People with intellectual disability and employment sustainability: A qualitative interview study

Abstract

Background

Swedish employment rates are disproportionately low among people with intellectual disability and research on employment sustainability in this group is scarce. This study investigated employment sustainability among people with intellectual disability, with a focus on identifying facilitators.

Method

Fifteen persons with intellectual disability who were gainfully employed and had been so for at least 1 year during the last 3 years, and 10 representatives from their employers, were interviewed.

Results

Five facilitators were identified: (1) having tried various types of work, (2) liking to be at work, (3) balance concerning expectations and adaptations, (4) mutual engagement and flexibility, and (5) wage subsidies.

Conclusion

Employment sustainability needs to be understood at individual as well as environmental and societal levels. In addition, both duration and progress should be considered regarding employment sustainability in this population.

1. INTRODUCTION

People with disabilities have the right to work ‘on an equal basis with others’, according to the UN Convention of Rights of People with Disabilities (United Nations, 2006, article 27). The convention also stipulates that State Parties (including Sweden, which is the setting for this study), shall promote employment opportunities and career advancement for persons with disabilities in the labour market, as well as assistance in finding, obtaining, maintaining and returning to employment. Thus, alongside gaining employment, maintaining employment over time is included in the right to work. In addition, employment for people with disabilities is part of the UN Sustainable Development Goals (United Nations, 2015, goal 8). These goals include opportunities for long‐lasting employment, not only brief or unstable jobs. Despite these high ambitions, employment rates among people with disabilities are still low. In Sweden, the situation is less severe than in many other countries, with a 71% employment rate compared to 79% in the total population (Statistics Sweden, 2022).

For one subgroup of people with disabilities—people with intellectual disability—the employment rate is disproportionally low (Ellenkamp et al., 2016); both internationally and in Sweden. In Australia, for instance, the 2012 employment rate for people with intellectual disability was 35% compared to 53% for all people with disability (Cheng et al., 2018). Previous Swedish research reports that only 22% of individuals with intellectual disability were employed in 2011 (Arvidsson et al., 2015). These numbers are alarming, as being employed is beneficial in a number of ways for people with intellectual disability (Jahoda et al., 2008; Robertson et al., 2019) including serving as an important aspect of adulthood (Arnett, 2004; Lövgren, 2013; Biswas et al., 2017; Salt et al., 2019) and citizenship (Tarvainen & Hänninen, 2022). Beyond its importance for the individual, employment among people with intellectual disability is important for society, not only at the ideological level but also because financial efforts made to promote employment among people with intellectual disability are economically beneficial in the long run (Hultkrantz, 2016). Previous research has mainly focused on obtaining employment, but many questions remain regarding what factors may help facilitate long‐term employment for persons with intellectual disability. Reviews of the literature (e.g., Ellenkamp et al., 2016; Taubner et al., 2021) have shown that research about employment sustainability among people with intellectual disability is scarce.

In Sweden, there is a special school form designed for pupils with intellectual disability. To be admitted the pupils are assessed and diagnosed. After graduating from compulsory special elementary school, adolescents with intellectual disability may attend the optional Upper Secondary School for pupils with Intellectual Disability (referred to as USSID below). Persons who graduate from USSID are likely to end up without occupation (Arvidsson et al., 2015; Luthra et al., 2018). When Arvidsson et al. (2015) studied post‐USSID occupation registered in 2011, they found that among the 12,269 individuals who graduated from USSID between 2001 and 2011, 24% were neither employed, enrolled in educational programs, nor participating in the unpaid occupational support service known as ‘daily activity’. Although these studies are important, they do not say anything about employment sustainability, about factors that may facilitate such sustainability, nor do they mention the lived experiences of being a person with intellectual disability facing the labour market. There is thus a need for qualitative research based on interviews through which people with intellectual disability can tell their own stories (Taubner et al., 2021).

