Employment – hope and reality

Alex Williams (Service user based in Tunbridge Wells, UK)

Mental Health and Social Inclusion

ISSN: 2042-8308

Publication date: 23 November 2012



This article aims to explore what are likely to be key factors in a successful journey to employment for someone who has experienced long‐term mental distress.


The article is a personal account of entering and sustaining employment by someone who has experienced long‐term mental distress and use of secondary mental health services. The writer reflects on a hard fought journey to start paid work in the hope that readers may understand this process for themselves and others in similar positions.


Key factors in the transition to employment are hard work, workplace support, specialist vocational advice, individual determination and willing employers. Support needs to be flexible, personalised, ongoing and sometimes intensive. Time is measured in years rather than months.

Practical implications

The integration of specialist vocational advice within mental health teams may be an effective approach.

Research implications

Further research into the practical and psychological barriers to employment for mental health service users, which may extend far beyond the more commonly studied stigma and discrimination, would enhance existing knowledge of vocational rehabilitation.


Published testimonies from service users and survivors on their experiences of entering employment for the first time are few in number. More such testimonies would help understanding of this potentially complex process.



Williams, A. (2012), "Employment – hope and reality", Mental Health and Social Inclusion, Vol. 16 No. 4, pp. 201-205. https://doi.org/10.1108/20428301211281069

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Copyright © 2012, Emerald Group Publishing Limited

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