Facilitators and Barriers to Vocational Rehabilitation for People with Mental Illness: A Qualitative Study of Perspectives from Mental Health Service Providers and Consumers

Severe and persistent mental illnesses often lead to long-term psychosocial disability, affecting work participation, recreation, relationships, and community integration. Vocational rehabilitation is recognized as a key pathway to recovery. This study explored the perspectives of mental health service providers and service receivers on facilitators of and barriers to vocational rehabilitation for people with mental illness in coastal Karnataka, India, through thematic analysis. A descriptive qualitative design was employed, and data were collected through in-depth interviews with people with mental illness, their caregivers, and employers. A focus group discussion with rehabilitation professionals was also conducted. The transcribed verbatims were thematically analyzed by trained qualitative researchers. Twenty-one participants provided insights into vocational rehabilitation experiences. Various themes emerged as facilitators and barriers. The findings highlight the role of supportive networks; clinical stability, such as compliance with medication, workplace accommodations, individual motivation, and acquired skills enabling vocational rehabilitation; and clinical vulnerabilities, such as cognitive deficits, stigma, systemic gaps, and high expectations, which remain significant barriers. Strengthening community-based and culturally tailored vocational rehabilitation models, enhancing employer sensitization, and expanding government support systems are critical to improving employment outcomes for people with mental illness in India.