Supporting young adults experiencing psychosis with their employment : A qualitative exploration of occupational therapists' experiences

Introduction
Young adults experiencing psychosis have the same plans for work and future careers as their peers; however, many find themselves unable to participate. While there is research available about interventions used to support employment of young adults with psychosis, there is little evidence regarding the experience of occupational therapists working in this field and the vocational rehabilitation interventions and practices they use.

Methods
A descriptive qualitative study using semi-structured interviews was used to explore the perspectives of occupational therapy practitioners who support young adults experiencing psychosis with employment. Qualitative data analysis was guided by cross case inductive thematic analysis.

Consumer and community involvement
This study did not include consumer and community involvement.

Findings
There were nine participants, two male and seven females (average 14.7 years mental health experience and age 39 years). All occupational therapists in this study were providing employment support interventions to young adults experiencing psychosis. These ranged from support with career exploration and job seeking to support with keeping and changing jobs. Thematic analysis generated five themes that characterised their experience including psychosis can make securing employment harder for young adults, young adults' pathways to work, and employment destinations of young adults. Finally, employment support interventions and strategies for young adults experiencing psychosis and the service system context—providers, problems, and possibilities for change were described.

Conclusion
Young adults experiencing psychosis can miss out on the employment support they need when services are not accessible and evidence-based interventions, such as individual placement and support and early intervention, are not available. Occupational therapists prioritise employment when working with young adults experiencing psychosis. Occupational therapists with their person-centred, consumer-directed, and occupation-focussed approach can provide a range of employment support interventions to enable young adults experiencing psychosis to reach their work and career goals.

PLAIN LANGUAGE SUMMARY
Nine occupational therapists shared how they help young people with psychosis find jobs. Not having transport or work experience can make it hard for young people to work. The occupational therapists talked about how it can be hard to work when you have psychosis. They shared ways to find a job. They shared stories of young people finding their own jobs, starting their own companies or getting jobs from family and friends. Sometimes young people wanted help, and they were having trouble getting someone to help them. Occupational therapists were trying to help young people get a job if they asked for help. For example, they helped young people think about jobs they would like to do and helped them with job applications. Young people need all the services and people they work with to help them with finding and keeping their jobs.

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