A Comparison of Healthcare Use and Costs for Workers with Psychiatric Disabilities Employed in Social Enterprises Versus Those Who Are Not Employed and Seeking Work.

Because of work's contribution to recovery, governments have moved to improve employment rates of people with severe mental disorders (SMDs). Social enterprises (SEs) have been identified as a means to achieve employment. In Ontario, Canada, the Ministry of Health and Long-Term Care (MOHLTC) have provided SEs government subsidies. Public funding arrangements create a potential trade-off for governments that must decide how to distribute constrained budgets to meet a variety of public needs. In Ontario, the government is potentially faced with choosing between supporting employment versus healthcare services. This study addresses the question, are there significant differences in service use and costs from the MOHLTC's perspective for people with SMDs working in SEs versus those who are not working and looking for work? Our results indicate there is a significant difference in healthcare use between the two groups suggesting there could be less healthcare use associated with SE employment.

Work Accommodations and Natural Supports for Employees with Severe Mental Illness in Social Businesses: An International Comparison.

Little is known about the types of work accommodations and natural supports that are useful for people experiencing severe mental illness working in social businesses. We conducted an exploratory, descriptive and cross-sectional investigation in Australia, Canada and Italy to study the nature of work accommodations and natural supports available in social businesses. Study findings are drawn from survey responses of a convenience sample of 90 employees with self-reported psychiatric disabilities. Results showed that, regardless of the country, social businesses provide many work accommodations and natural supports, especially those linked to schedule flexibility and support, while work accommodations related to training and schedule flexibility were linked to longer job tenure. Overall, this study advances our knowledge about the spectrum of work accommodations and natural supports that are available in social businesses for people with severe mental illness. Also, it highlights the type of work accommodations that are likely to support this population to sustain employment.

The affect heuristic in occupational safety.

BACKGROUND: The affect heuristic is a rule of thumb according to which, in the process of making a judgment or decision, people use affect as a cue. If a stimulus elicits positive affect then risks associated to that stimulus are viewed as low and benefits as high; conversely, if the stimulus elicits negative affect, then risks are perceived as high and benefits as low. OBJECTIVES: The basic tenet of this study is that affect heuristic guides worker's judgment and decision making in a risk situation. The more the worker likes her/his organization the less she/he will perceive the risks as high. METHOD: A sample of 115 employers and 65 employees working in small family agricultural businesses completed a questionnaire measuring perceived safety costs, psychological safety climate, affective commitment and safety compliance. RESULTS: A multi-sample structural analysis supported the thesis that safety compliance can be explained through an affect-based heuristic reasoning, but only for employers. CONCLUSIONS: Positive affective commitment towards their family business reduced employers' compliance with safety procedures by increasing the perceived cost of implementing them.

Workers' emotional exhaustion and mental well-being over the COVID-19 pandemic: a Dynamic Structural Equation Modeling (DSEM) approach.

The COVID-19 pandemic has presented significant challenges to the workforce, particularly concerning emotional and mental well-being. Given the prolonged periods of work-related stress, unexpected organizational changes, and uncertainties about work faced during the pandemic, it becomes imperative to study occupational health constructs under a dynamic methodological perspective, to understand their stable and unstable characteristics better. In this study, drawing on the Dynamic Structural Equation Modeling (DSEM) framework, we used a combination of multilevel AR(1) models, Residual-DSEM (RDSEM), multilevel bivariate VAR(1) models, and multilevel location-scale models to investigate the autoregression, trend, and (residual) cross-lagged relationships between emotional exhaustion (EmEx) and mental well-being (MWB) over the COVID-19 pandemic. Data were collected weekly on 533 workers from Germany (91.18%) and Italy (8.82%) who completed a self-reported battery (total number of observations = 3,946). Consistent with our hypotheses, results were as follows: (a) regarding autoregression, the autoregressive component for both EmEx and MWB was positive and significant, as well as it was their associated between-level variability; (b) regarding trend, over time EmEx significantly increased, while MWB significantly declined, furthermore both changes had a significant between-level variability; (c) regarding the longitudinal bivariate (cross-lagged) relationships, EmEx and MWB negatively and significantly affected each other from week to week, furthermore both cross-lagged relationships showed to have significant between-level variance. Overall, our study pointed attention to the vicious cycle between EmEx and MWB, even after controlling for their autoregressive component and trend, and supported the utility of DSEM in occupational health psychology studies.

Working plans of people with mental disorders employed in Italian social enterprises.

