Community Mental Health Journal

, Volume 55, Issue 2, pp 202–210 | Cite as

A Comparison of Healthcare Use and Costs for Workers with Psychiatric Disabilities Employed in Social Enterprises Versus Those Who Are Not Employed and Seeking Work

  • Carolyn S. DewaEmail author
  • Jeffrey S. Hoch
  • Marc Corbière
  • Patrizia Villotti
  • Lucy Trojanowski
  • Hélène Sultan-Taïeb
  • Sara Zaniboni
  • Franco Fraccaroli
Original Paper


Because of work’s contribution to recovery, governments have moved to improve employment rates of people with severe mental disorders (SMDs). Social enterprises (SEs) have been identified as a means to achieve employment. In Ontario, Canada, the Ministry of Health and Long-Term Care (MOHLTC) have provided SEs government subsidies. Public funding arrangements create a potential trade-off for governments that must decide how to distribute constrained budgets to meet a variety of public needs. In Ontario, the government is potentially faced with choosing between supporting employment versus healthcare services. This study addresses the question, are there significant differences in service use and costs from the MOHLTC’s perspective for people with SMDs working in SEs versus those who are not working and looking for work? Our results indicate there is a significant difference in healthcare use between the two groups suggesting there could be less healthcare use associated with SE employment.


Severe mental illness Employment Social enterprises Healthcare costs 



The funding was provided by Canadian Institutes of Health Research (Grant No. 12345)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Carolyn S. Dewa
    • 1
    Email author
  • Jeffrey S. Hoch
    • 2
  • Marc Corbière
    • 3
    • 4
  • Patrizia Villotti
    • 4
  • Lucy Trojanowski
    • 5
  • Hélène Sultan-Taïeb
    • 6
  • Sara Zaniboni
    • 7
  • Franco Fraccaroli
    • 8
  1. 1.Department of Psychiatry and Behavioral SciencesUniversity of CaliforniaSacramentoUSA
  2. 2.Division of Health Policy and Management, Department of Public Health SciencesUniversity of CaliforniaSacramentoUSA
  3. 3.Department of Education, Career CounsellingUniversité du Québec à MontréalMontréalCanada
  4. 4.Centre de Recherche de l’Institut Universitaire en Santé Mentale de MontréalMontréalCanada
  5. 5.Centre for Addiction and Mental HealthTorontoCanada
  6. 6.Département d’organisation et ressources humainesUniversité du Québec à MontréalMontréalCanada
  7. 7.Department of PsychologyUniversity of BolognaBolognaItaly
  8. 8.Department of Psychology and Cognitive ScienceUniversity of TrentoRoveretoItaly

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