'Having a mental illness does not mean that people cannot be gainfully employed,' says researcher
Dr. Kathleen Dobson, associate scientist at the Institute for Work & Health (IWH) and assistant professor at the University of Toronto, presents a compelling case for rethinking how Canadian workplaces understand the employment experiences of people living with mental health conditions. Speaking at the IWH Speaker Series, Dobson unveils findings from a landmark study that tracks the long-term employment trajectories of Canadians with common mental disorders, severe mental disorders, and substance use disorders.
Employment is not one-size-fits-all
“Having a mental illness does not mean that people cannot be gainfully employed,” Dobson asserts. “We saw many—and most—of our participants with a mental illness were securely employed for at least three decades. These individuals are working, and they can work.”
The study, which links 25 years of survey and tax data, challenges the notion that employment rates alone capture the complexity of workforce participation for people with mental health conditions. Instead, Dobson and her team identify six to eight distinct employment patterns, or “trajectories,” that reveal a far more dynamic and diverse landscape.
“Our study suggests that employment rates are dynamic, change, and follow a number of different patterns,” Dobson explains. “It’s not stable over time. There are six to eight unique patterns seen across disorders and gender.”
Key risks: Premature exit and gender differences
For health and safety leaders, the findings present both reassurance and a call to action. While many people with mental health conditions sustain long-term employment, Dobson warns that “sustained employment is difficult for some, particularly for those with common mental disorders and severe mental disorders.” The research shows that premature exits from the workforce are common, often occurring around ages 20, 30, and 50. “It wasn’t the case that people were moving between being employed and unemployed. When you start to leave, it’s hard to get back,” she says.
Notably, the study finds that men with substance use disorders have employment trajectories similar to those without any mental disorder—an unexpected result that Dobson says aligns with some international research. “Initially, when we saw the results, we were a little surprised, but when we went to the literature, we saw that it’s a finding that’s been seen before.”
For women, the employment picture is more varied. “For women, we saw variability in the number and the types of trajectories identified,” Dobson notes. “The employment picture is varied for women with mental illness, and we suggest that research explores this more.”
Implications for health and safety leaders
Dobson emphasizes the importance of moving beyond a “one-size-fits-all” approach to workplace mental health. “Given that we saw multiple different employment patterns, when it comes to mental health and employment, it’s more than a one-size-fits-all experience,” she says. “Interventions should focus on helping workers with mental illness not just obtain employment but also sustain employment when they have it.”
The study does not address every aspect of mental health and employment. Dobson acknowledges limitations, including the inability to distinguish between full-time and part-time work, or to account for the episodic nature of some mental illnesses. “This study can’t tell us the key drivers of employment trajectories or what the most appropriate interventions are for mental health and employment,” she says. “But it can still tell us really valuable information.”
For health and safety leaders, the message is clear: supporting mental health in the workplace requires nuanced understanding and flexible strategies. As Dobson concludes, “Most individuals with mental illness are working and attached to employment for generally three or more decades. That’s an important message, because sometimes, unfortunately, the narrative can be these individuals can’t work. But if they want to, we see that they are working.”
