Ask the Expert: Employment & Disability
An Interview with John O’Neill, PhD, CRC, Employment Researcher
Dr. O’Neill is director, Employment and Disability Research at Kessler Foundation; research professor, Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical school; senior research scientist, John J. Heldrich Center for Workforce Development, Rutgers, The State University of New Jersey, and professor emeritus, Hunter College, City University of New York.
While many people with spinal cord injury (SCI) were employed at the time of their injury, many find returning to work a challenge. Finding ways to help individuals with SCI stay in their jobs or redirect their careers is an important focus of Kessler Foundation’s research. Dr. O’Neill conducts collaborative research studies that are helping individuals with disabilities remain productive in the workplace. Read more about his pilot study on Resource Facilitation in this issue’s Personal Perspective.
Q: What contributes to the low employment rates after SCI?
A: The duration of inpatient rehabilitation has shortened over the years, leaving little time for patients to receive counseling about how to return to work and connect with vocational services. After discharge, follow-up is limited. Another limiting factor is the growing demand for existing state vocational rehabilitation services, which is difficult to meet with current resources and staff. We know, however, that work is a goal for the majority of people with disabilities, and we are working on promising strategies to help people with SCI and other disabilities achieve success in the workplace.
Q: What has been learned from research about employment and people with disabilities?
A: From the 2015 Kessler Foundation National Employment and Disability Survey, we know that the majority of people with disabilities are interested in working and are taking actions to achieve or maintain employment. Through research, we are finding ways to boost the potential for these individuals to stay in their jobs, or discover new ways to return to work. The benefits of working extend beyond financial aspects. People with SCI find meaning and value in contributing to society through work. There is evidence that links working with reduced depression and greater social integration, independence, satisfaction with life, well-being, and longevity. Research helps us identify factors associated with successful return to work, and develop approaches that maximize that success.
Q: What factors contribute to successful return to work after SCI?
A: Education is clearly associated with good employment outcomes, especially education gained after SCI. Engagement with vocational rehabilitation services is another positive factor. Individuals with fewer health problems are more likely to be successful, which underscores the need for follow-up care to minimize secondary complications and hospitalizations. Higher levels of functional independence are important also. Focusing on resources that boost independence such as use of assistive technology and access to transportation will improve the likelihood of employment.
Q: What approaches are helping people with SCI stay in their jobs or return to work?
A: Success is being achieved with team-based approaches that are integrated into rehabilitative and healthcare services. One such approach – Resource Facilitation - was recently studied in inpatients with SCI at Kessler Institute for Rehabilitation. Having a trained vocational resource facilitator as part of the SCI rehab team is a unique aspect of this model. Connecting newly injured individuals with the resource facilitator is an important first step toward helping them reach their employment goals. Preliminary results of this pilot study are encouraging – at one year after injury, 31% of patients enrolled in the study were working, compared with the national rate of 13%. Because of the interest in this project, we are looking at ways to expand Resource Facilitation at Kessler Institute for Rehabilitation, as well as and to other rehabilitation facilities. For more information on returning to work, visit our consumer resources web page.
Podcast featuring John O'Neill: