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Social Enterprises (SEn) are innovative companies that help disadvantaged people (e.g., individuals with mental disorders) with the work integration process. This study explores the working plan patterns of people with mental disorders employed in SEn. A cross-sectional design was adopted. One hundred and forty individuals with mental disorders employed in 19 Italian SEn filled out a battery of questionnaires. We identified three patterns of working plans: Cluster 1 (n = 39, 30%) showed a stronger intention to work in a competitive labor market; Cluster 2 (n = 16, 12.3%) showed a stronger intention to stop working; Cluster 3 (n = 75, 57.7%) showed a stronger intention to continue working at a SEn. Most of the sample had a pattern of intentions to keep working, thereby demonstrating the effectiveness of the SEn approach to work integration. Future studies should explore the approach further. Indeed, these results seem important for implications for practice, suggesting that people with mental disorders inside SEn can improve their level of interpersonal skills and reinforce their vocational identity, and ultimately increase their chances of employment in the regular labor market.
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55
Psychiatric Rehabilitation Journal
2011, Volume 35, No. 1, 55–58
Copyright 2011 Trustees of Boston University
DOI: 10.2975/35.1.2011.55.58
Brief report
Working Plans of People with
Mental Disorders Employed in
Italian Social Enterprises
t
Sara Zaniboni, Franco Fraccaroli and
Patrizia Villotti
University of Trento, Rovereto,
TN, Italy
Marc Corbière
University of Sherbrooke, Longueuil
QC, Canada
Acknowledgements: Funding for this study
was provided by the Municipality of Trento,
Italy. Fellowship for the first author has
been provided by the CAPRIT, QC, Canada.
Objective: Social Enterprises (SEn) are innovative companies that help disadvan-
taged people (e.g., individuals with mental disorders) with the work integration
process. This study explores the working plan patterns of people with mental dis-
orders employed in SEn. Methods: A cross-sectional design was adopted. One
hundred and forty individuals with mental disorders employed in 19 Italian SEn
filled out a battery of questionnaires. Results: We identified three patterns of
working plans: Cluster 1 (n= 39, 30%) showed a stronger intention to work in a
competitive labor market; Cluster 2 (n= 16, 12.3%) showed a stronger intention to
stop working; Cluster 3 (n= 75, 57.7%) showed a stronger intention to continue
working at a SEn. Conclusions and Implications for Practice: Most of the sample
had a pattern of intentions to keep working, thereby demonstrating the effective-
ness of the SEn approach to work integration. Future studies should explore the
approach further. Indeed, these results seem important for implications for prac-
tice, suggesting that people with mental disorders inside SEn can improve their
level of interpersonal skills and reinforce their vocational identity, and ultimately
increase their chances of employment in the regular labor market.
Keywords: social enterprises, mental disorders, working plans, cluster analysis
Different vocational services exist to
help with the work integration/reinte-
gration of people with mental disorders
(Corbière & Lecomte, 2009). Social
Enterprises (SEn) are an alternative to
vocational programs (Corbière &
Lecomte, 2009) and correspond to the
place-then-train approach placing the
person in real work situations prior to
offering them specific training
(Corrigan, 2001). SEn provide remuner-
ative work, like all businesses. They
also promote the physical, social, and
mental health of their employees, often
in a setting where a high percentage of
individuals have a mental or physical
disability (Savio & Righetti, 1993).
Disadvantaged people are usually re-
ferred by the Public Mental Health
Services. In terms of outcomes, SEn are
helpful in assisting people with mental
disability to improve income, work-re-
lated competence, social skills, and
psycho-social well-being (Ho & Chan,
2010; Pättiniemi, 2004).
