Barriers and facilitators to competitive employment in veterans with mental illness: A veteran-focused mixed methods study

Research Type

Consumer/Patient Level Research


  • Marina Kukla, PhD
  • Kelsey Bonfils, BS


Unemployment among veterans with mental illness is a pervasive and damaging problem, causing deleterious mental health and economic consequences. The factors that negatively impact occupational functioning in this group are not well understood. Further, although successful vocational interventions have been developed for people with psychiatric disabilities, a large proportion remain unemployed and very little work has addressed vocational functioning in people with post traumatic stress disorder (PTSD). Therefore, the current project seeks to uncover the complex factors that hinder and support work success using a mixed methods approach highlighting the perspectives of veterans with mental illness. Ultimately, this research will lend to the development of a psychological intervention (e.g., cognitive behavioral therapy intervention) aimed at enhancing competitive work outcomes and tailored to meet the unique needs of a range of veterans who typically struggle with vocational functioning in the community.

We will conduct a mixed methods assessment to identify barriers and facilitators to competitive work functioning in veterans with mental illness. We will combine a quantitative survey and a narrative interview focused on veterans as the key stakeholders. This research is particularly pressing, given the serious problem of unemployment in this population and the overwhelming dearth of prior studies in this area, particularly those examining the perspective of veterans.

Through quantitative and qualitative methods, we will compare barriers and facilitators to competitive work success between veterans with severe mental illnesses such as schizophrenia and affective disorders and veterans with post traumatic stress disorder. In the extant literature, a significant gap exists in understanding work challenges and barriers in veterans with PTSD, particularly compared with other psychiatric conditions commonly present in the veteran population. The knowledge gained will inform the future design of a psychological intervention aimed at improving vocational outcomes tailored to the unique needs of each veteran group. Furthermore, studies that have examined employment outcomes in veterans with PTSD suggest that their employment difficulties are distinct from other psychiatric groups and may require specially designed vocational services (e.g., Resnick & Rosenheck, 2008). However, widely implemented evidence-based vocational services specifically geared toward veterans with PTSD are lacking and studies investigating VA vocational services in this area are just beginning (see Davis et al., in press). The proposed study is a first critical step in understanding factors that impede and bolster work success in these veterans and may serve as a guide to the refinement of existing vocational services (e.g., VA supported employment) to best meet their specific service needs.


  • Aim 1: Identify the barriers and facilitators to competitive work functioning in veterans with mental illness.
  • Aim 2: Compare and contrast barriers and facilitators to competitive work functioning between veterans with severe mental illness and those with post traumatic stress disorder.