Affiliations: Department of Occupational Science and Occupational
Therapy, University of Toronto, Toronto, Canada | Graduate Department of Rehabilitation Sciences,
University of Toronto, Toronto, Canada | Kunin-Lunenfeld Applied Research Unit, Toronto,
Canada | School of Rehabilitation Therapy, Queen's University,
Ontario, Canada | School of Occupational Therapy, University of Western
Ontario, Ontario, Canada | School of Rehabilitation Science, McMaster University,
Ontario, Canada
Note: [] Address for correspondence: Bonnie Kirsh, PhD. Department of
Occupational Science & Occupational Therapy, University of Toronto, 500
University Ave., Toronto M5G 1V7, Canada. Tel.: +1 416 978 4647; Fax: +1 416
946 7102; E-mail: [email protected]
Abstract: Employment is a right of citizenship and a social determinant of
health, but employment rates remain low for persons with disabilities. The
purpose of this paper is to examine the principles and practices guiding work
integration within the fields of intellectual disability (ID), brain injury,
and mental illness and to identify best practices to support transitions to
employment across these three groups. This integrative review drew upon an
occupational perspective to analyze the current literature. Findings reveal
that the need and benefits of working are recognized across disability groups
but that philosophical perspectives guiding work integration differ. In the
area of mental illness, recovery is seen as a process within which work plays
an important role, in ID work is viewed as a planned outcome that is part of
the developmental process, and in the field of brain injury, outcomes of
employability and employment are emphasized. A common theme across the three
disability groups is that in order to facilitate work integration, the person,
the job and the work environment are important factors in need of examination.
Evidence pointing to the effectiveness of the supported employment model is
increasing across these three populations. A framework for guiding the
development of further research and for promoting changes to support work
integration is presented.
Keywords: Brain injury, mental illness, intellectual disability, employment, work integration
