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A Qualitative Investigation of Individual and Contextual Factors Associated With Vocational Recovery Among People With Serious Mental Illness


  • Erin C. Dunn is now at the Department of Society, Human Development, and Health, Harvard School of Public Health; Nancy Wewiorski is now at the National Center on Family Homelessness, Newton, MA.

  • This work was supported by a grant to the Center for Psychiatric Rehabilitation at Boston University from the National Institute on Disability and Rehabilitation Research (NIDRR) within the Department of Education and the Center for Mental Health Services (CMHS), a division of the Substance Abuse and Mental Health Services Administration Grant H133B40024. The findings and interpretation of the data expressed in this article do not necessarily represent the views of NIDRR or the CMHS, and are the sole responsibility of the authors.

concerning this article should be addressed to E. Sally Rogers, Center for Psychiatric Rehabilitation, Boston University, Boston, MA 02215. Electronic mail may be sent to


Most people with serious mental illness (SMI) experience difficulty in fulfilling a vocational role, with many being unemployed or underemployed. Given the profound social and economic costs of this level of work impairment, researchers have investigated ways to enhance “vocational recovery,” or the processes through which people with SMI regain their role as workers and reintegrate into the workforce. Using data collected from a larger qualitative study of 23 individuals who had progressed to an advanced stage of recovery from SMI, this study explored respondents’ perspectives on employment and its relationship to their vocational recovery. Text passages describing employment were analyzed inductively by a diverse team of researchers. Seven themes were identified as being important in helping participants return to work or remain employed following the onset of a serious psychiatric disability: having the confidence to work, having the motivation to work, possessing work-related skills, assessing person–job fit, creating work opportunities, receiving social support, and having access to consumer-oriented programs and services. Implications of these findings on the development of interventions and policies to improve the vocational outcomes of people with SMI are discussed.

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