Borzaga and Loss (2002) describe the
evolution of SEn Type B1in terms of
their purposes, from a “tool of social
inclusion” to a “labor policy tool.” The
initial goal of SEn implementation was
to integrate the disadvantaged into the
SEn. More recently, the main goal has
Psyc h i a t r i c Re h a b il i t ation J o u rn a l Working Plans of People with Mental Disorders
56
Report
been to integrate disadvantaged peo-
ple into the open labor market or, in
case of high disability, into a perma-
nent job in the SEn. The goal of obtain-
ing competitive employment may be
achieved after a period of training and
work experience within the SEn (on-
the-job training). Since SEn have differ-
ent work integration goals, it seems
important to explore the work inten-
tions of disadvantaged people working
in SEn, particularly people with mental
disorders. The theoretical and practical
reasons for focusing on work intentions
include: 1) No information exists in the
literature about the working plans of
people with mental disorders em-
ployed in SEn, yet intention has been
shown to be antecedent to actual work-
ing behavior (Azjen & Fishbein, 1980);
2) Studying future working plans could
provide margins for broader and more
timely intervention that could inform
SEn organizational policies.
The aim of this study is to explore the
work intentions of people with mental
disorders employed in Italian SEn and
to classify them on the basis of their fu-
ture working patterns. Indeed, people
exhibit different profiles in their future
plans, so that establishing clusters
would be useful for exploring differ-
ences among work-plan profiles ac-
cording to socio-demographic (i.e.,
gender and educational level), clinical
(i.e., severity of the symptoms), and
work (importance of work) variables.
Method
Participants
One hundred and forty individuals with
mental disorders, from a convenience
sample of 19 SEn Type B located in the
North of Italy, agreed to participate in
the research and completed a battery
of questionnaires. Of these, 63.8% (n=
83) were men. The average age of all
participants was 41 years (SD = 8.46,
age range: 20-64 years). Fifty-five per-
disagree and 7 = completely agree).
Cronbach’s alpha was .7.
Data Analyses
A cluster analysis procedure was used
to define working plan profiles in peo-
ple with mental disorders working in
SEn. We explored differences among
the clusters by considering: demo-
graphic information (using Chi-square
test of independence, appropriate for
categorical variables), clinical and
work-related variables (using one-way
Anova between-subjects, appropriate
for categorical independent variable
and continuous variables). All statisti-
cal analyses were conducted using
SPSS Version 17.0 software (SSPS Inc,
Chicago, IL).
Results
To classify individuals with mental dis-
orders into groups on the basis of their
working plans, we performed a hierar-
chical cluster analysis. Examination of
the agglomeration schedule and den-
drogram indicated that a three-cluster
solution provided the most relevant
pattern/profile of working plans. We
performed a k-means cluster analysis
using a three-cluster solution. The
means for the three clusters are pre-
sented in Figure 1. Cluster 1 (n= 39,
30%) showed strong intentions to work
in a public or private organization or to
freelance in a competitive labor mar-
ket, and, as a secondary choice, to con-
tinue to work in a SEn. Cluster 2 (n=
16, 12.3%) was characterized by strong
intentions to definitively stop working;
nonetheless, people in this cluster
were also indecisive since they did not
reject the idea of continuing to work.
People in Cluster 3 (n= 75, 57.7%) pre-
sented strong intentions to continue
working in a SEn, and, as a secondary
choice, to work in a public or private
organization.
cent (n= 72) of the participants held a
middle school certificate or less, 21.4%
(n= 28) had a secondary-level educa-
tion, 17.6% (n= 23) had completed
high school, and 6.1% (n= 8) had at-
tained a university-level qualification.
The psychiatric diagnosis (self-report)
consisted of 25% (n= 29) of people
with schizophrenia, 19% (n= 22) with
other psychotic disorders, 12.1% (n=
14) with depression, 9.5% (n= 11) with
a personality disorder, 3.4% (n= 4)
with anxiety disorders, and 31% (n=
36) with other psychiatric diagnoses
(e.g., substance abuse).
After complete description of the study
to the participants, written informed
consent was obtained. The research
was approved by the University of
Trento Research Ethics Board.
