I do not expect much ikigai from work: A failed link between employment and well-being among adults with serious mental illness

BACKGROUND: Researchers argue that employment positively affects the well-being of people with serious mental illness. However, empirical studies have provided limited support for these hypotheses. OBJECTIVE: This study aimed to investigate perceptions of employment in relation to the meaning and purpose of life, an important aspect of well-being, among people with serious mental illness. METHOD: Qualitative research design was employed. Psychiatric service users with a history of employment (n = 21) were recruited from Japan. Photo-elicitation interviews were conducted, and the interview data were analyzed using thematic analysis. RESULTS: Employment was recognized as a source of life meaning and purpose when it reflected personal values such as mastery and contribution to society. Employment was not recognized as relevant to life's meaning and purpose if it was regarded as an instrumental activity for making a living. Nevertheless, participants generally agreed that employment was indispensable because it was essential for fulfilling their basic needs and overcoming the stigma of mental illness. CONCLUSION: Our results demonstrate diverse attitudes toward employment among people with serious mental illness, which may explain why employment had only a small effect on well-being.