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Old 09-27-04, 08:08 AM
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Work and Mental Illness - What Do We Really Know?

...NAMI Advocate, January/February 1998

Work is at the very core of contemporary life for most people, providing financial security, personal identity, and an opportunity to make a meaningful contribution to community life. For individuals with severe mental illness, however, work has been a difficult and often unattainable goal.

The following are facts about the capabilities of this emerging workforce, facts that draw upon a broad base of reliable rehabilitation research.

Copies of the entire brochure and information on specific studies cited can be obtained from MRI, 6008 Wayne Avenue, Philadelphia, PA, 19144, 215.438.8200.

FACT: There are three million working age adults with severe mental illness in the nation's communities, of whom 70 percent (about 2.5 million people) are unemployed.

The National Institute of Mental Health estimates that there are a little more than three million adults ages 18 to 69 who have a serious mental illness. Estimates of unemployment among this group are startling: Between 70 percent and 90 percent are unemployed, a rate higher in the nation than for any other group of people with disabilities.

FACT: A diagnosis of serious mental illness is not a reliable indicator that someone cannot work, indeed, many people are able to work successfully despite their symptoms.

Several years of study report only a small relationship between a diagnosis and work capacity, or between psychiatric symptoms and work capacity. While it is true that some of the symptoms of mental illness - its often unpredictable nature and its impact on both cognitive and interpersonal functioning - make work a real challenge, these symptoms vary from person to person.

FACT: On-the-job accommodations that make it possible for people with serious mental illness to succeed at work are proving relatively straightforward and inexpensive to provide.

Recent surveys indicate that job accommodations for people with disabilities of all kinds are not difficult to make or costly to implement - 68 percent of all accommodations cost less than $500.00. The changes at work that people with serious mental illness request most often - alterations in the work schedule, modifications in job descriptions, clear communication patterns or additional training for supervisors - are generally low-cost or no-cost to employers and differ only slightly from options offered for other employees.

FACT: The great majority of people with a serious mental illness want to work. Recent surveys report that approximately 70 percent of those with significant psychiatric problems rank work as an important goal for themselves.

Many consumers receiving SSI or SSDI financial and medical benefits are often reluctant to give up their eligibility for what may be low-paying and low-benefit jobs. Nonetheless, about 71 percent of those people with serious mental illness who are asked about their future goals identify work - and the financial independence and social identity it provides - as a central and important ambition for themselves.

FACT: Innovative rehabilitation programs, which help people with the most serious mental illnesses, are placing more than 50 percent of their clients into paid employment.

A number of innovative programs that move clients into "real jobs for real pay" as quickly as possible - and then provide extensive supports for them either on-the-job or off-the job - are reporting considerable success. An in-depth analysis of supported employment outcomes, for instance, found 52 percent of people still working after a year. Intensive case management and individual placement and support models that emphasize employment regularly report significant increases in wages, hours worked, work tenure, and career advancement.

FACT: Employers who have hired persons with serious mental illness in the past are generally very positive about their experience.

Many employers throughout the country have hired people with serious mental illness. More than 70 percent of these employers report their willingness to continue working with rehabilitation programs that place and support people with serious mental illness. Employers who are involved with rehabilitation programs are less likely to share the public's concerns and fears about people with mental illness, particularly with regard to violent behavior.

FACT: Although job loss continues to be a problem, those individuals with serious mental illness who are working can be helped to stay on the job if they receive the additional support they need.

The reasons for job loss vary widely. In one study, only 12 percent of those people who left their jobs said they resigned because they didn't want to work, and only 15 percent had to leave for medical reasons unrelated to their mental health. The others who became unemployed faced a variety of problems - layoffs, problems with co-workers or supervisors as well as mental health problems - that led to diminished work capacities. Many of these problems might have been resolved without job loss if ongoing support had been available.

FACT: Because people with psychiatric disabilities are the largest part of the recent increase in persons dependent upon SSI/SSDI support, the nation can't afford to shortchange rehabilitation programs that help people with mental illness to work.

With growing numbers of persons with serious mental illness seeking SSI/SSDI support, far more emphasis needs to be placed on vocational rehabilitation programs that can help people to work and live more independently. People with mental illness can and want to work and rehabilitation programs can be successful in getting people onto the job and keeping them employed.
Be nice to me, I have powers and Andrew no longer compensates me with shoes!!
Do what you feel in your heart to be right - for you'll be criticized anyway. You'll be damned if you do, and damned if you don't.--Eleanor Roosevelt
I'm all in favor of keeping dangerous weapons out of the hands of fools. Let's start with typewriters. --Frank Lloyd Wright

Everything I write is fully substantiated by my personal opinion.
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