Development and Validation of The Employability Scale: An Employment Measure for People With Mental Illness

Background and Purpose: Despite high rates of unemployment for people with a mental illness, a large gap exists in the literature on how to best assist this population in obtaining and maintaining employment.  Much of the research on employment and specific populations focuses on the needs of people with physical or mental disabilities, which is then often applied to people with mental illness.  Many employment barriers of people with mental illnesses are overlooked as a result.  The purpose of The Employability Scale is to give people with a mental illness the opportunity to identify barriers they are experiencing towards employment, and may be a tool which mental health clinicians and employment specialists can use with clients who wish to pursue employment.  This study hopes to answer the following research question: What questions aimed at identifying personal barriers to employment experienced by people with a mental illness can be combined into a valid and reliable measure? 

Methods: Participants were recruited using a purposive sampling method via the social networking site Facebook.  Keywords identifying various mental illnesses were searched, and a brief introduction and link to the survey were posted on subsequent community, group and organization pages.  Content validity of the measure was determined using an expert panel, and resulted in an initial item pool of 65 questions.  The final sample consisted of n = 121 participants, who were predominantly female (n = 98, 81.0%) and Caucasian (n = 106, 87.6%).  Approximately 88.4% (n =107) of the sample had a mental illness, and of those, n = 68 (63.6%) reported having more than one mental illness.  Additionally, n = 77 participants indicated they were taking medication for their mental illness, and n = 33 reported receiving or applying to receive disability benefits. 

Results:  Final Cronbach’s alpha scores for the Attitudes towards Employment, Functional Health, Mental Health, Self-Efficacy, and Medication subscales ranged from .73 to .94.  The Financial Implications subscale was removed from the model, as initial Cronbach’s alpha score of .51 could not be improved based on alpha-if-item-deleted coefficients.  The final scale consisted of 38 questions without the Medication subscale and 47 questions with the Medication subscale.  Confirmatory factor analysis of the first model indicated acceptable to excellent fit, with a stratified global alpha coefficient of .97.  Confirmatory factor analysis of the second model, restricted to only participants who answered the Medication subscale questions (n = 77), indicated acceptable fit, with a stratified global alpha coefficient of .97.  Construct validity correlations were all significant (p < .001).

Conclusions and Implications: The Employability Scale may be a positive way to help identify potential barriers to employment for clients with mental illness.  It can be used to guide clinicians, employment specialists, and clients in addressing clients’ barriers to employment and in coping with stressors that accompany living with a mental illness.  This preliminary analysis of The Employability Scale gives encouraging results that help to confirm the reliability and validity of the measure, and its use with people who have a mental illness.