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Psychosis and the Experience of Employment

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Abstract

Introduction Although unemployment is common among those diagnosed with psychotic illnesses, few studies have looked directly at the experience of those who have gained competitive paid employment subsequent to being diagnosed. This study explored the experiences of people diagnosed with schizophrenia or schizoaffective disorder in relation to paid employment. Methods Eight participants with experience of paid employment were interviewed. The data were analysed using Interpretative Phenomenological Analysis (IPA) [Smith et al. (In: Murray, Chamberlain, editors) Qualitative health psychology, 1999]. Results Three super-ordinate themes; ‘Coping’, ‘Interpersonal support and reactions’, and ‘Personal change’ were identified. Conclusions Interpersonal support seemed to be lacking in workplaces, where discrimination was a reality for people with psychosis. Further study into what facilitates coping with symptoms in the workplace is needed.

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Notes

  1. Classification was based upon clinicians’ opinion. When interviewed two participants did not accept or stated they did not know their diagnosis.

References

  1. Smith A, Twomley B. Labour market experiences of people with disabilities. National statistics feature. Labour market trends. 2002; p. 415–27.

  2. Goodwin A, Kennedy A. The psychosocial benefits of work for people with severe and enduring mental health problems. In submission to Community, Work and Family. 2004.

  3. Bond G, Resnick S, Drake R, Xie H, McHugo G, Bebout R. Does competitive employment improve non-vocational outcomes for people with severe mental illness? J Consult Clin Psychol. 2001;69(3):489–501.

    Article  PubMed  CAS  Google Scholar 

  4. McGurk S, Mueser K, Harvey P, LaPuglia R, Marder J. Cognitive and symptoms predictors of work outcomes for clients with schizophrenia in supported employment. Psychiatr Serv. 2003;54(8):1129–35.

    Article  PubMed  Google Scholar 

  5. Bassett J, Lloyd C, Bassett H. Work issues for young people with psychosis: barriers to employment. Br J Occup Ther. 2001;64(2):66–72.

    Google Scholar 

  6. Goldberg R, Luckstead A, McNary S, Gold J, Dixon L, Lehman M. Correlates of long-term unemployment among inner-city adults with serious and persistent mental illness. Psychiatr Serv. 2001;52(1):101–3.

    Article  PubMed  CAS  Google Scholar 

  7. Taris T. Unemployment and mental health: a longitudinal perspective. Int J Stress Manag. 2002;9(1):43–57.

    Article  Google Scholar 

  8. Comino E, Harris E, Chey T, Manicavasagar V, Penrose Wall J, Powell Davies G, Harris M. Relationship between mental health disorders and unemployment status among Australian adults. Aust N Z J Psychiatry 2003;37:320–235.

    Article  Google Scholar 

  9. Murphy G, Athanasou J. The effect of unemployment on mental health. J Occup Organisational Psychol. 1999;72:83–89.

    Article  Google Scholar 

  10. Shepherd M, Watt D, Falloon I, Smeeton N. The natural history of schizophrenia: A five-year follow-up study of outcome and prediction in a representative sample of schizophrenics. Psychol Med. 1989;15:1–146.

    CAS  Google Scholar 

  11. Barker P, Buchanan-Barker P. Schizophrenia: The not-so-nice guidelines. J Psychiatr Ment Health Nurs. 2003;10(3):374–8.

    Article  PubMed  Google Scholar 

  12. The Mental Health Foundation, Out at Work. 2002. (Press release).

  13. Drake R, McHugo G, Becker D, Anthony W, Clark R. The New Hampshire study of supported employment for people with severe mental illness. J Consult Clin Psychol. 1996;64:391–99.

    Article  PubMed  CAS  Google Scholar 

  14. Twamley E, Jeste D, Lehman A. Vocational rehabilitation in schizophrenia and other psychotic disorders: a literature review and meta-analysis of randomised controlled trials. J Nerv Ment Dis. 2003;191(8):515–23.

