Academic journal article The Journal of Rehabilitation

Consumers with a Bipolar Bisorder: A Theory-Based Approach to Explore Beliefs Impacting Job Placement

Academic journal article The Journal of Rehabilitation

Consumers with a Bipolar Bisorder: A Theory-Based Approach to Explore Beliefs Impacting Job Placement

Article excerpt

Of the U.S. population aged 18 and older, 57.7 million people have a diagnosable mental disorder in a given year. Mental disorders are the leading cause of disability in the U.S, of which bipolar disorder is the fifth leading cause of disability among young adults 15-44 years of age. Bipolar disorder has a 3.7% lifetime prevalence and affects approximately 5.7 million adults 18 years and older in a given year (National Alliance on Mental Health, 2009; World Health Organization, 2004; U.S. Census Bureau, 2005). The prognosis may facilitate distorted self-perception with a fluctuating mood, poor judgment and decision making; therefore limiting one's opportunities to complete vocational education and training, develop a successful work ethic, and establish appropriate attitudes and skills for work. The economic impact of bipolar disorder includes increased use of health services and lost productivity of wage earners that exceeds $17 billion and lost productivity costs due to suicide that exceeds $8 billion (Elinson, Houck, & Pincus, 2007; Kessler, Chui, Delmar, & Walters, 2005).

Among persons with bipolar disorder, functional impairment is likely and correlated with pre-morbid function, number of episodes, presence of inter-episode symptoms, co-morbidity, and neuroleptic treatment. There is a low rate of functional impairment recovery among persons with bipolar disorder, impacting their employment-seeking behavior. An estimated 60% of persons with bipolar disorder are unemployed, including persons with college degrees (Fenn et al., 2005; Laxman, Lovibond, & Hassan, 2008; Zarate, Tohen, Land, & Cavanagh, 2000).

During the past two decades, the Americans with Disabilities Act (ADA) enhanced opportunities for persons with disabilities, including persons with bipolar disorder. The ADA reflects congressional intent to prohibit discrimination against persons, who meet defined disability criteria. These persons are eligible for specific services, including job placement, through public vocational rehabilitation services (Americans with Disabilities Act, Section 3: Definitions, 1990). Although federal legislation addresses placement for persons with disabilities, there is limited emic or "insider" knowledge of the influences on rehabilitation professionals to place consumers with bipolar disorder into jobs.

Within the public vocational rehabilitation system, research suggests that job placement services for persons with disabilities is influenced by attitudes held by public rehabilitation placement professionals (e.g., job placement specialists, rehabilitation counselors, employment specialists) employed by state and federal vocational rehabilitation agencies to place individuals with disabilities into jobs. Attitudes of public rehabilitation placement professionals toward persons with disabilities (e.g., consumers) have been correlated with consumer self-concept, self-efficacy, and level of job-seeking skills (Hergenrather, Rhodes, & McDaniel, 2005; Mullins, Roessler, Schriner, Brown, & Bellini, 1997; West & Miller, 1999). Successful placement of persons with bipolar disorder may be enhanced by exploring and understanding the salient beliefs of public rehabilitation placement professionals toward the behavior of placing consumers with bipolar disorder.

The Theory of Planned Behavior (TPB) suggests that a person's behavior is a function of his or her salient beliefs toward performing a specific behavior (Ajzen, 2001; Ajzen, 1988). The TPB is a widely applied behavioral theory used to elicit and identify beliefs and develop interventions to enhance behaviors that include: behavioral determinants as predictors to work (Brouwer et al., 2009), HIV prevention among adolescents in the UK (Sutton, McVey, & Glanz, 1999), the effect of organization-based self esteem (Hsu & Kuo, 2003), research dissemination among addictions counselors (Breslin, Li, Tupker, & Sdao-Jarvie, 2001), placement of consumers with a disability of substance abuse (Hergenrather & Rhodes, 2006), technology training adaptation in the workplace (Morris & Venkatesh, 2000), enrollment in distance education courses (Becker & Gibson, 1998), placement of consumers with HIV/AIDS (Hergenrather & Rhodes, 2008), and influences of intrinsic motivation on behavior (Chatzisarantis, Hagger, Smith, & Luke, 2006). …

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