Working and Schizophrenia

  • Jenny Droughton
  • Steve Williams


This chapter focuses specifically on how the availability or otherwise of paid or voluntary work, and the nature of such work can be a huge source of stress for people with schizophrenia (Warner, 1994) or provide therapeutic opportunity. it argues that mental health professionals should orientate themselves to the occupational needs of people with schizophrenia in a systematic way to improve recovery, provide outcomes valued by sufferers and their families, that is, work and its associated status, and possibly reduce the secondary disabilities associated with schizophrenia. The aim of this chapter to challenge the undue pessimism regarding addressing the vocational needs of people with schizophrenia that is so prevalent among many mental health professionals by reviewing some of the recently published literature in this field. Models of social intervention specifically focused upon employment/vocational needs are described. This chapter also provides a checklist to help grassroots workers ensure that their own PSI practice is appropriately social as well as psychological.


Mental Health Mental Health Professional Severe Mental Illness Assertive Community Treatment Vocational Rehabilitation 
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  1. Bailey, E.L., Ricketts, S.K. and Becker, D.R. et al. (1998) ‘Do long-term day treatment clients benefit from Supported Employment?’, Psychiatric Rehabilitation Journal, 22(1), 24–9.CrossRefGoogle Scholar
  2. Becker, D.R., Drake, R.E., Farabaugh, A. and Bond, G.R. (1996) ‘Job preferences of clients with severe psychiatric disorders participating in supported employment programs’, Psychiatric Services, 47(11), 1223–6.CrossRefPubMedGoogle Scholar
  3. Becker, D.R., Torrey, W.C. and Toscano, R. et al. (1998) ‘Building Recovery-oriented Services: lessons from implementing individual placement and support (IPS) in community mental health centers’, Psychiatric Rehabilitation Journal, 22(1), 51–4.CrossRefGoogle Scholar
  4. Bell, M.D., Lysaker, P.H. and Milstein, R.M. (1996) ‘Clinical Benefits of Paid Work Activity in Schizophrenia’, Schizophrenia Bulletin, 22, 51–67.CrossRefPubMedGoogle Scholar
  5. Brenner, M.H. (1973) Mental Illness and the Economy, Cambridge, MA, Harvard university Press.Google Scholar
  6. Clark, R.E., Dain, B. J., Xie, H., Becker, D.R. and Drake, R.E. (1998) ‘The Economic Benefits of Supported Employment for Persons with Mental Illness’, Journal of Mental Health Policy and Economics, 1(2), 63–71.CrossRefPubMedGoogle Scholar
  7. Cook, J.A. (1992) Outcome assessment in psychiatric rehabilitation services for persons with severe and persistent mental illness. Prepared for the National Institute of Mental Health, Contract No. 91MF23474902D.Google Scholar
  8. Crowther, R., Bond. G., Huxley, P. and Marshall, M. (2000) Vocational rehabilitation for people with severe mental disorders (Cochrane Review), Cochrane Library, 3, oxford, update Software.Google Scholar
  9. Crowther, R.E., Marshall, M., Bond, G.R. and Huxley, P. (2001) ‘Helping people with severe mental illness to obtain work: systematic review’, British Medical Journal, 322, 204–8.CrossRefPubMedPubMedCentralGoogle Scholar
  10. Department of Health (1998) Modernising Mental Health Services: safe, sound, supportive, London, The Stationery Office.Google Scholar
  11. Department of Health (1999) National Service Framework for Mental Health, London, The Stationery Office.Google Scholar
  12. Drake, R.E., Fox, T.S. and Leather, P.K. et al. (1998) ‘Regional Variation in Competitive Employment for Persons with Severe Mental Illness’, Administration and Policy in Mental Health, 25(5), 493–504.CrossRefGoogle Scholar
  13. Evans, J. and Repper, J. (2000) ‘Employment, social inclusion and mental health’, Journal of Psychiatric and Mental Health Nursing, 7, 15–24.CrossRefPubMedGoogle Scholar
  14. Griffiths, R.D. (1974) ‘Rehabilitation of chronic psychotic patients’, Psychological Medicine, 4, 316–25.CrossRefPubMedGoogle Scholar
  15. Hill, R.G. and Shepherd, G. (1997) ‘Positively Transitional or unfortunately Permanent? The Status of Work within Clubhouses in the UK’, A Life in the Day, 25–30.Google Scholar
  16. Hooper, R. (1996) Adult Education for Mental Health: a study in innovation and partnership, Adults Learning, November, 71–4.Google Scholar
  17. Jablensky, A., Sartorius, N., Ernberg, G., Anker, M., Korten, A., Cooper, J.E., Day, R. and Bartelsen, A. (1992) Schizophrenia: manifestations, incidence and course in different cultures, Cambridge, Cambridge University Press.Google Scholar