OBJECTIVE: Social Enterprises (SEn) are innovative companies that help disadvantaged people (e.g., individuals with mental disorders) with the work integration process. This study explores the working plan patterns of people with mental disorders employed in SEn. METHODS: A cross-sectional design was adopted. One hundred and forty individuals with mental disorders employed in 19 Italian SEn filled out a battery of questionnaires. RESULTS: We identified three patterns of working plans: Cluster 1 (n = 39, 30%) showed a stronger intention to work in a competitive labor market; Cluster 2 (n = 16, 12.3%) showed a stronger intention to stop working; Cluster 3 (n = 75, 57.7%) showed a stronger intention to continue working at a SEn. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Most of the sample had a pattern of intentions to keep working, thereby demonstrating the effectiveness of the SEn approach to work integration. Future studies should explore the approach further. Indeed, these results seem important for implications for practice, suggesting that people with mental disorders inside SEn can improve their level of interpersonal skills and reinforce their vocational identity, and ultimately increase their chances of employment in the regular labor market.

The mediational effect of social support between organizational identification and employees' health: a three-wave study on the social cure model.

BACKGROUND: Recent research postulated that organizational identification plays an important role in employees' health and well-being. Building on the Social Identity Approach as a framework, we test the so-called social cure hypothesis, according to which group-based processes of social support should reduce employees' psychological distress. DESIGN AND METHODS: While there is a considerable amount of cross-sectional evidence concerning the positive role played by organizational identification in this dynamic, there is a lack of full panel studies. This study tries to fill this gap by using data from a sample of technical and administrative staff of a University in Italy at three time points (N = 96). Data were analyzed using Autoregressive Cross-Lagged Panel models. RESULTS: We found support for the hypothesized longitudinal mediational model. Specifically, strongly identified employees tend to receive more social support, and this in turn reduces psychological distress over time. CONCLUSIONS: This study is the first test of the social cure hypothesis in an organizational context that uses a panel study design. We discuss the theoretical and practical implications for management.

Job Demand, Job Control, and Impaired Mental Health in the Experience of Workplace Bullying Behavior: A Two-Wave Study.

Workplace bullying is an extreme social stressor at work leading to a severe deterioration of health amongst its targets. Research has revealed two important orders of factors that may trigger workplace bullying: Poor working conditions and individual factors such as impaired mental health that determine a personal psychological vulnerability to bullying. However, research has rarely investigated their role simultaneously. In response, we investigated whether the relationship between poor working conditions (i.e., high job demand) at time 1 (T1) and the experience of bullying at time 2 (T2) is strengthened by experiencing symptoms of impaired mental health at T1. We also tested whether job control-which contributes to better working conditions-at T1 moderates the relationship between job demand at T1 and bullying at T2. Participants (N = 235) were workers in the health sector. The time lag between T1 and T2 was one year. Cross-lagged path analysis revealed that the relationship between job demand at T1 and the experience of bullying behavior at T2 was strengthened by T1 impaired mental health. This suggests that considering both working conditions and individual factors together may be important for reaching a better understanding of the development of bullying.

Relationships between mobbing at work and MMPI-2 personality profile, posttraumatic stress symptoms, and suicidal ideation and behavior.

This study investigates the relationships between the experience of mobbing at work and personality traits and symptom patterns as assessed by means of the revised version of the Minnesota Multiphasic Personality Inventory (MMPI-2). Participants were 107 workers who had contacted mental health services because they perceived themselves as victims of mobbing. In line with previous research, the results showed that the MMPI-2 mean profile was characterized by a neurotic component as evidenced by elevations of Scales 1, 2, and 3 and a paranoid component as indicated by elevation of Scale 6. Contrary to previous research, a pattern of positive and significant correlations was found between the frequency of exposure to mobbing behaviors and the MMPI-2 clinical, supplementary, and content scales, including the posttraumatic stress scale. Only about half the participants showed a severity of posttraumatic stress symptoms indicative of a posttraumatic stress disorder. The frequency of exposure to mobbing predicted suicidal ideation and behavior, with depression only partially mediating this relationship.

Work productivity of people with a psychiatric disability working in social firms.