Therefore, this study aims to investigate employment sustainability for people with intellectual disability living in Sweden through the use of qualitative interviews. Drawing on the relational definition of disability, which states that disability ‘is created in interaction between individual and environmental characteristics’ (Söder, 2013, p. 102), the interviews included both employees with intellectual disability and representatives from their employers. Accordingly, the research question was: What facilitates employment sustainability for people with intellectual disability, according to accounts given by themselves and by their employers?

Kellard et al. (2001) defined employment sustainability as ‘the maintenance of a stable or upward employment trajectory in the longer term’, preferably over a period of at least 1 year (p. 20). It is a multifaceted concept, which is determined by ‘personal characteristics and circumstances and by labour market opportunities’ (p. 20). When studying employment sustainability, both ‘duration’ and ‘trajectories and progress’ must be considered. Employment sustainability, consequently, not only concerns longer‐term employment, but also the experience of a stable or positive career development. The above definition of employment sustainability by Kellard et al. (2001) was applied throughout this study and is used in the below discussion of our findings.

2. METHOD

Data were collected through Problem‐Centred Interviews (PCI, Witzel & Reiter, 2012) with employees with intellectual disability (n = 15, interviewed twice) and representatives from their employers (n = 10, interviewed once). Participants with intellectual disability (defined as having graduated from USSID) were recruited through researchers' pre‐existing relevant contacts who were asked if they knew any potential participants. Inclusion criteria were:

• having graduated from USSID between 2001 and 2016

• being gainfully employed at the time of the interview (with possible exceptions due to the COVID‐19 pandemic and its effects on the labour market)

• having been employed for at least 1 year during the last 3 years

• giving consent to participate

A list of potential participants was created, from which participants with intellectual disability were selected. We applied a strategic selection approach to get a diverse group of participants. The final sample included 15 participants with intellectual disability (eight men and seven women). Throughout this article, they are referred to by assigned pseudonyms (Abdul, Adnan, Anders, Bogdan, Elin, Elsa, Emma, Lisa, Lotta, Minna, Molly, Patrik, Rickard, Tommy and Victor) or as ‘the participants’. Further details about them are displayed in Table 1.

TABLE 1.

Details about the participants with intellectual disability and whether their employers were interviewed

Pseudonym	Age at initial interview	Gender	Work sector	Years of employment	Employed with wage subsidy	Employer interviewed
Abdul	34	Male	Restaurant	<2	Yes	No
Adnan	22	Male	Retail trade	2–5	Yes	Yes
Anders	35	Male	Retail trade	>10	Yes	Yes
Bogdan	30	Male	Transportation	2–5	No	No
Elin	28	Female	Transportation	2–5	No	No
Elsa	26	Female	Restaurant	6–10	Yes	Yes
Emma	25	Female	Restaurant	6–10	Yes	No
Lisa	28	Female	Café	6–10	Yes	Yes
Lotta	30	Female	Retail trade	6–10	Yes	Yes
Minna	28	Female	Farming	>10	No	No
Molly	25	Female	Manufacturing	2–5	Yes	Yes
Patrik	25	Male	Restaurant	2–5	Yes	Yes
Rickard	25	Male	Warehousing	6–10	Yes	Yes
Tommy	29	Male	Maintenance	2–5	Yes	Yes
Victor	24	Male	Café	2–5	Yes	Yes

Employer representatives were recruited by asking the participants with intellectual disability if their employers could be invited to participate. The inclusion criteria for employer representatives were as follows:

• being the employer of a person with intellectual disability already included in the study

• giving consent to participate

• having the employee's consent to participate

Four participants did not consent to us inviting their employers. In one additional case, the employer did not want to participate although the employee had consented. As a result, 10 employers were included. They were not assigned pseudonyms, but are referred to as, for example, ‘Lotta's boss’ or ‘the employers’. No further details are provided to describe the employers, for de‐identification purposes.

