Learning the Principle of Zero Exclusion. Managers Challenging the Logic of Professionalism in Services for People with Psychosocial Disabilities

Abstract

Individuals with psychosocial disabilities face substantial barriers that hinder their equal participation in working life, such as discrimination and lack of self-determination. A method developed to increase work integration and self-determination for persons experiencing mental illness is Individual Placement and Support (IPS), which embraces the zero-exclusion principle. This entails that service users themselves should decide when they want to engage in work (re-)integration and that professionals should not, based on their professional assessments, exclude anyone. The study reveals that managers in healthcare and employment services experience practitioners’ adherence to a professionalism logic, which hinders self-determination because professionals make pre-assessments to determine who is job ready. However, managers made use of the zero-exclusion principle to promote self-determination and challenge the dominant professionalism logic. Additionally, findings indicate that managers observed a gradual shift in perceptions about job readiness and referrals to IPS over time as practitioners gained experience with the zero-exclusion principle.

Keywords

• self-determination
• psychosocial disabilities
• professionalism
• medical model
• relational model
• individual placement and support