BACKGROUND: Several factors impact work productivity in employees with a psychiatric condition. OBJECTIVE: In the context of social firms (SFs) the goal of this study is to test a theoretical model to predict work productivity across time, while considering worker and workplace factors. METHODS: 222 people with a psychiatric disability employed in SFs were enrolled in a longitudinal study (6 month follow up) and completed the baseline battery of questionnaires on health (severity of symptoms), individual (self-esteem as a worker) and organizational factors (organizational constraints and supervisory support), and their work productivity (also measured at follow-up). Path analysis was used to test the hypothetical model, assessing individual and organizational factors in the context of social firms that could facilitate or hamper work productivity in the immediate term (T1), as well as the stability of work productivity in the middle/long term (T2 or 6 month follow up). RESULTS: Work productivity of people with a psychiatric disability was affected negatively by severity of the symptoms, organizational constraints, and positively by self- esteem as a worker at T1. The stability of work productivity was significant across time (T2). Supervisor support was only related to work productivity at 6 month follow-up. CONCLUSIONS: The results highlight the importance of the supportive workplaces for people with mental disorders that SFs provide, and the stability of work productivity across time. Supervisor support seems to have a delayed impact on work productivity. In future studies, researchers could determine how individual and organizational variables influence job tenure of employees with a psychiatric disability.

Can social firms contribute to alleviating the economic burden of psychiatric disabilities for the public healthcare system?

In a number of countries, unemployment rates for people with psychiatric disabilities are much higher than in the general population. On the one hand, the expenses for mental health reach 3.5% of the total public health and social services budget in Québec. On the other hand, social firms (SFs) receive government subsidies. The objective was to compare public healthcare expenses for people with psychiatric disabilities who work in SFs with those associated with people with a similar condition who are looking for a job in the competitive labour market. This study followed a retrospective comparative design and considered two groups, namely: 122 employees working in SFs and 64 individuals participating in a supported employment program as job-seekers. Two complementary datasets were used: a self-report questionnaire and public healthcare databases. The cost analysis was performed from the perspective of the public healthcare system and included outpatient visit fees to physicians, outpatient visits to health professionals other than physicians in public healthcare centres, inpatient expenses due to hospitalisations, emergency room visits and amounts reimbursed to patients for medication. Regression analyses using generalised linear models with a gamma distribution and log link were used. Our results revealed that when controlling for sociodemographic variables (gender, age, marital status, education, physical disability), global health (EuroQol EQ-5D-5L), the severity of psychiatric symptoms (18-item Brief Symptom Inventory) and self-declared primary mental health diagnosis, annual healthcare costs paid by the public insurance system were between $1,924 and $3,912 lower for people working in SFs than for the comparison group. An explanatory hypothesis is that working in SFs could act as a substitute for medical treatments such as outpatient visits and medication use. There might be a form of compensation between supporting SFs and financing the public healthcare system, which provides valuable insights for public decision-making.

Unraveling the organizational mechanism at the root of safety compliance in an Italian manufacturing firm.

Safety performance is recognized as the more proximal and effective precursor of safety outcomes. In particular, safety compliance significantly reduces workplace accidents and injuries. However, it is not entirely clear what role organizational factors play in determining workers' safety. The present study contributes to defining which organizational factors increase safety compliance by testing a mediational model in which supervisor support is related to safety climate, which in turn is related to organizational identification that finally is related to safety compliance. We tested our hypotheses in a sample of 186 production workers of an Italian manufacturing firm using a cross-sectional design. Findings confirm our hypotheses. Management should consider these organizational factors in order to implement primary prevention practices against work accidents.

Reducing perceived stigma: Work integration of people with severe mental disorders in Italian social enterprise.

OBJECTIVE: People with mental illnesses face stigma that hinders their full integration into society. Work is a major determinant of social inclusion, however, people with mental disorders have fewer opportunities to work. Emerging evidence suggests that social enterprises help disadvantaged people with their work integration process. The purpose of this study is to enhance our understanding about how perceptions of stigma can be decreased for people with mental disorders throughout their work experience in a social enterprise. METHOD: Using a longitudinal study design, 310 individuals with mental disorders employed in Italian social enterprises completed a battery of questionnaires on individual (e.g., severity of symptoms; occupational self-efficacy) and environmental (e.g., social support; organizational constraints) variables. Of the 223 individuals potentially eligible at the 12-month follow up, 139 completed a battery of questionnaires on social and working skills, perceived work productivity and perceived stigma. Path analyses were used to test a model delineating how people with mental disorders working in social enterprises improve social and work outcomes (i.e., motivation, skills and productivity), and reduce the perception of being stigmatized. RESULTS: Working in a social enterprise enhances working social skills, which leads to a perception of higher productivity and, consequently, the perception of being discriminated against and stigmatized is reduced. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Social enterprise provides a context in which people with mental disorders reach a sense of work-related and social competence. This sense of competence helps them to reduce perceived stigma, which is a crucial step toward social inclusion. (PsycINFO Database Record

A serial mediation model of workplace social support on work productivity: the role of self-stigma and job tenure self-efficacy in people with severe mental disorders.

