Perspectives of mental health service users on vocational rehabilitation in Namibia

Background: Occupational therapists provide vocational rehabilitation to mental health service users enabling them to purposefully and meaningfully engage in work. A vocational rehabilitation practice framework to guide occupational therapists working in mental healthcare settings is absent in Namibia. Objectives: The study explored contextual factors to consider in developing vocational rehabilitation practice framework from the views of mental health service users and their primary caregivers. Method: A qualitative collective case study design situated within an interpretivist paradigm was employed. Seven focus group discussions and 23 in-depth individual interviews were conducted with service users and primary caregivers purposively selected from two study sites where vocational rehabilitation service is provided. An inductive thematic analysis was conducted utilising ATLAS.ti. Results: Three themes emerged: (1) service users want to and need to work, and have the rights to equitable work opportunities; (2) obtaining and sustaining work is difficult because of stigma and discrimination; (3) collaborative action is needed to create equitable work opportunities. Conclusion: Occupational therapists should embrace an advocacy role to improve equitable work opportunities for chronic mental illness service users, and collaboration with employers and family members is crucial to achieve vocational rehabilitation outcomes. Contribution: The study contributes to the field of mental disability and informs vocational rehabilitation strategies for mental health service users.