    Article  PubMed  Google Scholar 

  15. Lehman A, Goldberg R, Dixon L, McNary S, Postrado L, Hackman A, McDonnell K. Improving employment outcomes for persons with severe mental illnesses. Arch Gen Psychiatry. 2002;59(2):165–172.

    Article  PubMed  Google Scholar 

  16. Read J, Baker S. Not just sticks and stones: a survey of the stigma, taboos and discrimination experienced by people with mental health problems. Mind. 1996.

  17. Yardley L. Dilemmas in qualitative health research. Psychol Health. 2000;15:215–28.

    Article  Google Scholar 

  18. Smith J. Beyond the divide between cognition and discourse: using interpretative phenomenological analysis in health psychology. Psychol Health. 1996;11:261–71.

    Article  Google Scholar 

  19. Smith J. Qualitative psychology: a practical guide to research methods. Sage; 2003.

  20. Brocki J, Wearden A. A critical analysis of the use of interpretative phenomenological analysis (IPA) in health psychology. Psychol Health. 2006;21(1):87–108.

    Article  Google Scholar 

  21. Knight M, Wykes T, Hayward P. ‘People don’t understand’: an investigation of stigma in schizophrenia using interpretative phenomenological analysis (IPA). J Ment Health. 2003;12(3):209–22.

    Article  Google Scholar 

  22. Laurance J. Pure madness: how fear drives the mental health system. Routledge; 2003.

  23. Smith J, Osborn M, Jarman M. Doing interpretative phenomenological analysis. In: Murray M, Chamberlain K, editors. Qualitative health psychology. 1999; p. 16–23.

  24. Stiles W. Quality control in qualitative research. Clin Psychol Rev. 1993;13:593–618.

    Article  Google Scholar 

  25. Romme M, Escher S. Accepting voices. Mind. 1993.

  26. Scheff T. The labelling theory of mental illness. Am Sociol Rev. 1974;38:444–52.

    Article  Google Scholar 

  27. Dunn S. Creating accepting communities. Report of the mind enquiry into social exclusion and mental health problems. Mind. 1999.

  28. Graffam J, Naccarella L. What makes ‘work’ work? Client, employment, support staff and mental health and rehabilitation staff perspectives on employment for people with psychiatric disabilities. Weaving the threads together. Proceedings of the 7th Annual THEMHS Conference. Sydney: Standard Publishing House; 1997. p. 119–31.

  29. Nuechterlain K, Dawson M. A heuristic vulnerability/stress model of schizophrenic episodes. Schizophr Bull. 1984;10:300–11.

    Google Scholar 

  30. Sainsbury Centre for Mental Health. Keys to engagement: review of care for people with severe mental illness who are hard to engage with services. London: Sainsbury Centre for Mental Health; 1998.

    Google Scholar 

  31. Corrigan P, Watson A. The paradox of self stigma and mental illness. Clin Psychol Sci Pract. 2002;9(1):35–53.

    Article  Google Scholar 

  32. Thompson A, Stuart H, Bland R, Arboleda-Florez J, Warner R, Dickson R. Attitudes about schizophrenia from the pilot site of the WPA worldwide campaign against the stigma of schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 2002;37:475–82.

    Article  PubMed  Google Scholar 

  33. Goffman E. Stigma: notes on the management of spoiled identity. Englewood Cliffs, NJ: Prentice Hall; 1963.

    Google Scholar 

  34. McGlashan T, Carpenter W. Does attitude towards psychosis relate to outcome? Am J Psychiatry. 1981;138:797–801.

    PubMed  CAS  Google Scholar 

  35. Graetz B. Health consequences of employment and unemployment: longitudinal evidence for young men and women. Soc Sci Med. 1993;36(6):715–24.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Vicky Nithsdale.

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Nithsdale, V., Davies, J. & Croucher, P. Psychosis and the Experience of Employment. J Occup Rehabil 18, 175–182 (2008). https://doi.org/10.1007/s10926-008-9131-6

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