Social Firm — MRCPsych Paper B MCQ

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ModerateRehabilitationSocial FirmMRCPsych Paper B

A 35-year-old man with schizophrenia is a paid employee in a café that sells food and drinks to the public and derives income from this trading activity. The business has an explicit social mission to create sustainable jobs for people disadvantaged in the labour market. He works alongside employees with and without disabilities and receives flexible workplace support. Which employment model is this?

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Correct answer: B — Social firm

The correct answer is B, a social firm. A social firm is a trading business with a social mission that provides paid employment and a supportive workplace for people disadvantaged in the labour market, including those with mental illness. The café's commercial sales, genuine employee status and inclusive, supported workforce are the key discriminators. IPS instead places an individual rapidly into mainstream competitive employment and then provides continuing personalised support; it does not itself operate the employing business. Pre-vocational programmes prepare someone for later employment rather than providing an established paid job. Sheltered workshops generally provide protected or segregated work outside ordinary competitive employment. Day centre programmes primarily provide structured therapeutic or social activity rather than commercial paid employment.

Reference: Gilbert E, Marwaha S, Milton A, et al. Social Firms as a means of vocational recovery for people with mental illness: a UK survey. BMC Health Services Research. 2013;13:270. https://pubmed.ncbi.nlm.nih.gov/23844779/