  18. Jenkins, J.H. and Karno, M. (1992) ‘The meaning of expressed emotion: theoretical issues raised by cross-cultural research’, American Journal of Psychiatry, 149(1), 9–21.CrossRefPubMedGoogle Scholar
  19. Luo, K. and Yu, D. (1994) ‘Enterprise-Based Sheltered Workshops in Nanjing: a new model for the Community Rehabilitation of Mentally 1ll Workers’, British Journal of Psychiatry, 165(suppl. 24), 89–95.Google Scholar
  20. Mancuso, L.L. (1993) Case Studies on Reasonable Accommodations for Workers with Psychiatric Disabilities, Sacramento, CA, California Department of Mental Health.Google Scholar
  21. McGurrin, M.C. (1994) ‘An overview of the effectiveness of traditional vocational rehabilitation services in the treatment of long term mental illness’, Psychosocial Rehabilitation Journal, 17(3), 37–54.CrossRefGoogle Scholar
  22. Mueser, K.T., Becker, D.R., Torrey, W.C. and Xie, H. et al. (1997) ‘Work and non-vocational domains of functioning in persons with severe mental illness: A longitudinal analysis’, Journal of Nervous and Mental Disease, 185(7), 419–26.CrossRefPubMedGoogle Scholar
  23. Nehring, J. and Hill, R.G. (1995) The Blackthorn Garden Project: Community Care in the Context of Primary Care, London, Sainsbury Centre for Mental Health.Google Scholar
  24. Perkins, R.E. (1991) Access to Work. Paper presented at the British Association for Behavioural Psychotherapy Annual National Conference, University of Oxford.Google Scholar
  25. Perkins, R., Buckfield, R. and Choy, D. (1997) ‘Access to employment: A supported employment project to enable mental health service users to obtain jobs within mental health services’, Journal of Mental Health, 307–18.Google Scholar
  26. Perkins, R.E. and Repper, J.M. (1996) Working Alongside People with Long-Term Mental Health Problems, London, Chapman & Hall.Google Scholar
  27. Pozner, A., Ng, M.L., Hammond, J. and Shepherd, G. (1996) Working it out. Creating work opportunities for people with mental health problems: a development handbook, London, Sainsbury Centre for Mental Health/Brighton, Pavilion Publishing.Google Scholar
  28. Read, J. and Baker, S. (1996) Not just sticks and stones. A survey of the stigma, taboos and discrimination experienced by people with mental health problems, London, MIND Publications.Google Scholar
  29. Rogers, E.S., Walsh, D., Masotta, L. and Danley, K. (1991) Massachusetts survey of client preferences for community support services (Final report), Boston, Center for Psychiatric Rehabilitation.Google Scholar
  30. Scheid, T.L. and Anderson, C. (1995) ‘Living with chronic mental illness: understanding the role of work’, Community Mental Health Journal, 31(2), 163–76.CrossRefPubMedGoogle Scholar
  31. Shepherd, G., Murray, A. and Muijen, M. (1994) Relative values: the different views of users, family carers and professionals on services for people with schizophrenia, London, Sainsbury Centre for Mental Health.Google Scholar
  32. Stein, L.I. and Santos, A.B. (1998) Assertive Community Treatment of Persons with Severe Mental Illness, New York, Wold. Norton.Google Scholar
  33. Torrey, W.C., Becker, D.R. and Drake, R.E. (1995) ‘Rehabilitative day treatment vs. supported employment: II. Consumer, family and staff reactions to a program change’, Psychosocial Rehabilitation Journal, 18(3), 67–75.CrossRefGoogle Scholar
  34. Torrey, W.C., Mead, S. and Ross, G. (1998) ‘Addressing the Social Needs of Mental Health Consumers when Day Treatment Programs Convert to Supported Employment: can consumer-run services play a role?’, Psychiatric Rehabilitation Journal, 22(1), 73–5.CrossRefGoogle Scholar
  35. Warner, P. (1994) Recovery From Schizophrenia: Psychiatry and political economy, 2nd edn, London, Routledge.Google Scholar
  36. Wexler, B.E., Hawkins, K.A., Rounsaville, B., Anderson, M., Sernyak, M.J. and Green, M.F., et al. (1997) ‘Normal neurocognitive performance after extended practice in patients with schizophrenia’, Schizophrenia Research, 26, 173–80.CrossRefPubMedGoogle Scholar
  37. Wing, J.K. and Brown, G. (1970) Institutionalism and Schizophrenia: a comparative study of three mental hospitals 1960–1968, Cambridge, Cambridge University Press.CrossRefGoogle Scholar
  38. World Health Organization (1979) Schizophrenia: An International Follow-Up Study, Chichester, Wiley.Google Scholar
  39. Zubin, J. and Spring, B. (1977) ‘Vulnerability: A new view of schizophrenia’, Journal of Abnormal Psychology, 86, 103–26.CrossRefPubMedGoogle Scholar

Copyright information

© Neil Harris, Steve Williams, Tim Bradshaw 2002

Authors and Affiliations

  • Jenny Droughton
  • Steve Williams

There are no affiliations available

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