and experience), the network of support (social and institutional) and the characteristics of the work itself (support, connection and interest, environment, adaptations and salary). Likewise, the limitations of access and permanence to employment: personal characteristics (psychological aspects and mental illness), characteristics of employment (limited support, activity, salary and relationships), the social network (scarce resources and negative messages) and aspects of society (politics and stigmas).¹⁹

Currently, studies focused on job satisfaction are scarce, although there is a significant relationship between levels of satisfaction and access and permanence in employment for people with SMI. The current nature of work and the productive demands that it imposes on any person, the labor market, act as clear obstacles to the labor integration of people with SMI.

The characteristics of current employment and the productive demands are obstacles to the integration of people with SMI. Therefore, it is necessary to investigate and know the experiences and opinions of these people to define the variables that are related to job satisfaction. The work context will favor the learning of new skills, the acquisition of skills, social contact and relationships; it will allow people with SMI to have a life project and social integration.

None.

The autor declares there is no conflcit of interest.

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