'Yes, I've got the job, but my challenge is keeping the job': an evaluation of a new pathway to open employment to meet the needs of people with acquired brain injury in Australia.

Background and objectives: In Australia, people with disability continue to experience low employment rates (48%), compared to the national average (79%), and employment is even lower (30%) for people with acquired brain injury (ABI). This paper evaluates a pilot study of a new mainstream employment pathway following ABI, called Employment CoLab.

Method: Employment CoLab was piloted across multiple industries using a mix of reasonable employer adjustments, insurance-funded supports and/or access to capacity-building supports. Semi-structured interviews were undertaken with four stakeholders; (1) Employees with ABI (n = 5, age 31-49 years, time since injury M(R) = 11(4-26) years); (2) Employers/co-workers (n = 3); (3) Allied health professionals/vocational providers (n = 4); and (4) Injury insurance funders who hold portfolio responsibility for disability employment (n = 5). An explorative economic evaluation was also conducted to compare the cost to the funder for Employment CoLab compared to traditional employment pathways.

Results: Employment CoLab offered a new approach for people with ABI to gain and sustain open employment. Four major themes were identified from participant interviews: valuing employment and diversity; barriers to mainstream employment; reflections on being employed; and being supported over time. The economic evaluation was unable to detect if the pathway was, or was not, less costly when compared to traditional employment pathways.

Conclusions: Employment CoLab is a person-centred collaborative approach which, together with effective social disability insurance approaches, has built new opportunities for inclusive mainstream economic participation following ABI.