Measures
Working Plans – WP. Four items inves-
tigated the intentions to: stop working,
keep working at a SEn; work in a public
or private organization in the regular
labor market; undertake freelance
work. Items were scored on a 5-point
scale (1 = completely disagree and 5 =
completely agree).
The Brief Symptom Inventory – BSI
(Derogatis & Melisaratos, 1983). A self-
report scale of 53 items assessed the
symptom severity, using the global
severity index. Items were rated on a 4-
point scale (0 = not at all and 4 = ex-
tremely). Cronbach’s alpha was .97.
Importance of Work – IW (Roques,
1995). The concept of importance of
work originates from studies on the
meaning of working and refers to peo-
ple’s general attitude to work. We used
13 items, initially conceived for unem-
ployed people and subsequently
adapted to people with mental disor-
ders, to evaluate the importance of
work on a 7-point scale (1 = completely
57
Report
When the three working plan profiles
were compared, results from the Chi-
square tests of independence showed
no significant gender-based differ-
ences, c²(2, N= 127) = 5.50, p = .06,
age, c²(4, N= 127) = 3.67, p = .45, and
educational level, c²(8, N= 127) =
4.38, p = .82. The results from one-way
Anova between-subjects (post hoc
Fisher’s LSD test) showed no signifi-
cant differences for the Brief Symptom
Inventory, F(2, 127) = .04, p = .96, and
significant differences for Importance
of Work, F(2, 127) = 5.95, p = .003, on
the three working plan profiles. Post
hoc analyses showed that people with
mental disorders who plan to stop
working, Cluster 2 (M = 4.25, SD = .74),
reported significantly less IW com-
pared with those planning to work in a
SEn, Cluster 3 (M = 5.00, SD = .85), or
in a regular market, Cluster 1 (M = 4.78,
SD = .72).
Discussion
Our goal was to describe people with
mental disorders working in SEn, par-
ticularly their work intentions. Since
SEn have different work integration
goals for this population, it is crucial to
establish profiles of work intentions
and to investigate the relationship of
these profiles with demographic, clini-
summ e r 2 01 1 V olume 3 5 N u m b e r 1
their positive attitude to work and en-
hance their employment chances.
Since there were no significant differ-
ences for socio-demographic and clini-
cal variables among the three clusters,
these variables were not important for
describing the clusters obtained.
To conclude, the results of our research
showed the predominant pattern of in-
tentions related to continuing to work,
and this may be an indicator of the ef-
fectiveness of the SEn work integration
approach. The principal limitations are
the cross-sectional design of the study,
and the fact that the participants were
exclusively people with mental disor-
ders working in Italian SEn. It `would
be interesting if future studies compare
this model of SEn with models from
other contexts.
References
Azjen, I., & Fishbein, M. (1980). Understanding
attitudes and predicting social behavior.
New Jersey: Prentice Hall.
Borzaga, C., & Loss, M. (2002). Work integra-
tion social enterprises in Italy. From EMES
European Research Network
http://www.emes.net/fileadmin/emes/PD
F_files/PERSE/PERSE_WP_02-02_I.pdf
Corbière, M., & Lecomte, T. (2009). Vocational
services offered to people with severe
mental illness. Journal of Mental Health,
18, 38–50.
Corrigan, P. W. (2001). Place-then-train: An al-
ternative service paradigm for persons
with psychiatric disabilities. Clinical
Psychology: Science and Practice, 8,
334–349.
Derogatis, L. R., & Melisaratos, N. (1983). The
Brief Symptom Inventory: An introductory
report. Psychological Medicine, 13,
595–605.
Ho, A. P., & Chan, K. (2010). The social impact
of work-integration social enterprise in
Hong Kong. International Social Work, 53,
33–45.
Pättiniemi, P. (2004). Work Integration Social
Enterprises in Finland. From EMES
European Research Network:
http://www.emes.net/fileadmin/emes/PD
F_files/PERSE/PERSE_WP_04-07_FIN.pdf
Roques, M. (1995). Sortir du chômage. Liege:
Mardaga.
cal, and work-related variables. Three
profiles emerged from cluster analysis.
