Enhancing employment outcome among stable psychiatric patients: lesson learnt on innovative model of work inclusion

Karniza Khalid ,1,2 Ruzita Jamaluddin,3 Mohd. Safiee Ismail4

(1) Clinical Research Centre, Hospital Tuanku Fauziah, Ministry of Health Malaysia, Kangar, Malaysia (2) Specialised Diagnostic Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia (3) Department of Psychiatry and Mental Health, Hospital Tuanku Fauziah, Ministry of Health Malaysia, Kangar, Malaysia (4) Director’s Office, Hospital Tuanku Fauziah, Ministry of Health Malaysia, Kangar, Malaysia


Background Poor employment rate among psychiatric patients is poorly discussed.

Purpose To share our strategies in boosting employment rate among stable psychiatric patients and discuss the lessons learnt.

Particular focus Multifaceted strategies were remodelled to ensure a three-dimensional optimisation: (1) strengthening clinical service to ensure stable disease and appropriate patient selection through battery of assessments, (2) provision of psychosocial support to boost self-esteem and foster discipline among patients through encouragement, guidance and regular monitoring by the multidisciplinary community mental health team and (3) encourage willingness and confidence among stakeholders and local market to host job opportunities to stable mental health patients.

Overview The yearly employment rate among our stable psychiatric patients under supported employment programme from 2020 to 2021 was 28.6% (2/7) and 30.0% (3/10), respectively. A qualitative survey found the main hindrance to recruitment were employers’ scepticism on work performance, while poor work retention was due to patients’ lack of specific skill set and discipline to adhere to routine. We restructured our supported employment programme by adding the role of community mental health facility to foster discipline and routine for 6 months prior to referral to a job coach. Until June 2022, two out of five patients managed to secure job positions (40.0%). Despite our efforts to improve employment with the instituted remedial strategy, we still fail to reach the minimum standard set by ministry. Future plan will focus on tailoring individual interests to a specific set of skills that match industrial expectation prior to seeking employment. Additionally, enhancing public education using social media may foster better inclusion of psychiatric patients and social acceptance.