Abstract
Introduction: Increasing numbers of young people receiving permanent or temporary disability benefits represent a conundrum for the Norwegian Labor and Welfare Administration’s (NAV) goal of labor market inclusion. This study explores the trajectories of young adults with spinal cord injuries and young adults with mental health problems within NAV.
The study aims to map out and compare the factors influencing the different client trajectories of the two groups within a public welfare system aiming for labor market inclusion, exploring three main topics:
• Key features of the two groups’ trajectories towards (or away from) employment.
• Commonalities and differences in ‘motivation’ for employment between the two groups.
• The influence of medical diagnosis and relational competence impacting the two groups’ experience with the NAV system.
Methods: Qualitative semi-structured interviews conducted with young adults with spinal cord injuries (SCI) (N=8 for round 1, and N=7 for round 2 6-8 months later) and common mental disorders (CMD) (N=10 for round 1). Both groups’ age spans from 19-39, with an even gender balance. SCI participants were recruited through interest organizations and their networks, while CMD participants were recruited through a non-profit organization and a municipal facility for occupational training. All participants received information about the study prior to informed consent. Interviews were recorded, transcribed, and coded manually through thematic analysis.
Results: SCI participants value and aspire to full-time employment, while CMD participants prefer part-time employment in combination with partial disability benefits. SCI participants tend to downplay the role of their diagnosis, while CMD participants seek a diagnosis to better understand themselves and obtain necessary accommodations from the healthcare system and workplace. The perception of time within NAV differs for the two groups: SCI participants experience time in NAV (post injury) in a linear sense, depending on whether they retain the disability benefits or decide to pursue employment independently. CMD participants experience time in NAV as loops or fragments (various programs, assessments, mappings, etc.) leading in circles. SCI participants report being treated as less capable and more disabled than they actually are by NAV and employers. Conversely, CMD participants experience not being taken seriously due to the complexity and ambiguity of their medical condition and diagnosis.
Both groups describe the ‘good’ supervisors at NAV as essential success factors for their own motivation and progress. Additionally, both groups describe the relational competence and system knowledge of clients and NAV supervisors as major factors influencing NAV clients’ trajectories towards (or away from) employment.
Conclusion: Despite theoretically universal rights, welfare provisions, and ambitious vocational rehabilitation systems, this study shows that the role and function of diagnosis vary between the two groups in terms of client treatment. The findings underscore the importance of not limiting the analysis of pathways to individual factors or bureaucratic norms and rules, but the potential barriers and facilitators in the interaction between clients and supervisors.