30% of participants wanted to work in
the regular labor market and SEn was
perceived as a step toward obtaining a
competitive job, consistently with the
purpose of the SEn. More than half of
participants perceived the SEn as a
good place to continue to work. This
work environment probably enables
people with mental disorders to feel
fulfilled as workers. With regard to the
implications for practice of these two
last clusters, people may improve their
level of interpersonal skills and rein-
force their vocational identity, poten-
tially transferable to the regular labor
market. Other authors have noted that
SEn have the advantage of offering
real-world remuneration and a sense of
belonging (Corbière & Lecomte, 2009).
Finally, a small percentage of partici-
pants (12%) were not interested in con-
tinuing to work. When the clusters
were compared, only WI differentiated
participants according to their working
plans. Otherwise, respondents who
gave more importance to work were
usually those who wanted to continue
working in SEn or who wanted to find
competitive employment. These results
are important for vocational and career
counseling services for people with
mental disorders, which can foster
Figure 1 – Patterns of Working Plans for People with Mental
Disorders Employed in Italian SEn
stop working social co-operative public or private free-lance work
organization
working plans
Cluster 1 – stronger intention to work in a competitive labor market (N=39, 30%)
Cluster 2 – stronger intention to stop working (N=16, 12.3%)
Cluster 3 – stronger intention to continue working inside a SEn (N=75, 57.7%)
35.1.2.2 Zaniboni 10
Figure 1. Patterns of Working Plans for People with Mental Disorders Employed in Italian
SEn
35.1.2.2 Zaniboni
1035.1.2.2 Zaniboni
SEn
Figure 1. Patterns of
lans for Ping orkWFigure 1. Patterns of
ental Meople with Plans for
mployed in Italian Eisorders Dental
mployed in Italian
Psyc h i a t r i c Re h a b il i t ation J o u rn a l Working Plans of People with Mental Disorders
58
Report
Savio, M., & Righetti, A. (1993). Cooperatives
as a social enterprise in Italy: A place for
social integration and rehabilitation. Acta
Psychiatrica Scandinavica, 88, 238–242.
Sara Zaniboni, PhD, Researcher, Department
of Cognitive Sciences and Education,
University of Trento, Rovereto (TN), Italy.
Franco Fraccaroli, PhD, Professor,
Department of Cognitive Sciences and
Education, University of Trento, Rovereto
(TN), Italy.
Patrizia Villotti, MS, PhD candidate,
Department of Cognitive Sciences and
Education, University of Trento, Rovereto
(TN), Italy.
Marc Corbière, PhD, Associate Professor,
School of Rehabilitation, University of
Sherbrooke, Centre for Action in Work
Disability Prevention and Rehabilitation,
Longueuil QC, Canada.
Corresponding Author:
Sara Zaniboni
Department of Cognitive Sciences and
Education
University of Trento
Corso Bettini 31
I-38068 Rovereto (TN), Italy
P: (+39) 0464 80 8138
Fax: (+39) 0464 808602
sara.zaniboni@unitn.it
Notes
1 Italian Law 381/1991 distinguishes between
two types of social enterprises: Type A deliv-
ers social, health and educational services;
Type B provides work integration for disad-
vantaged people through agriculture, indus-
trial, commercial or service activities.
... Notably, in the context of Social Enterprise (unlike 'sheltered employment'), workers are all attributed the socially valued status and rights of 'employees', rather than being considered 'clients' of the service. Zaniboni, Fraccaroli, Villotti, and Corbiere (2011) examined Social Enterprises in Italy and noted that they shared similar characteristics to vocational rehabilitation services, with 'place and train models' of engagement. In Australia, similar models have existed since that mid 1950's, when the Commonwealth Rehabilitation Service (CRS) was established to work with people with 'non-life long disability' to re-enter the workforce. ...
