Persons with severe mental illness (SMI) have reduced workforce participation, which leads to significant economic and social disadvantage. This theoretical review introduces the strategies that have been implemented to address this issue. These include Individual Placement and Support (IPS) services, the most widely researched form of supported employment, to which cognitive remediation has more recently been recognised in the USA, as an intervention to improve employment outcomes by addressing the cognitive impairments often experienced by people with SMI. The authors review the international literature and discuss specifically the Australian context. They suggest that Australia is in a prime position to engage clients in such a dual intervention, having had recent success with increasing access to supported employment programs and workforce reentry, through implementation of the Health Optimisation Program for Employment (HOPE). Such programs assist with gaining and maintaining employment. However, they do not address the cognitive issues that often prevent persons with SMI from effectively participating in work. Thus, optimising current interventions, with work-focused cognitive skills development is critical to enhancing employment rates that remain low for persons with SMI. 1. Introduction High unemployment amongst people with severe mental illness (SMI) has become an area of much concern in the mental health and public policy [1, 2] sectors alike. Numerous studies have concluded that employment status is highly correlated with social, economic, and health outcomes and overall quality of life. From a personal perspective, employment promotes a sense of purpose, self-esteem, independence and greater satisfaction with finances [3, 4]. It provides daily routine, social involvement, and personal achievement [5] and provides opportunities to affirm one’s ability and feel useful to others [6, 7]. Stable employment has also been associated with a decreased level of risk for exacerbation of psychiatric symptoms [8, 9] and less frequent substance abuse [10]. It is thus not surprising that the vast majority of individuals experiencing SMI express a desire to work and consider it as a key aspect of their life [11, 12]. Despite the clear benefits of a paid vocation for this subgroup of the community, unemployment rates in people with SMI worldwide are high. In the UK, unemployment rates for this group are estimated to be between 61%–73%. This rises as high as 75%–85% in the United States [13]. In Australia, workforce nonparticipation rates for people with SMI
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