| The purpose of this study was to explore the influence of place on access to employment for persons who experience serious mental illness (SMI) residing in two northeastern Ontario case communities. A qualitative case study using mixed methods and participatory action research was used to explore access to employment, including rates of employment, and to examine whether place influenced their access to employment. Forty-six interviews conducted with persons who experience SMI, decision-makers and providers informed the findings and community-based participatory methods were used to engage stakeholders across the case communities. Qualitative findings indicate that participants are "stuck in the mud" regarding their experiences of access to employment. Participants described being trapped by a local discourse that questioned the capacity of persons with SMI to become employed, and by the low priority assigned to employment within the jurisdiction of community mental health. Participants were also immobilized by a variety of systemic and local tensions which contributed to a tendency to settle for less in the area of employment. Analyses of the dominant ideas and tensions evident in the interview data revealed the influence of neoliberal ideas and interests on policy and practices in this area. In general, the dominant ideas of individualism (and a disregard for difference), competition, and equality of opportunity are at the root of the dominant discourse regarding the employment of persons with SMI in the case communities, and contribute to their low employment success.;Primary quantitative data sources indicated limited participation in employment activities by people with SMI and their mental health providers, and restricted collaboration with the vocational services sector. Secondary quantitative data sources on 4,112 northern Ontario beneficiaries of income support revealed a 91.3 % unemployment rate, employment tenure not exceeding one year, and few beneficiaries exiting income support in the case communities. Policy implications target the competitive nature of the funding model for employment services and supports, the lack of a standard implementation plan for employment supports in Ontario, and the embedded disincentives for organizations to work together, to work with persons with SMI, or to work with individuals residing in rural places. Community-generated solutions target the need to build community capacity, to build consumer capacity, and to change the thinking about the capacity of persons with SMI for employment. It is hoped that by raising the bar and the expectations about the employability of persons with SMI in northeastern Ontario, employment may become a part of the mental health discourse and not merely an afterthought.;Place was found to influence the provision of best practice supported employment (SE) in the case communities. In the north, limited resources are dedicated to employment across a large geography. It is also argued that neoliberal ideas and interests influence funding and allocation decisions; these are I) antithetical to the provision of empirically-based employment supports and services, 2) an inadequate framework for providing supports and services to persons with SMI and other vulnerable populations experiencing difference, 3) insensitive to place and related effects, 4) contrary to collaboration, and 5) neither efficient nor effective in rural and northern contexts. |
