The shift to rapid job placement for people living with mental illness: An analysis of consequences.
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OBJECTIVE: This article reports on the consequences of the revised policy for employment supports within the Ontario Disability Support Program, a disability benefit program administered by the provincial government in Ontario, Canada. The revised policy involves a change from a fee-for-service model to an outcome-based funding model. This revision has encouraged a shift from preemployment to job placement services, with a particular focus on rapid placement into available jobs. METHOD: Using a qualitative case study approach, 25 key informant interviews were conducted with individuals involved in developing or implementing the policy, or delivering employment services for individuals living with mental illness under the policy. Policy documents were also reviewed in order to explore the intent of the policy. Analysis focused on exploring how the policy has been implemented in practice, and its impact on employment services for individuals living with mental illness. RESULTS: The findings highlight how employment support practices have evolved under the new policy. Although there is now an increased focus on employment rather than preemployment supports, the financial imperative to place individuals into jobs as quickly as possible has decreased attention to career development. Jobs are reported to be concentrated at the entry-level with low pay and little security or benefits. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: These findings raise questions about the quality of employment being achieved under the new policy, highlight problems with adopting selected components of evidence-based approaches, and begin to explicate the influence that funding structures can have on practice.
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