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Clinicians’ attitudes to the employment of people with psychosis

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Abstract

Background

Negative staff attitudes have been cited as a factor in explaining the low rates of employment in people with psychosis. We aimed to conduct the first systematic survey of staff attitudes in UK community mental health teams.

Methods

A questionnaire survey of clinicians working in community mental health teams in North London, UK.

Results

Clinicians believed that many more people with psychosis were capable of working than were actually doing so. Nevertheless they believed that about two thirds of their caseloads were either incapable of working or able only to do voluntary or sheltered work. The work roles they saw as suitable tended to be ones requiring lower levels of technical skills. Clinicians saw helping people get back to work as a core part of their role, but felt they had little relevant training and limited confidence in the vocational services currently available for their clients.

Conclusions

In this London catchment area, clinicians believed the majority of people with psychosis to be capable of some kind of work, albeit not always open market, but they had few resources available to them to facilitate this. They give priority to the development of place and support vocational services.

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References

  1. Auslander LA, Jeste DV (2002) Perceptions of problems and needs for service among middle aged and elderly out-patients with schizophrenia and related psychotic disorders. Community Ment Health J 38:391–402

    Article  PubMed  Google Scholar 

  2. Becker D, Drake R, Farabaugh A, Bond G (1996) Job preferences of clients with severe psychiatric disorders participating in supported employment programs. Psychiatr Serv 47:1223–1226

    PubMed  CAS  Google Scholar 

  3. Billing J, Johnson S, Bebbington P, Greaves A, Priebe S, Muijen M, Ryrie I, Watts J, White I, Wright C (2003) Assertive outreach teams in London: staff experiences and perceptions-Pan-London assertive outreach study, part 2. Br J Psychiatry 183:139–147

    Article  Google Scholar 

  4. Bond GR, Becker DR, Drake RE, Rapp CA, Meisler N, Lehman AF, Bell MD, Blyler CR (2001) Implementing supported employment as an evidence-based practice. Psychiatr Serv 52:313–322

    Article  PubMed  CAS  Google Scholar 

  5. Burns T, Catty J, Becker T, Drake RE, Fioritti A, Knapp M, Lauber C, Rössler W, Tomov T, Busschbach J van, White S, Wiersma D, for the EQOLISE Group (2007) The effectiveness of supported employment for people with severe mental illness: a randomised controlled trial. Lancet 370(9593):1146–1152

    Article  PubMed  Google Scholar 

  6. Burns T, Catty J, White S, Becker T, Koletsi M, Fioritti A, Rössler W, Tomov T, van Busschbach J, Wiersma D, Lauber C, for the EQOLISE Group. (2008) The impact of supported employment and working on clinical and social functioning: results of an international study of individual placement and support. Schizophr Bull doi:10.1093/schbul/sbn024

  7. Castle D, McGrath J, Kulkarni J (2000) Women and schizophrenia. Cambridge University Press, UK

  8. Conning AM, Rowland LA (1995) Staff attitudes and the provision of individualised care: what determines what we do for people with long-term psychiatric disabilities. J Ment Health 4:289–296

    Article  Google Scholar 

  9. Crowther RE, Marshall M, Bond GR, Huxley P (2001) Helping people with severe mental illness to obtain work: systematic review. Br Med J 322:204–208

    Article  CAS  Google Scholar 

  10. Doherty I, Craig T, Attafua G, Boocock A, Jamieson-Craig R (2004) The consumer-employee as a member of a mental health assertive outreach team II: impressions of consumer employees and other team members. J Ment Health 13:71–81

    Article  Google Scholar 

  11. Drake RE, Becker DR, Biesanz JC, Torrey WC, McHugo GJ, Wyzik PF (1994) Rehabilitation day treatment vs. supported employment: I: vocational outcomes. Community Ment Health J 30:519–532

    Article  PubMed  CAS  Google Scholar 

  12. Grove B, Membrey H (2005) Sheep and goats: new thinking on employability. In: Grove B, Secker J, Seebohm P (eds) New thinking on mental health and employment. Radcliffe Publishing, Oxford, pp 3–11

    Google Scholar 

  13. Goldberg RW, Lucksted A, McNary S, Gold JM, Dixon L, Lehman A (2001) Correlates of long term unemployment among inner-city adults with serious and persistent mental illness. Psychiatr Serv 52:101–103

    Article  PubMed  CAS  Google Scholar 

  14. Jahoda M (1981) Work, employment, and unemployment: values, theories, and approaches in social research. Am Psychol 36:184–191

