Managing disclosure in recent-onset psychosis: utilizing the individual placement and support model

Presentation First Author: 
Luana R Turner

Individual Placement and Support is the most studied evidence-based approach to supported employment for severe mental illness, including recent-onset psychosis. Furthermore, employment and education are viewed as integral aspects of treatment and recovery. Yet, there is little discourse or empirical work regarding the management of mental illness disclosure to employers or educators when utilizing the Individual Placement and Support model. Our presentation describes the initial disclosure preferences of young people with recent-onset psychosis enrolled in Individual Placement and Support, and guidance for managing disclosure when delivering Individual Placement and Support with this population. Drawing from sites experienced in providing Individual Placement and Support to recent-onset psychosis clients in Melbourne, Australia and Los Angeles, USA, client initial disclosure preferences were computed. Results indicate no disclosure of mental illness or disability was requested by 54-59% of clients, requiring the Individual Placement and Support worker to work ‘behind the scenes’ and 46-51% of clients permitted partial or complete disclosure, allowing the Individual Placement and Support worker to have contact with employers/instructors and work ‘on the front lines’. Two illustrative case vignettes will be presented to describe the approaches to providing Individual Placement and Support when no disclosure is permitted as compared with when disclosure is permitted. The Individual Placement and Support principles will be presented and illustrate the educative and collaborative manner which embodies this model, while honouring client disclosure preferences. It is suggested that level of disclosure does not prevent successful supported employment outcomes, although this supposition requires empirical investigation.

Conference Name: 
Presentation Date: 
January, 2013
Additional Authors: 
Luana R Turner, Gina L Chinnery, Kelly A Allott, Keith H Nuechterlein, Eoin J Killackey
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