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Work-integration social enterprises (WISEs), established mainly by non-government welfare agencies and managed by social workers, provide disadvantaged groups with an opportunity for employment and training in businesses. The participants benefit in terms of income, and also through expanded social networks and improved psycho-social well-being. WISEs thus contribute to poverty alleviation and social capital building.
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Background: Vocational services offered to people with severe mental illness represent a cornerstone for their social integration. Differences in terminology and the adaptations or modifications in vocational services make it difficult for stakeholders to have a clear understanding of the goals and content of the vocational services offered to people with severe mental illness. Aims: To facilitate comparisons of vocational services worldwide; this paper describes the most common types of vocational services identified in the literature. Conclusion: An empirical investigation of the effectiveness of specific vocational services components is warranted in order to determine which types or combinations of services work best for which individuals with severe mental illness.
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Train-place programs make up the traditional paradigm for addressing the vocational and independent living goals blocked by psychiatric disabilities; the strategy is to train persons in the necessary skills to manage their disability, only then placing them in settings where they might accomplish work and residential goals without the fear of relapse. Place-train services, which consist of placing persons on the job or in their apartments and then training them in the skills they immediately need to succeed in these settings, describe an alternative paradigm that challenges many of the notions of traditional services. In particular, place-train approaches contest a basic assumption of traditional services—namely, using a carefully mapped continuum of care to slowly progress persons through safe environments until they are able to cope with the demands of working and living in the real word. Place-train approaches also contest other assumptions of the traditional service delivery system: assessing readiness for specific services, contrasting readiness with adherence to treatment; and defining relapse and recovery. The implication of these challenges for clinical services is discussed.
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Synopsis This is an introductory report for the Brief Symptom Inventory (BSI), a brief psychological self-report symptom scale. The BSI was developed from its longer parent instrument, the SCL-90-R, and psychometric evaluation reveals it to be an acceptable short alternative to the complete scale. Both test-retest and internal consistency reliabilities are shown to be very good for the primary symptom dimensions of the BSI, and its correlations with the comparable dimensions of the SCL-90-R are quite high. In terms of validation, high convergence between BSI scales and like dimensions of the MMPI provide good evidence of convergent validity, and factor analytic studies of the internal structure of the scale contribute evidence of construct validity. Several criterion-oriented validity studies have also been completed with this instrument
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This article analyses the history and development of an integrated cooperative established in 1981 in northern Italy. Integrated cooperatives, otherwise known as social enterprises, are among the most interesting activities developed in the area of social assistance and rehabilitation in recent years in Italy. In particular, they acquired relevance in the care of mentally disordered people by providing them with job opportunities, which is an important rehabilitative and integrative factor. The aim of social enterprises is two-fold. They have the economic goal of offering remunerative work just as any other commercial enterprise, as well as the social mandate of promoting the physical, social, and mental health of their members. A positive coexistence between market competition and rehabilitation is therefore constantly pursued. This research aimed at analysing the working and social experience of people employed by the cooperative during its 10-year life. The study was limited to those who had a social or health problem when entering the cooperative. The investigation was promoted by cooperative members, who felt the need to document their experience and to undertake initiatives towards evaluating the rehabilitative value of the social enterprise. The results show that cooperative members come from different marginalized areas of social and health distress, of which the two largest are social service users and psychiatric service users. There is a noticeable turn-over rate, which underlines one function of the cooperative as being a transitional working context from which users can gain access to other more rewarding job opportunities in the labour market.
Work Integration Social Enterprises in Finland. From EMES European Research Network: http://www.emes.net/fileadmin/emes
  • P Pättiniemi
Pättiniemi, P. (2004). Work Integration Social Enterprises in Finland. From EMES European Research Network: http://www.emes.net/fileadmin/emes/PD F_files/PERSE/PERSE_WP_04-07_FIN.pdf