It is hard for people with mental illnesses to get an employment, for various reasons. Here we discuss the paper “Attitudes towards work life among clients in psychiatric outpatient clinics” published in Nordic Journal of Rehabilitation (Cornelia Wulff Hamrin, 2023). More than 250 Swedish psychiatric outpatients participated in the study. A majority of them had an intention to work. The participants´ diagnoses were not taken, and will in the following not been taken, into consideration.
Below we discuss the four factors of importance for psychiatric clients’ which were found in the study: fighting spirit; to have a work and the intention to work; work environment and prejudices.
Fighting spirit has seldom been examined in relation to mental illness even though fighting spirit is essential and has impact on the identity. In the study it was measured as an index of three items, one of them being “I am me, not my illness”. Which means that you need to identify yourself as a competent individual. You need to believe in your own power and will to master your life and change your situation to the better; not as a helpless patient without ‘a voice’. Fighting spirit is important in this and will be improved by work. In the study, those who were working or had been working recently had a higher fighting spirit compared to those who had not.
To have a work/to recently have had a work and the intention to work
A majority of the participant in the study had some recent work experience. This was also connected to their intention to work. It is argued that work is of importance for a better health and recovery for this group. It will improve their self-concept and contribute to their inclusion in society. People with mental illness are among those who have most difficulties to get an employment. This also affect their economy, which for many people with mental illness is problematic. Many have very restricted budget. However, work per se is important, this is not a contradiction to a good enough economic situation. But good enough economy will per se not have the beneficial effects of work.
A good work environment is beneficial for everyone and especially so for people with mental illnesses. Karasek and Theorell’s famous DCS-model show that a healthy work is characterised by reasonable levels of demand and control together with high levels of support. In the reported study employed participants reported a higher degree of social support than those unemployed.
Indicating that this group of clients can gain health benefits from having a job. The attempts towards a more inclusive labour market in accordance with Agenda 2030 could lead to positive effects for clients in psychiatric outpatients’ clinics. Especially if employers were offered special training or qualified advice in how to create a good work environment for employees.
There are still prejudices against people with mental illness, both in working life and in health care. People with mental illness are very aware of this, and that awareness add to the stigmatization. In the study work as such was more common among those who experienced less prejudices. Why? Probably not just because working clients might be more functional and in less need of care. Skilled professionals as psychiatrists and psychologist, are very important and wanted in this, and can make a difference for the clients.
There must be more concern to help individuals with mental illness to get gainful employments and to be included in work life. In those cases, where employers would need guidance how to accomplish this psychiatrist, and psychologist can contribute with expert knowledge which can make a difference for the clients. It is argued; accordingly, enhanced fighting spirit will empower the clients, and as mentioned work per se is important in this. It will also improve autonomy and life quality for these individuals. In most cases, it is not a great and expensive effort, for employers to hire people with mental illness. On the contrary, some research shows that in most cases a healthy work environment is all that is needed. Both for people with mental illness and society, it is a win-win situation if this group has gainful employments. □