Persisting Barriers to Employment for Recently Housed Adults with Mental Illness Who Were Homeless

J Urban Health. 2016 Feb;93(1):96-108. doi: 10.1007/s11524-015-0012-y.

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.

Keywords: Homelessness; Mental illness; Supported employment; Supported housing.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Disclosure
  • Educational Status
  • Employment / psychology*
  • Employment / statistics & numerical data*
  • Female
  • Housing / statistics & numerical data*
  • Humans
  • Ill-Housed Persons / psychology*
  • Ill-Housed Persons / statistics & numerical data*
  • Interviews as Topic
  • Male
  • Mental Disorders / epidemiology*
  • Mental Disorders / psychology
  • Middle Aged
  • Motivation
  • Qualitative Research
  • Resilience, Psychological
  • Substance-Related Disorders / epidemiology