Since each respondent ‘has the right to be understood’ (Witzel & Reiter, 2012, p. 82) PCI endorses flexibility in order to meet the demands of each respondent's communicative capacity. When interviewing people with intellectual disability, such flexibility is required to create a setting in which the interviewee is understood. In all cases, the interviewer is the one who needs to adapt, not the interviewee. Döringer (2021) argues that the PCI draws on an egalitarian perspective, since it ‘gives equal right to the previously accumulated theoretical and empirical knowledge of the researcher and to the individual knowledge and personal experiences of the respondent’. Therefore, PCI is a suitable method for interviewing people with intellectual disability.

During a PCI interview, the interviewer shifts between questions aimed at generating storytelling (inductively) and comprehension (deductively), with the goal of reconstructing knowledge about a relevant research problem (in this case employment sustainability for people with intellectual disability). During the initial interview with participants with intellectual disability in this study, the interview guide comprised the following themes: timeline between graduation and employment and onwards to the future; current work; individual characteristics; experiences from USSID; contact with agencies and authorities; and living situations and social relationships. A summarising post‐script was created after each interview. The second interview with these participants was a follow‐up, conducted approximately 6 months after the initial interview to ensure that no significant work‐related changes had occurred, not least in relation to the COVID‐19 pandemic and its impact on the labour market.

When interviewing employers, the interview guide contained the following themes: recruitment, collaboration with agencies and authorities, the current work including adaptations and wage subsidies, and employment for people with intellectual disability in general terms. No follow‐ups were conducted with the employers, since the follow‐ups with the participants with intellectual disability did not raise any questions or concerns that would have motivated an additional round of interviews with the employers.

Data were collected during the COVID‐19 pandemic, and therefore most interviews were conducted remotely as video calls. Interviews were recorded and then transcribed verbatim. Qualitative content analysis (Graneheim & Lundman, 2004) was then performed using the software NVivo. Initially, the themes from the interview guides served as coding categories, and when new themes emerged, new codes were created, applying an abductive constant comparison approach (Fram, 2013); that is, combining deductive and inductive perspectives. This is a suitable design when analysing PCIs, since the interviews include questions targeting both storytelling and comprehension (Döringer, 2021; Witzel & Reiter, 2012) and as such, comprise abductive information.

The first author conducted and transcribed the interviews and performed the coding in NVivo. The second and third authors were involved in designing the study and recurrently discussed the findings with the first author. All three authors have contributed in the writing of this article and have agreed on the final version.

2.1. Ethics

Research involving people with intellectual disability requires a high level of ethical awareness and sensibility (Dalton & McVilly, 2004; Doody, 2018). The researchers have extensive experience in conducting research involving people with intellectual disability and therefore possess a high level of such awareness. None of the researchers had any previous connection to any of the participants, including the employers. Throughout the research process, we consulted a reference group consisting of representatives from various relevant organisations, including the Swedish National Association for People with Intellectual Disability (FUB). Unfortunately, due to the COVID‐19 pandemic gathering a reference group of people with lived experiences with intellectual disability was not an option.

All participants in this study were repeatedly informed about the purpose of the study, their right to terminate their participation at any time, and about the de‐identification of the collected material during which each participant with intellectual disability was assigned a pseudonym. Information was provided orally by the interviewing researcher, but also via text and a recorded video. Participants were informed that a support person could be present during the interview, an opportunity taken by Victor, Lisa and Tommy. Written consent was obtained before interviews commenced. Alongside giving consent to their own participation, participants with intellectual disability were informed that their employers would not be invited to participate without their consent. Thus, for an employer to participate, consent was needed both from the employee with intellectual disability and the employer. The participants with intellectual disability were also informed that no information collected during the study was going to be passed on to the employer. The study was approved by the Swedish Ethical Review Authority (Ref 2020‐01548).

3. RESULTS

Five categories were identified as facilitators for maintaining employment over time: (1) having tried various types of work, (2) liking to be at work, (3) balance concerning expectations and adaptations, (4) mutual engagement and flexibility, and (5) wage subsidies.

