LAUSR

Background. A mixed-methods case study exploring access to competitive employment for persons with serious mental illness (SMI) revealed limited access to work and low employment success across two northern communities. Purpose. To explore possible explanations for why low employment rates persist despite existing employment services and supports. Methods. A total of 46 individual or group interviews were conducted with persons with SMI, vocational providers, and decision-makers regarding access to competitive employment in the case communities. Data were systematically analysed for dominant ideas, interests and institutions using a neo-institutional framework. Findings. Participants described access to employment to be constrained by provider competition, limited supports, and a lack of consideration of difference—ideas and interests associated with neoliberal influences within provincial employment supports policy. Implications. Enabling participation in meaningful employment for people with SMI will require occupational therapists to appreciate and contest the oppressive nature of neoliberal policies on local programs and services.