June 25, 2007

Must "Recovery" from Schizophrenia Include Maintaining Employment?

In The Royal College Of Psychiatrists' Annual Meeting, focusing on "recovery" from psychiatric disorders including severe depression, bipolar, anxiety and schizophrenia, a joint paper was presented "to provide a succinct account of the meaning of recovery, its underlying principles and implications".

A press release about the conference and the paper presented, stated:

Recovery is seen as having at least 3 different meanings: as a spontaneous and natural process; as a response to effective treatments; and as a way of growing with, or despite, continuing disability. The focus of the paper, titled 'A Common Purpose - Recovery in Future Mental Health Services' has a focus directed at living with and beyond the limitations of continuing symptoms or disabilities.

"I very much welcome the arrival of 'A Common Purpose: Recovery in Future Mental Health Services'", said Professor Louis Appleby, National Director for Mental Health. "This timely publication re-emphasises the values, aims and purpose of modern mental health services, essentially as supporting people in recovery. Recovery now sits beside choice, independence and inclusion as the watchwords of modern mental health care. The focus for the next decade will be in working together to turn these principles into practice and making a reality of the aspiration that recovery should be the common experience for all people who use mental health services. This paper deserves to be widely adopted, it is challenging, humane and, above all, hopeful."

Concepts of recovery emphasise the value and uniqueness of each person, and regard their different viewpoints and cultural perspectives as a resource.

The conference acknowledged that in some cases, "recovery" might not include active employment. One speaker, Mr Arbuthnott who is on invalidity (disability) benefit has had several episodes of psychosis requiring hospitalization. He was employed between hospitalizations, but terminated employment after another psychotic episode.

He told the conference that sometimes going back to work in what can be a 'brutal and competitive workplace' can actually undermine recovery. For some people, the stress may be counter-productive. He is worried that findings emphasizing "recovery" and employment may, when combined with "a government obsessed with cutting expenditure on welfare benefits for the disabled could use such findings to review and redefine service users' entitlement to incapacity benefit and disabled living allowance."

Mr. Arbuthnott said that some people may not be working but find their own way to live a good life while coping with their illness. "They feel safe, happy and secure with the minimum of social engagement. Who is to say that such service users have not achieved their own recovery goals and have not recovered?"

The opinion of Professor Sue Bailey, Registrar of the Royal College of Psychiatrists was voiced that although the hope is that the patient's recovery would include employment in work that the patient found fulfilling, it is the psychiatrists' job to support the patient in their personal road to recovery, and to hear what patients such as Mr Arbuthnott have to say.

Read the article: Don't Assume Recovery Makes Us Fit For Work, Say People With Mental Illness

Read the Press Release from the Royal College of Psychiatrists: A Common Purpose - Recovery in Future Mental Health Services

Related Reading:
Schizophrenia Treatment Goal Can Go Beyond Simple Maintenance
Schizophrenia Society of Canada Emphasizes Quality Of Life
Schizophrenia Drug Studies: One Size Does Not Fit All; Community Services Also Needed
New Job Programs for People with Schizophrenia Sought in Australia
Working with Schizophrenia


Interesting article. Indeed working can be stressful at times but responsibility and accomplishment feel good. Perhaps each individual has to consider/re-consider pros & cons. Also maybe doing or taking a different job with maybe less stress would be a good idea. A component of work is it places you in a social context rather then being alone & isolated which personally makes me feel awkward.

Posted by: Frank S at June 25, 2007 12:44 PM

I have Schizophrenia since 2000 year, and now i have worked since 2004 year a, so about 3 years, i recomnd working its good to mind and selfesteem and better sleep and you have somthing to do so i think less to my illness and less to medication .But i left my job where i was 2,5 years ,because my brain worked against me, now i learn baker work, but i have little pay, but its less demand so i can still work.

Posted by: roger at June 26, 2007 05:45 AM

I feel conflicted about this. On one hand, I think it could be argued that if a person is not well enough to work, that perhaps "recovered" may be too strong a word.

On the other hand, I can see that the person may truly be as well "recovered" as possible, but remain very vulnerable to stress, and have PTSD and even an anxiety problem left over from their horrific ordeal. I can see that for some people, they may actually live a better life by simply being allowed to go at their own pace, possibly taking on odd jobs when they feel up to it, doing their laundry, grocery shopping, exercising, going to appointments and socializing in a more unhurried manner. They are "recovered" but adding in a full day's work with perhaps low energy level and vulnerability to stress is just too much and we should respect the individual's need.

In some countries, the person who even tries to work part time or intermittently risks losing access to their disability payments and even their medications. That risk can add to their stress as well.

Posted by: Naomi at June 26, 2007 11:58 AM

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