Labor Day, Work, and Recovery from Psychosis

Posted by Jessica Arenella, Moderator

“What’s all this talk about empowerment? I can tell you the definition of empowerment: “It’s a decent paycheck at the end of the week.”

Quotation quoted by Patricia Deegan, Ph.D. in her incisive and inspiring paper “Recovery and the Conspiracy of Hope”, and sadly still as relevant today as it was in 1996 when she delivered it.

Labor Day is the bastard child of the railroad unions and the federal government. It was hastily declared a holiday in order to appease the working class after government intervention in the Pullman Strike left American workers dead, as they attempted to intervene in the conflict between management and labor unions. The date was chosen in part to segregate American workers from the international labor union movement, which celebrated its struggles on May 1.

This got me thinking about the role of work in the recovery from psychosis. As those of you who have read Robert Whitaker‘s latest book, Anatomy of an Epidemic know, psychiatric illness is the leading reason that Americans received disability benefits from the federal government (Social Security Disability / Supplemental Security Income). The unemployment rate for people with psychiatric illness is estimated to be around 80%. It is common for unemployed CNPs (chronically normal people) to suffer from depression, anxiety and substance abuse, so it makes sense that people with schizophrenia and psychosis also succumb from the despair associated with unemployment (not to mention the stress of poverty and stigmatization).

While there are lots of reasons for the high rates of unemployment among people with schizophrenia and psychosis, here are my two pet peeves:

Although there are flexible work options for some highly educated professionals, most hourly-wage jobs have overly rigid rules that are intimidating and negatively impact employees recovering from psychotic illness.

1. Hiring practices are increasingly intrusive, including self-report of medical problems, medications, credit checks, urinalysis, etc. Since when do employers need to know the intimate details of your life?! What if you are already prone to paranoia, feeling insecure about gaps in your resume and taking psychiatric medication?

2. Work hours are often unnecessarily rigid, making it difficult to keep treatment appointments or attend support groups, which are often critical during the transition to work. Is it really that difficult to adjust start times 30 minutes later or quitting time fifteen minutes later? Fortunately, such accommodations are available under the ADA, but many are uninformed about their rights and unsure about how to seek appropriate accommodations. Admitting psychiatric symptoms to authority figures (mental health professionals, parents etc.) is often linked with coercive measures on the part of authority figures, so it can be frankly intimidating and certainly counter-intuitive to tell your boss that you need to leave early on Thursday to go to your Double-Trouble Meeting.

Now, why are these my pet peeves? Because in addition to posing particular problems for people with schizophrenia and psychosis, these are issues that impact all American workers negatively. The preeminence of corporations and the tyranny of the workplace affect the well-being of all of us. Being respectful of individuals and respected in the workplace, including earning a decent living wage, is a goal that we can all work toward on this Labor Day.

Comment posted on September 16, 2010 by rosstappen

Congratulations on the blog launch.

Jessica your point about the travails of dealing with the contemporary work force are well taken.  As someone said to me last week “I need to be involved with a system that can help me with this – otherwise I am stuck in some 4-12 thing after clinic, and do you think I am going to tell them sorry I gotta go give blood so I can take my medicine?  They don’t want to hear that!”  And, thanks for your reminder that the struggles of people dealing with mental illness are foremost the struggles of people, and are shared by people everywhere.

Look forward to more stimulating posts from ISPS blog..

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