3.1. Having tried various types of work

Seven participants (Emma, Elsa, Adnan, Patrik, Minna, Lisa, and Rickard) experienced a straight path from internships during school to their current employment. How they got these internships varied. Some of them had worked extra during school breaks, leading to internships and then to employment. Others started their internships without any previous work experience. All seven were offered employment after finishing their internship, and have remained there since.

All except one of the participants explicitly stated that they had a number of different internships, and that this variation was important because it gave them an opportunity to try different types of jobs. Having one internship was good, but not sufficient. Instead, the combination of different internships was key.

One example is Adnan's way to employment. He was an intern in several places during school, for instance at a conference centre. He did not like working there, and quit after only a few days. He also tried working in a canteen, but did not want to continue there either. He says that although these internships did not work out, he learned things about what he likes to do and what is required for him to feel good at work. Later, when he was an intern in a grocery store, everything fell into place, and that is where he still is employed. Adnan describes how he ended his initial internship at the conference centre:

Adnan: But then I actually found the strength and said to her that “I just feel that this is not something I want to work with”. And she said “Absolutely, let's end it then. You shouldn't feel pressured to be here.” And that was nice, that I could tell her, that “I feel like this”. And then…later I was at the canteen. And I was there for a few weeks, but I again felt that I didn't want to be there.

Interviewer: So because you have had so many internships, you have been able to find out what you like?

Adnan: Yes, what I really wanted and what I didn't want.

Trying different jobs through internships may have a significant impact even without immediately leading to employment. Bogdan's story is an example. In his case—as opposed to Adnan—the internship did not lead straight to employment. He was an intern at a farm, in a store, and in maintenance. Now he is a taxi driver, which is unrelated to any of his former internships. Nevertheless, he says that it was important to try out different jobs through internships:

Bogdan: Then I was like in maintenance, yes in two places, actually. I have a friend who works at a farm too, so then I was there, eh with him and built balconies and painted and such things. Then I worked…at [a store] I think. More of a supermarket, really.

Interviewer: Have these different internships played any part, you think, in you doing what you do today?

Bogdan: You sort of compare them. You compare them and kind of what you have learned. Both here and there. So yes, I would say that it matters.

Thus, trying various types of work is a way of finding a good match between the individual and the workplace, which in turn facilitates stable employment.

3.2. Liking to be at work

It is crucial to like being at work in order to remain there, according to a majority of participants with intellectual disability. Several of them—most explicitly Adnan, Elin, Elsa and Lisa—state that their co‐workers are ‘like a family’ and Bogdan says that his work has led to making new friends. Adnan says he really enjoys being at work, and that he appreciates being viewed as one of the team. His co‐workers treat him like anybody else, and have ‘opened their arms, like for anybody else’. He also describes the workplace as ‘a safe space’. Victor has difficulties communicating verbally, and his father helped with the interview. Together, they say that in regard to remaining at a workplace, whether Victor likes being with his co‐workers is more important than his actual job tasks.

Victor's father: I think that…as long as you have nice friends at work, if you get to make friends, or if you have co‐workers that you enjoy spending time with at work, then you can work there forever.

Victor: Yes.

Anders connects liking to be at work with finding the right level of employment. He used to work full‐time, but that was overwhelming for him. Now he works part‐time and is satisfied with the arrangement. He manages to both work and have meaningful leisure time. He can see himself working at his current workplace until he retires.

3.3. Balance concerning expectations and adaptations

To achieve employment sustainability, a balance is needed concerning expectations of the employee's work performance and skills, and concerning adaptations. A level of expectation that is too low is not beneficial. For instance, Tommy feels under‐stimulated at his present job. But on the other hand, too high a level of expectation is also hindering. Anders states that too‐high expectations have resulted in fatigue in the past and he had been on sick leave for long periods of time. Thus, the required balance includes finding the right level of expectations. On one hand, participants want to feel challenged so that they can learn new things and grow as people. Both Emma and Patrik would love to have more responsibility in the restaurant kitchens in which they work. However, on the other hand, they want to feel safe and to know what is expected from them.

