To address misconceptions and concerns about employment for people with mental health issues, we speak with Dr Mangala, a consultant psychiatrist with SCARF (Schizophrenia Research Foundation).
Could you please explain what in medical parlance is known as ‘Mentally ill or Mentally Disabled’? Are these labels useful/helpful?
A disturbance in one’s ability to think, behave or express feelings is termed as mental illness. When someone lacks the ability to:
- meet or fulfill basic physical and emotional needs
- manage day to day events
- control his/her behaviour, then he/she is considered mentally ill.
The labels help in understanding the condition. But, sadly, they are always used in a derogatory way. But for want of a better word, these labels are in use.
Do you think in your experience that a person suffering from a mental health issue is able to do a full time job properly with a performance at par with their colleagues?
Persons with mental illnesses may not be able to work to their full potential when they have an active illness and when symptoms can cause difficulties in concentration, attention span and motivation to do work. However, they can resume their work, once the acute phase of illness abates.
Work can be therapeutic and can aid recovery in mental illness. The earlier a person with mental illness starts or resumes his activities / work, it always proves beneficial for the process of recovery.
Persons who have recovered from the acute phase of illness can do a full time job like others. However, some people with very long duration of illness or severe symptoms may not be able to perform at par with normal people. Persons who were doing highly skilled jobs prior to illness may not be able to return to the same jobs or positions but can function well in lesser capacities.
Regular and fixed working hours, preferably in the day and in a convenient location from their residence,would be ideal conditions for them to work.
Contrary to popular belief, skills and knowledge gained before the onset of illness are not completely lost.
Should prospective or current employers differentiate between specific illnesses?
Some understanding about specific illnesses does help. This can help in deciding the nature of job that can be assigned. Social and cognitive deficits, if any, can be understood better and handled appropriately. Most importantly, knowledge of specific illnesses and their symptoms can help in identifying a relapse/exacerbation quickly, facilitating intervention.
Do employers and colleagues need to make certain adjustments and accommodations when working with someone with mental health issues?
Yes and No. It is not necessary all the time. Someone with mental health issues can do as much work as others, if not more. However, it would be ideal if they are exempted from night shifts.
Some of them may be quiet and withdrawn. Some of them may be slower than colleagues at work. Some amount of understanding about their limitations goes a long way to help them sustain at work and improve their performance.
Persons with mental illnesses do not need sympathy. They should be treated with the same respect and dignity as other employees in the organisation, but with a little extra support and encouragement. Ridiculing them or treating them differently will worsen the stigma that already exists in their minds.
Medically speaking, are all people with mental health illnesses encouraged to go out and work?
All people with mental health issues are encouraged to be active and productive as soon as possible after the onset of illness. It can be resumption of earlier work or a newer one which the person can comfortably do. This includes both gainful employment and responsibilities at home.
A person can choose either one of these depending on his/ his family’s needs. But an activity with an incentive in some form, usually money, helps better.
Are such people more likely to falter, given workplace stress and dynamics?
That depends on several things like the type of illness, premorbid functioning and nature of work to quote a few. So, some of them (not all) do have difficulty in coping with workplace stress and dynamics a little more than others.
Keeping in mind the adage ‘Fairness in employment’, how fair do you think it is for employers to hire mental health patients when the output will always be suspect? Or, would you like to go against the common belief that output would be suspect?
It would be unfair to make such a statement. From the experience at SCARF (Schizophrenia Research Foundation), there are several employers who will vouch for the work output of persons with mental health problems. SCARF also has employed quite a few recovered patients in various capacities in the organisation and we have no regrets at all. We, in fact, miss some of them who are working elsewhere now. One of the employers, in fact, goes even a step further and says he feels persons with mental health problems work better than others.
How far do you think employment improves the mental health of people?
Serious mental illnesses like schizophrenia and related psychotic disorders require rehabilitation in some form along with medication on their road to recovery. Rehabilitation can be done in many ways. Paid employment tops the list of rehabilitation measures. It remains the ultimate goal for patients and families in countries like India where social security schemes are either not available or insufficient for sustenance for persons with mental illnesses.
Remuneration in some form is a great incentive for a person ill or otherwise to continue doing the task. So a paid job can motivate persons with mental illnesses to engage in such activities on a regular basis.
Besides economic benefits, employment keeps them engaged in meaningful and purposeful activities and brings some structure to their everyday life. They are treated better by family, friends and the society which goes a long way to improve their self esteem.
Employment plays a big role in their inclusion into the mainstream society thereby reducing stigma.
Is it okay when people with mental health problems hide it from their employers? Or is it better to come clean at the very outset?
That is a difficult question. Ideally it would be best if the employer is aware of the person’s mental health problems. But that requires the employer to have some prior knowledge of mental health problems without which he may not understand the person or his illness. This can be disadvantageous to the potential employee.
This can be addressed in several ways. If the person was already employed before he became ill it is easier to explain his condition, when he returns to work in the same place.
Employment in family businesses or through friends and relatives is an option that works. The employer is aware of the person’s condition and is in contact with the family in case of need.
Assisted employment through mental health organizations (like SCARF) is another option. Here, again, the employer is aware that the person is on treatment for a mental health condition and has improved enough to work. He may not know all details about the illness. The occupation therapist or the case manager is in frequent touch with the employer to know the progress or problems if any.
Whatever the mode of finding employment identifying a mentor at workplace will help the person in a big way at work. This could be another employee supervisor or another employed patient.
Given our objective to create an inclusive society, what would be your advice to employers and people with mental health challenges?
Employers should have an open mind when they are approached for jobs by person with mental health issues.
There exists only one kind of mental illness in the minds of most people in the society and that is labelled “Mad”. It is this lack of awareness about mental illnesses and deep rooted misconceptions which make them wary of persons with mental health problems.
So it becomes the responsibility of mental health service providers to promote awareness among potential employers.
Efficiency and satisfactory performance in the assigned work is the only way the employee can impress the employer and clear all doubts around him.
