This book details the development of a theory to explain the decisions and actions taken by people with mental illness with regard to employment. In-depth interviews were conducted with users of psychiatric services. Some participants were employed, others were seeking employment, while others were not engaged in employment-related activities. The study found that all participants were engaged in a process of negotiating an appropriate vocational place. This process is cyclical, ongoing and dynamic, as individuals' views and circumstances change. The findings present a challenge to policy and practice in which a successful outcome is defined as obtaining and maintaining a paid position in the workforce. They provide a framework for practitioners, policy makers and researchers to understand the decisions made by people with mental illness and their actions in relation to employment. Findings support the notion that substantially increasing employment rates for people with mental illness will require change at a number of levels of society and will not be achieved by merely putting greater pressure on people with mental illness to work.