None of the participants in this study stated the need for any technical or communicative adaptations to manage their work. Instead, they all perform their work tasks in the same way as other employees. Adnan says that he does not want to be treated any differently than any others, not even in a positive sense.

Adnan: Everything that applies to others applies to me too. They have never adapted, like, not that I have noticed…but I have had the same conditions and rules as everybody else. In that way, I have never felt, like, special or how to say this, but I have felt like I am part of the group…What goes for everybody goes for me too. And that has felt nice.

Still, there is a level of adaptation in terms of selecting which tasks the participants are involved in. One example is Lotta, who works in a supermarket while having difficulties handling cash money. Her work tasks have been adjusted so that she only works at a counter where every customer pays by credit card. Thus, there is no problem since she does not have to handle cash. When working at the credit card counter, she performs the tasks in the same way as her co‐workers.

Lotta: And I only work with credit cards, so…I don't handle any cash at all, and that's great. I don't like money, you see. Not cash. I find it hard to count. We tried placing me at the cash counter, but they, the team leaders, realised pretty fast that it wouldn't work. So, we decided that I only work with credit cards, to make it easier.

Her boss is also very satisfied with this solution. She emphasises that Lotta has grown a lot since starting to work at the supermarket.

Lotta's boss: And this is SO important to her. She is like everyone else in this department. Like, she has grown so much, so now she basically does the same tasks as the rest of the team. And in her case, she has even learned how to work at the counter, well not with cash that is, but with credit cards. No one could have imagined that. So, in her case, it has turned out very good.

A similar example is Molly, who also has difficulties counting. She only performs tasks that do not include counting. Her boss says that they have given some tasks to other employees to make things easier for Molly. But the tasks that she does perform are performed in the same way as her co‐workers.

Another type of adaptation concerns time. Tommy's boss says that it takes longer for Tommy to perform certain tasks than it does for other employees. Similarly, Lisa's boss says that things may take longer in the café in which Lisa works (where all employees have disabilities, and not only Lisa) than in other cafés. In both these cases, their solution is to explain to others—in Tommy's case his co‐workers and in Lisa's case the customers—that things will take longer than expected. In addition, Patrik's boss says that Patrik may need more time to learn how to perform certain tasks, and in this case the solution is that the boss dedicates time to instruct Patrik repeatedly.

3.4. Mutual engagement and flexibility

The employers who participate in this study show great flexibility and engagement, which is crucial for employments to be long‐lasting. For instance, they are willing to adjust the level of employment (e.g., that Anders is allowed to work half‐time), to let the employer change departments within the company (e.g., that Lotta and Adnan moved to different departments in their respective workplaces, and that Emma and Victor moved between restaurants within the respective chain). Several of the employers stated that they are willing to be this flexible and engaged as long as the person with intellectual disability displays a readiness to grow and do their jobs.

Elsa's boss: To keep your employment, you of course have to do your job, be on time, not be absent too much, do your tasks properly, obviously, and develop… Yes, that's what we see mostly among our employers with wage subsidies, that they grow and want to develop.

Thus, the fact that the employer and the employee both want the employment to be sustainable is crucial. It takes mutual engagement and, especially on the employer's part, a willingness to be flexible. This kind of solution would not be possible without an underlying ambition to keep the employee at the workplace. It would be easy to just terminate their employment, as confirmed by Adnan's boss. He describes how Adnan got his employment. Adnan had been an intern in one department, but there was no job opening there at that time. However, there was an opening in another department, and when Adnan was offered a position there, he accepted. His boss says that Adnan had been active in a way that made them want to keep him on:

Adnan's boss: We easily could have said “now the internship is over and there is no opening for a job” and we would have, if Adnan hadn't shown us his ambition. He took the chance. He wanted this, and we have great possibilities in a workplace as big as this one, where we have a constant flow of staff. Relatively big, anyway. Then there are openings. So Adnan should look himself in the mirror and say “I did this myself, I got the chance to do the internship, and I showed them what I could do and what I wanted”.

