Cover image of Let's Talk Employment guide
Let’s Talk Employment
A Guide for Family Members of Individuals in Mental Health Recovery


Alternatives to Traditional “Job Placement”


What Questions Should I Ask?

  • Are any of the options that are alternatives to traditional jobs relevant for my family member?
  • Why are creative alternatives beneficial?


What You Should Know

Some individuals have functional, familial, or other pressing reasons for wanting or needing a non- traditional alternative employment situation.



Several approaches have been used to accommodate the needs and interests of individuals with mental health conditions:

a. Customized employment:

Shoes with a Peace symbol painted onIn all situations we should strive to achieve the best match possible for employee and employer. However, there are some individuals for whom a very tailored or engineered job situation is best. Customized employment is a flexible process designed to personalize the employment relationship between a job candidate and an employer in a way that meets the needs of both. It is based on an individualized match between the strengths, conditions, and interests of a job candidate and the identified business needs of an employer. Customized employment utilizes an individualized approach to employment planning and job development — one person at a time one employer at a time.



  • Task reassignment: Some of the job tasks of existing workers are reassigned to a new employee. This reassignment allows existing workers to focus on the critical functions of their job (i.e., primary job responsibilities) and complete more of the central work of the job. Task reassignment typically takes the form of job creation, whereby a new job description is negotiated based on current, unmet workplace needs.
  • Job carving: An existing job description is modified — containing one or more, but not all, of the tasks from the original job description.
  • Job sharing: Two or more people share the tasks and responsibilities of a job based on each other’s strengths.

Vocational Story of Customization: Arturo wants to work in customer services. He knows from previous experience that he is good at helping customers with problems or questions, but is not good at trying to interest them in other products or be on the sales end of things. In looking at the team at the company, the employer found that some other employees enjoyed the sales part of the job, and others were good at problem solving and complaints. The employer worked with the team, which helped to restructure jobs so that those who were not good at sales all worked together serving customers only, while the others primarily dealt with sales. Two were able to do both. This provided a perfect job for Arturo and in the end helped others as well.


b. Self-Employment:

Having one’s own business can be challenging in many ways, and we often hear about the number of businesses that fail in our communities. However, self-employment also can be a good choice for persons with disabilities in that it allows them to have more control over the work setting, hours and conditions and to choose a type of business that has meaning. There are two main types of self-employment: 1) a person works solo providing a product or service, 2) one or more persons with disabilities own a business and employ others. Individuals interested in operating their own business also can purchase a franchise, provided they have the capitol to invest and have explored all that is involved in the franchise. Sometimes families have their own business and can carve out a meaningful job/role for their family member with a mental health condition in the business.

As with a regular job, it is equally important that if someone embarks on their own business that they have the right support to make it successful. That would include help with choosing the right type of business for a particular community; help is getting financing; help managing the business in every aspect and support for dealing with stress, personal or disability-related problems. The idea is to choose a business that is not too high a risk either in a business sense or in a personal sense.

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The guidebook on Self-Employment for People with Disabilities. (2013). Office of Disability Employment Policy. U. S. Dept. of Labor includes extensive information on factors for successful self-employment; models of self-employment tested in different states; webcasts with resources for funding a new business and success stories of self-employed disabled individuals.

One ambitious self-employment project is at the Bedford, MA, Veterans Administration’s Vocational Rehabilitation Program. Supported Self-Employment provides a structured training program for prospective self-employed veterans with mental health conditions. Well over a hundred successful businesses have been launched through the Massachusetts program, which has now spread to New Hampshire.

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Some supports in the VA program include 1) business mentors: employers in the community willing to assist a new business owner, 2) education and training: a 3-4 month training in a “street MBA” business plans, marketing, etc. (called the Business Gym), and 3) money management. Early graduates from the program formed a non-profit organization, the Veterans Business Owners Association, to provide microloans and peer supports to disabled Veteran business owners. The VBOA is a key partner in all activities. About 52% of those who enter the training become self-employed. Qualitative data support the view that participation is highly energizing for Veterans with an interest in self-employment. Participants find the opportunity to pursue this goal to be a focus of their interest in returning to the community, and motivate them to take a wide range of recovery-oriented steps.

Another option that your family member might undertake would be a “Social Business,” which is generally a non-profit organization established to deal with one or more social problems, such as providing supports to low-income or disabled individuals, offering services such as tutoring, peer mentoring, outreach, or housing search. The supports someone would need to be successful may be similar to a for-profit business, but there may be some different funding options. The Social Business is usually not dependent on donations or public funding.

While the above-mentioned supports may not be available to your family member within a single program, an Employment Specialist (e.g., IPS Supported Employment, state Vocational Rehabilitation agency) might be able to assist with helping your family member locate financial or mentoring supports. Some clever networking could help to bring together people with disabilities, who have started or want to start their own business. Programs like the Social Security PASS plan or the Small Business Administration could be used for the financial start up.