Moving beyond the illness: Factors contributing to gaining and maintainingemployment

The work presented here, exploratory in nature, uses a comparative and qual itative approach to understand the factors associated with the ability of i ndividuals with severe and persistent mental illness to successfully gain a nd maintain employment. Based on open-ended interviews with individuals in an Assertive Community Treatment (A CT) program we compare the experiences of those who have been successful gaining and maintaining employment, with those who have been successful gaining but not maintaining work, and those who have been unsuccessful gaining employment. The three groups seemed to d iffer in three significant ways: (1) in the ways the individuals talked abo ut their illness, (2) in the ways the individuals talked about work, and (3 ) in the strategies they described for coping with bad days. In each of the se areas individuals' awareness of and attitude toward their illness was si gnificant. The findings have clear implications for agencies working to hel p people with severe and persistent mental illness obtain and maintain empl oyment.