As mentioned by Adnan's boss, a prerequisite for this kind of flexibility is whether the workplace is big enough to find solutions. Emma could change from one restaurant to another because the company ran several restaurants. Similarly, Lotta would not have been able to change departments if the store did not have several departments. Larger workplaces thus tend to have more opportunities than smaller ones for the kind of flexibility that promotes long‐lasting and sustainable employment.

3.5. Wage subsidies

When entering the Swedish labour market, people with intellectual disability may benefit from a certain type of tax‐financed wage subsidy, which aims to compensate and support employers who hire people with disabilities. A certain amount of money is transferred to the employer, and the employee is hired on normal conditions with a proper salary. These subsidies vary in size depending on assessments of the individual's capacity to work. Their duration is limited, and therefore they are re‐negotiated regularly either annually or every few years.

Twelve of the 15 participants included in the study turned out to be employed via such subsidies (see Table 1). Several of the interviewed employers say that they would not be able to keep the person with intellectual disability as an employee without the subsidies. Tommy's boss is very straightforward:

Tommy's boss: To be honest, Tommy wouldn't work here without the wage subsidy. That space […] doesn't exist.

The same idea is expressed by Patrik's boss, who also relates the subsidy to Patrik's positive development:

Patrik's boss: It is pretty crucial. I would not have dared to hire him if I didn't know that I had support. Because it takes a fair amount of time, and everybody doesn't have that time, to give to one individual, to work and struggle to make everything work well. Without the extra hours, when I started working with Patrik, he wouldn't be [at his] current level.

Some of the employers have a sense of societal responsibility and believe it is important to offer employment to people with intellectual disability. Tommy's boss emphasises that public employers, such as the school where Tommy works, has a responsibility to offer jobs to people in need. And Rickard's boss even thinks that organisations of a certain size should be obliged to employ people who would otherwise struggle to find jobs. Molly's boss shares this willingness to ‘do good’ but states that the positive feeling of taking social responsibility would not be enough without the wage subsidy:

Molly's boss: It feels good. Not just because it is financially good, but because we do something…that's not only good for us but also helps someone else. But… we are no saints, so if we didn't get this financial support, I don't think that, because it requires an effort and it is a slower pace and there are some extra things with… an employee with a disability.

Thus, in terms of employment sustainability, the wage subsidies are of great importance, alongside and even more important than social responsibility and the ambition to help a person with intellectual disability get a job.

Anders' boss emphasised that wage subsidies must be understood in relation to the organisation's business model. Anders works within a grocery store chain, where success is measured in sale rates compared to number of hours worked by staff. Having a wage subsidy for an employee results in more hours worked, since another employee gets hours to supervise the person with the disability or in some other way compensate for these difficulties. Thus, the store's result in terms of sale rates compared to hours worked is reduced. This would not be the case if success were measured in, e.g., sale rates compared to actual staff costs. Consequently, the store chain is restrictive in employing people with wage subsidies.

Anders' boss: The co‐workers we have now, who are on wage subsidies, they have been working here for so long and become so well‐adjusted, so we have made it work. But we don't have the space within our business to accept more employers that we need to do adjustments for. And of course, this is related to the [store chain's] model in which we are measured in sale rates compared to hours worked, rather than being measured in actual staff costs. Of course, that matters. If the model were different, maybe we could have…dealt with it differently.

One unusual business model, which is almost entirely based on wage subsidies, is applied at the café where Lisa works. The company is a cooperative economic association, which employs its own members. Almost all of the employees (who are also part‐owners via their membership in the association) are employed via a wage subsidy, and through this arrangement the business is not solely financially dependent on earnings from the café. Thus, in Lisa's case, the wage subsidies are not only crucial for her own employment but for the entire existence of the organisation.

