Funded with 4 million euros, Work & Psyche has been an experimental project to test, validate and disseminate an innovative approach to employment assistance for people with serious mental disorders.
The project pursued the following goals:
- increasing employment in public agencies, social enterprises and mainstream businesses as well as job tenure for people with mental disorders;
- supporting and easing their transition into employment, promoting their social inclusion and development of interpersonal relationships
- fostering the formation of a coordinated system of private and public services supporting people with mental illness;
- raising awareness in the labor market of the importance of integrating people with mental disorders into the world of work;
- launching partnerships among businesses, social enterprises and public services to promote integration into the world of work for people with mental illness;
- developing an employment assistance policy for people with mental disorders based on the project experience, if successful.
The project was backed by Lombardy’s Regional Administration and coordinated by a Steering Committee made up of representatives from Fondazione Cariplo, Lombardy’s Regional Administration (Directorates General for Health, Education & Employment, Family, Social Solidarity and Volunteer Work), Federsolidarietà (federation of social cooperatives, a member of the Confederation of Italian Co-operatives), Urasam (union of associations in Lombardy helping people with mental health problems and their families), Assolombarda (Lombard business association, a member of the Confederation of Italian Industry), Ala Sacco (Milan Sacco Hospital Education & Employment Services for people with mental illnesses, as implementing organization) and ASVAPP (organization for research, analysis and assessment of public policies, as independent assessor).
Work&Psyche introduced three key novel features:
- Technical Committees. Implementing already existing regional legislation (Circular 19 of the Lombardy Regional Administration health department dated 2005), a Technical Committee on easing employment for people with mental disorders was established within each of 4 Mental Health Coordination Units (MHCUs) in Lombardy. These committees involved and engaged a broad set of players in their work as their members included representatives from: local healthcare units, hospitals, provincial administrations’ supported employment services for people with disabilities, education and training providers, consortia/associations of social co-operatives, associations of families of people with mental illness, municipal administrations’ social program officers, trade/industry organizations;
- Coaches. People with mental disorders participating in the project received individualized assistance from an employment specialist (a ‘coach’). Working synergically with local public services and with the support of the Technical Committees, the coach put in place all actions needed to build an effective personalized pathway for an eased transition into the world of work for people with mental illness participating in the project;
- Randomized controlled trial. A strictly scientific method (a randomized controlled trial) was used to measure project outcomes in terms of employment status and overall wellbeing of people with mental disorders involved in the project.
The project spanned four years and unfolded as follows:
- First, the Steering Committee developed the guidelines for the intervention under a participatory approach (2008); then
- the project was carried out at 4 select Mental Health Coordination Units in the Provinces of Bergamo, Como, Milan and Sondrio and involved 8 hospitals, 15 coaches and 300 people with mental disorders (2009-2012).
Results showed that the Work&Psyche intervention had a statistically significant and positive impact (around 15% at 24 months after enrolment) on the rate of people with mental illness being in a work experience. This was associated with the positive effects of being assisted by a coach on the likelihood of getting work placements. However, results at 24 months after enrolment showed no statistically significant impact of the intervention on the likelihood of finding paid employment.
The measures tested in the intervention were found to be financially sustainable and capable of being integrated into regional policies for easing the transition into the world of work for people with disabilities as the cost of funding those measures was lower than the financial resources allocated in aggregate to the so-called “dowry system” under the current regional policy.
Further details can be found in Handbook n. 12 “Work&Psyche” (only in Italian) at