    Article  Google Scholar 

  15. Lehman AF, Kreyenbuhl J, Buchanan RW, Dickerson FB, Dixon LB, Goldberg R, Green-Paden LD, Tenhula WN, Boerescu D, Tek C, Sandson N, Steinwachs DM (2004) The schizophrenia patient outcomes research team (PORT): updated treatment recommendations 2003. Schizophr Bull 30:193–217

    PubMed  Google Scholar 

  16. Marmot MG, Bosma H, Hemingway H, Brunner E, Stansfield S (1997) Contribution of job control and other risk factors to social variations in coronary heart disease incidence. Lancet 350:235–239

    Article  PubMed  CAS  Google Scholar 

  17. Martikainen P, Volkonen T (1996) Excess mortality of unemployed men and women during a period of rapidly increasing unemployment. Lancet 348:909–912

    Article  PubMed  CAS  Google Scholar 

  18. Marwaha S, Johnson S (2004) Schizophrenia and employment: a review. Soc Psychiatry Psychiatr Epidemiol 39:337–349

    Article  PubMed  Google Scholar 

  19. Marwaha S, Johnson S (2005) Views and experiences of employment among people with psychosis: a qualitative descriptive study. Int J Soc Psychiatry 51:302–316

    Article  PubMed  Google Scholar 

  20. Moser KA, Goldblatt PO, Fox AJ, Jones DR (1987) Unemployment and mortality: comparison of the 1971 and 1981 longitudinal study census samples. Br Med J 1:86–90

    Article  Google Scholar 

  21. Office of Population Censuses and Surveys (2001). http://www.statistics.gov.uk/census2001/pyramids/pages/h.asp

  22. Olson JM, Maiol GR (2003) Attitudes in social behaviour (chapter 13). In: Weiner IB (ed) Handbook of psychology. Wiley, UK

  23. Perkins R, Rinaldi M (2002) Unemployment rates among patients with long term mental health problems. Psychiatr Bull 26:295–298

    Article  Google Scholar 

  24. Priebe S, Fakhoury WKH, Hoffman K, Powell RA (2005) Morale and job perception of community mental health professionals in Berlin and London. Soc Psychiatry Psychiatr Epidemiol 40:223–232

    Article  PubMed  Google Scholar 

  25. Reininghaus UA, Morgan C, Simpson J, Dazzan P, Morgan K, Doody GA, Bhugra D, Leff J, Jones P, Murray R, Fearon P, Craig TK (2008) Unemployment, social isolation, achievement-expectation mismatch and psychosis: findings from the AESOP study. Soc Psychiatry Psychiatr Epidemiol 43:743–751

    Article  PubMed  Google Scholar 

  26. Royal College of Psychiatrists (2002). Council report CR111. employment opportunities and psychiatric disability. Royal College of Psychiatrists, London

  27. Secker J, Grove B, Seebohm P (2001) Challenging barriers to employment, training and education for mental health service users: the service users perspective. J Ment Health 10:395–404

    Article  Google Scholar 

  28. Twamley EW, Jeste DV, Lehman AF (2003) Vocational rehabilitation is schizophrenia and other psychotic disorders: a literature review and meta-analysis of randomized control trials. J Nerv Ment Dis 191:515–523

    Article  PubMed  Google Scholar 

  29. Vogel R, Bell V, Blumenthal S, Neumann NU, Schuttler R (1989) Work and psychiatric illness: the significance of the post- hospitalisation occupational environment for the course of psychiatric illness. Eur Arch Psychiatry Neurol Sci 238:213–219

    Article  PubMed  CAS  Google Scholar 

  30. Wamala A, Bostrom G, Nyqvist K (2007) Perceived discrimination and psychological distress in Sweden. Br J Psychiatry 190:77–79

    Article  Google Scholar 

  31. World Health Organization (2000) Mental health and work: impact issues and good practice: Geneva. http://www.who.int/mental_health/media/en/712.pdf

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Acknowledgments

We would like to thank the clinicians of the Camden and Islington NHS Foundation Trust who generously gave their time to complete the questionnaire used in this study. We are also grateful to Bruce Buckmaster a project manager for a service user employment programme in Camden and Islington who advised on some aspects of the construction of the questionnaire.

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Correspondence to Steven Marwaha.

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Marwaha, S., Balachandra, S. & Johnson, S. Clinicians’ attitudes to the employment of people with psychosis. Soc Psychiat Epidemiol 44, 349–360 (2009). https://doi.org/10.1007/s00127-008-0447-5

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  • DOI: https://doi.org/10.1007/s00127-008-0447-5

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