A few of the interviewed employers (e.g., Lotta's boss and Elsa's boss) describe how much the person with intellectual disability has grown, and therefore the wage subsidy may soon no longer be required. For Bogdan, the wage subsidy has been removed and his employment is now independent of financial support. So even if the wage subsidies are crucial for many of the participants in this study, there are also counter examples in which the subsidies have reduced their importance over time.

3.6. Additional finding: Lacking alternatives

Alongside the five identified facilitators, we identified situations in which remaining at a workplace is the result of lacking alternatives. A few of the participants remain at their workplaces because they are worried about what might happen if they leave, in terms of not being able to find another job. For different reasons, Emma, Tommy, and Molly are not happy at their current workplaces. Emma does not like the company's leadership. But she is afraid to leave, because she is convinced that the Swedish Public Employment Service would offer her a position in a ‘daily activity’ or in a sheltered workshop and she refuses to accept such a change.

Emma: [The Swedish Public Employment Service] may help me find another job…but then it will be a daily activity. And that…that's not me. It would be like “So, you weren't happy with that job, alright, so what do we do about that? You can go to [sheltered work] and clean.” Never!

Tommy describes his work situation as a Catch‐22. He is under stimulated but he does not have the opportunity to show that he can do more or better work. Similarly, Molly works half‐time but she wants to work full time. In her current job, she has the capacity to work full time, but the company cannot offer her more than half time. So, in order to get a full‐time job, she would need to resign, return to the Swedish Public Employment Service and get another internship. Then she has no guarantees that such an internship would lead to employment, so it would mean taking a risk. She ends up being trapped in her current workplace.

4. DISCUSSION

This study set out to identify factors that facilitate employment sustainability for people with intellectual disability, and to do so by interviewing 15 employees with intellectual disability and their employers. We have identified five such facilitators, covering individual as well as environmental characteristics. Our findings confirm that employment sustainability is multifaceted and needs to be understood at different levels. It is a relationship between, on one hand, the employees' skills and experiences, and on the other, societal aspects including norms, attitudes and welfare systems. One such example is that Lotta works at a cash‐free counter. Her difficulties in handling cash are compensated by only having to handle credit card payments. The environment is altered to match her skills and preferences, and in consequence her disability is considerably reduced (cf Söder, 2013). Accordingly, Kellard et al. (2001) argue that employment sustainability is determined by ‘personal characteristics and circumstances and by labour market opportunities’ (p. 20).

In terms of personal characteristics, this study has shown that the individual's willingness to learn and develop is important to maintain employment over time. Several of the interviewed employers emphasise that they are willing to continue to find solutions as long as the employee displays an interest in making progress. Progress itself is not the focus here; emphasis is instead on a willingness to keep developing. These findings thus confirm that employment sustainability includes both duration and trajectory (Kellard et al., 2001)—simply studying duration will not capture issues of willingness and opportunities to develop (trajectory).

Circumstances surrounding the individual are also identified in our findings. Liking to be at work is highly dependent on co‐workers' and managers' attitudes and behaviours, and several participants describe their workplace as being ‘like a family’. Circumstances include employer flexibility, since finding solutions is key to keeping a person with intellectual disability as an employee. The interplay between the individual's personal characteristics and the circumstances at the workplace is manifested in finding a balance concerning expectations and adaptations. Circumstances need to be adapted to match the individual's unique characteristics. While such adaptations must fit within the workplace, they also need to be individually designed. For instance, our findings include a contradiction regarding half‐time positions. For Anders, working half‐time is what makes his employment sustainable. For Molly, on the other hand, working half‐time leads to feeling trapped because she would like to work full time but at the same time, she is not willing to risk leaving her current position. In addition to highlighting the interplay between the individual and environmental characteristics (cf Söder, 2013), this shows that a solution that is a facilitator for one person might be hindering another person.