PURPOSE: Compared to groups with other disabilities, people with a severe mental illness face the greatest stigma and barriers to employment opportunities. This study contributes to the understanding of the relationship between workplace social support and work productivity in people with severe mental illness working in Social Enterprises by taking into account the mediating role of self-stigma and job tenure self-efficacy. METHOD: A total of 170 individuals with a severe mental disorder employed in a Social Enterprise filled out questionnaires assessing personal and work-related variables at Phase-1 (baseline) and Phase-2 (6-month follow-up). Process modeling was used to test for serial mediation. RESULTS: In the Social Enterprise workplace, social support yields better perceptions of work productivity through lower levels of internalized stigma and higher confidence in facing job-related problems. When testing serial multiple mediations, the specific indirect effect of high workplace social support on work productivity through both low internalized stigma and high job tenure self-efficacy was significant with a point estimate of 1.01 (95% CI = 0.42, 2.28). CONCLUSIONS: Continued work in this area can provide guidance for organizations in the open labor market addressing the challenges posed by the work integration of people with severe mental illness. Implications for Rehabilitation: Work integration of people with severe mental disorders is difficult because of limited access to supportive and nondiscriminatory workplaces. Social enterprise represents an effective model for supporting people with severe mental disorders to integrate the labor market. In the social enterprise workplace, social support yields better perceptions of work productivity through lower levels of internalized stigma and higher confidence in facing job-related problems.

The relation between overcommitment and burnout: does it depend on employee job satisfaction?

Using the Conservation of Resources (COR) theory as a framework, we hypothesized a maladaptive role played by overcommitment in the escalation of burnout. We further specified our model by testing an interaction effect of job satisfaction. By using a longitudinal design, we proposed a moderated mediational model in which burnout at Time 1 (T1) increases overcommitment, which in turn leads to more burnout one month later. We further expected to find a moderating role of job satisfaction in the link between overcommitment and burnout at Time 2 (T2). A group of 86 white-collar workers in personnel services in Italy (longitudinal response rate = 77.48%) participated in our study. The findings supported our hypotheses even when controlling for gender and role stressors. In particular, by using bootstrapping procedures to test mediation, we found evidence that employees reporting burnout tend to develop a maladaptive coping style, i.e., overcommitment, which in turn increases burnout over time. This relation was particularly strong for dissatisfied employees. These results highlight the importance of overcommitment for burnout escalation, as well as of job satisfaction, since it may mitigate, at least in the short term, the effect of such dysfunctional strategies.

Individual and environmental factors related to job satisfaction in people with severe mental illness employed in social enterprises.

OBJECTIVE: The purpose of this study was to enhance understanding of the impact of individual and environmental variables on job satisfaction among people with severe mental illness employed in social enterprises. PARTICIPANTS: A total of 248 individuals with severe mental illness employed by social enterprises agreed to take part in the study. METHODS: We used logistic regression to analyse job satisfaction. A model with job satisfaction as the dependent variable, and both individual (occupational self-efficacy and severity of symptoms perceived) and environmental (workplace) factors (provision of workplace accommodations, social support from co-workers, organizational constraints) as well as external factors (family support) as predictors, was tested on the entire sample. RESULTS: All findings across the study suggest a significant positive impact of both individual and environmental factors on job satisfaction. People with higher occupational self-efficacy who were provided with workplace accommodations and received greater social support were more likely to experience greater job satisfaction. CONCLUSIONS: These results suggest that certain features of social enterprises, such as workplace accommodations, are important in promoting job satisfaction in people with severe mental illness. Further studies are warranted to expand knowledge of the workplace features that support employees with severe mental illness in their work integration process.

Workplace bullying and its relation with work characteristics, personality, and post-traumatic stress symptoms: an integrated model.

Workplace bullying refers to prolonged exposure to frequent hostile behaviors at work, which can lead to severe stress reactions. Research in this area has not revealed a clear picture on how bullying escalates in organizations. Drawing on recent developments in work stress theory, this study tested a comprehensive model of bullying in which work environmental and personality factors were hypothesized to act as antecedents of bullying and post-traumatic stress symptoms as an outcome. Structural equation modeling on data provided by 609 public sector employees in Italy showed that job demands (workload and role conflict) and job resources (decision authority, co-worker support and salary/promotion prospects) were related to bullying over and above neuroticism, and that bullying mediated the relationship between job demands and PTSD symptoms. Evidence also emerged for a buffering effect of job resources on the job demands-bullying relationship. Overall results are compatible with a view of bullying as a strain phenomenon, initiated by both work environmental and personality factors.