Resilience at work

An ecological conceptualisation of resilience was one of the major orientating concepts for this doctoral research which used critical realist methodology to gain explanatory insight into the job retention challenges faced by employees recovering from mental health problems. Methods involved a literature review of qualitative job retention research, a comparative case study approach, and service user collaboration. One case study comprised seven employed people who were using acute mental health services. The second comparative case study comprised fourteen users of a community-based job retention project. Work mattered to people during recovery because of feelings of guilt about not working, and because some feared that work had, or could, exacerbate their mental health problems. Such fears co-existed with a strong sense that work was an important part of people's lives in terms of finance, social capital, occupational capital and personal capital. These assets were under threat, but they also had the potential to be deployed to support a resilient recovery. Participants were on complex and uncertain return-to-work journeys, facing a combination of internal and external obstacles. Barriers arose from the direct impacts of mental health problems, external and internalised stigma, job demands and the workplace environment - particularly relationships with colleagues and, above all, managers. Findings suggest that return-to-work trajectories are likely to be more successful and sustainable when such challenges are addressed. Broader implications were that occupational and ecological resilience perspectives can be integrated to help understand the challenges people with mental health problems encounter when seeking to retain employment.