On a societal level, Kellard et al. (2001) mention labour market opportunities, which in this study are related to wage subsidies and the politics behind this support system. Being able to receive a subsidy for employing a person with intellectual disability is not only crucial in offering them a job in the first place, but also for maintaining employment over time. Some of the interviewed employers state that their sense of doing something good is not enough, and without the wage subsidies they would not be able to keep the person as an employee. Another aspect of societal factors is the opportunity to try different types of work. Almost all of the participants have been interns at various workplaces, and they underline the importance of trying various jobs to find out what they like. Although trying different jobs could be beneficial for anyone, we argue that this experience may be especially important for people with intellectual disability since they may have difficulties imagining what working would be like. Actually trying out various jobs—hands on experience—may offer better insight when making decisions about their future.

Kellard et al. (2001) also emphasise that employment sustainability not only concerns long‐term employment, but also the experience of stable and positive career development. Our findings confirm that being employed for a long time at the same workplace is not necessarily beneficial in terms of development or progress. Instead, Emma, Tommy and Molly are employed long‐term due because they feel they lack alternatives. In terms of ‘trajectories and progress’ (Kellard et al., 2001) their situation cannot be defined as sustainable, regardless of the duration of their employments. These additional findings about a lack of alternatives can also be discussed at the societal level. As mentioned initially, the UN Convention of Rights of People with Disabilities (CRPD, United Nations (2006), article 27) includes the right to sustainable employment. We argue that some cases in our study shows that these rights are not always respected.

4.1. Implications and future research

Our findings have implications at multiple levels. We have presented 15 cases of people with intellectual disability who are employed in the open labour market. Hopefully, their stories can be inspiring to anyone involved in issues of employment within this group. Employers may be inspired to find adaptations, in terms of choosing tasks or adjusting time frames for the employee with intellectual disability. Schools and other organisations working in educating or supporting people with intellectual disability play an important role in helping them find internships, and we argue that even more important is helping them find various internships in different fields. Our findings may be used to encourage teachers and others who work on internship placements. A high level of sensitivity is needed from authorities such as the Swedish Public Employment Service to counteract situations in which people with intellectual disability remain at a workplace due to a lack of viable alternatives.

This article reports findings from a qualitative study. This approach was chosen because of its ability to capture people's own stories. Conducting qualitative interviews with people with intellectual disability may be challenging due to potential communication difficulties. However, we argue that such challenges must not hinder doing research in which these individuals are being heard. In particular, the PCI method (Witzel & Reiter, 2012) is a suitable choice because of its flexibility and emancipatory capacity.

We have presented several themes that may inspire further qualitative research to potentially deepen and broaden the picture presented here. However, quantitative studies such as surveys and register studies are also needed to deepen the knowledge about factors—age, gender, socioeconomic status, ethnicity, living area, or parents' level of education—that may influence employment sustainability for people with intellectual disability. We argue that a combination of qualitative and quantitative methods is beneficial in studying this complex phenomenon.

Based on our findings about the importance of wage subsidies, we suggest further research about welfare system issues related to this type of support. While these subsidies are of great importance, the system is not utilised as often as it could be. Each year in Sweden, a considerable amount of available subsidies are not claimed by employers (Swedish Public Employment Service, 2021). Therefore, research is needed about why the system is failing to provide wage subsidies to a higher number of employers, and thereby employment to a higher number of individuals with disabilities. Such research should be informative for policymakers. Our findings also raise questions about business models in relation to wage subsidies. Depending on how success is measured within a business, subsidies will have different effects. This is a field that needs further research to develop more targeted subsidies or policies. In addition, the cooperative business model applied at the café where Lisa works may inspire more research about emancipatory forms of employment.

The labour market is still inaccessible for people with intellectual disability, not least in terms of sustainability. We have merely scratched the surface of this issue, and we strongly suggest more research in this field.

CONFLICT OF INTEREST

None of the authors report any conflict of interest.

Helena, T. , Magnus, T. , & Carin, S.‐N. (2023). People with intellectual disability and employment sustainability: A qualitative interview study. Journal of Applied Research in Intellectual Disabilities, 36(1), 78–86. 10.1111/jar.13036

DATA AVAILABILITY STATEMENT

Research data are not shared.