Introduction: People with serious mental illness (SMI) have an interest in working, but they experience high
levels of marginalization from the community based labour force. Psychiatric/psychosocial rehabilitation (PSR) has
advanced a variety of innovative approaches to address the range of individual, occupational, workplace and societal
factors that contribute to this marginalization. Employment and education-related approaches consistent with the values of
PSR include those that are directly focused on securing and sustaining employment or education, and those that create
employment opportunities. The objective of this review was to summarize the evidence for these approaches, report
predictors of outcomes where available and identify relevant gaps and other issues.
Method: A selective (but within that comprehensive) narrative review of the peer reviewed literature was conducted to
evaluate the status of the scholarship for four employment and education-related intervention approaches in this area.
Results: The individual placement and support (IPS) model has demonstrated efficacy in improving employment
outcomes. There are few empirical studies of social businesses and other initiatives to create employment for people with
SMI, although there has been a recent wave of promising literature and research on these approaches. There is some
support for supported education for this population, with a recent focus on the potential of supported education that is
directly linked to employment supports.
Conclusion: Work and education participation is improved with approaches that provide direct and comprehensive
supports to individuals with SMI as they engage in work and school. Career trajectories, the social status of jobs and the
economic status of individuals are emerging issues for further study to promote full social inclusion.