Work Programs Benefit Schizophrenia Patients
Splete, Heidi, Clinical Psychiatry News
PITTSBURGH -- Meaningful work can lead to reduced symptoms for schizophrenia patients, Gary R. Bond, Ph.D., said at a conference on schizophrenia sponsored by the University of Pittsburgh.
Benefits of work also include increased income and an improved sense of self and quality of life, said Dr. Bond, a professor of psychology at both Indiana and Purdue universities in Indianapolis.
Dr. Bond cited an observational study he conducted in 2001 showing that patients employed in "competitive" work over an 18-month period scored significantly lower on the Brief Psychiatric Rating Scale than those who worked sporadically, did not work, or worked in a sheltered environment.
"I don't think it's a hard sell to [schizophrenia patients] that work is a good thing," he said. Patients who work report that they don't hear voices as much, and family members observe reduced symptoms as well.
Competitive work means a regular job in the community that pays at least minimum wage, with coworkers who are "regular folks," not only other people with some sort of disability, he noted. Patients also want a real job--not one that has been created to give them something to do.
Most people with severe mental illness say they want to work, and physicians who want to serve their patients should consider helping them find work, Dr. Bond advised. Part of a normal adult role involves holding a job--it's part of Maslow's hierarchy of needs--and a meaningful daytime activity is important in our society.
Supported programs do succeed in helping those who want to work find jobs, which by extension may reduce overall use of the mental health system. Dr. Bond shared a review of five standard day treatment centers that converted to supported employment centers and showed an average employment rate of 43%, compared with a 17.1% employment rate among controls.
Understanding the symptomatology of schizophrenia is a part of the partnership between the employers and the employment program. Some employers do have reservations about hiring someone with schizophrenia, but those who hire and report positive experiences often become strong advocates. Although many surveys show that 60%-70% of people with schizophrenia and other mental illness have the interest and desire to work, less than 15% are working because of several persistent barriers, including social stigma, clinician attitudes, the mental health system itself, patient characteristics, and poorly structured employment programs. …