ABSTRACT Pathways to employment are typically interrupted by first-episode psychosis (FEP) which strikes during the developmentally critical time of young adulthood. This paper reports on the key moments and messages that influenced the developing employment, education, or disability trajectories of young adults in the years following completion of Coordinated Specialty Care (CSC) for FEP. Nineteen semi-structured interviews were conducted with young adults with both lived experience of a FEP and a CSC program, from a critical case sample of 10 persons who were involved in an advocacy group. Results indicate that family support and expectations, disability narratives from mental health professionals, the realities of the modern labor market, and university disability support strongly influenced the pathway to employment, education, or disability, and that these were influenced by multiple structural realities such as family SES, disability policies, and treatment ideology, and the capacity of the labor market and universities. This paper concludes that CSC services should create a unified plan to address the structural barriers that challenge those from marginalized families, reevaluate traditional disability ideology in mental health treatment, and better support new pathways to secure employment and education for all young adults with FEP.

中文翻译：

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家庭支持，职业发展和打破残疾观念：在首发精神病的协调性专科护理中解决就业途径的结构性障碍的意义

摘要就业途径通常会因首发性精神病（FEP）而中断，该病在年轻成年期的发展关键时期发作。本文报告了在完成FEP协调专业护理（CSC）之后的几年中影响年轻人发展的就业，教育或残疾轨迹的关键时刻和信息。对来自既有FEP经验又有CSC计划经验的年轻人进行了19次半结构化访谈，这些案例来自于一个参与倡导小组的10人的关键案例。结果表明，家庭的支持和期望，精神卫生专业人员的残疾陈述，现代劳动力市场的现实以及大学的残疾支持对就业，教育或残疾途径产生了重大影响，并且这些因素受到多种结构现实的影响，例如家庭社会经济，残障政策，治疗意识形态以及劳动力市场和大学的能力。本文的结论是，CSC服务应创建一个统一的计划，以解决挑战来自边缘化家庭的结构性障碍，重新评估心理健康治疗中的传统残疾意识形态，并更好地支持为所有FEP年轻人提供就业和教育的新途径。