December 04, 2007

In Germany, Approximately 30% of People With Schizophrenia Able to Work

A new study examines the factors associated with employment rates of people suffering from schizophrenia in Germany, the UK and France. The study finds that employment rates for people suffering from schizophrenia are higher in Germany than they are in either the UK or France.

Though work is often a goal many people with schizophrenia hope to meet, the employment rate for people suffering from the illness is often low. In the United States, recent estimates show that only about 10% of the schizophrenic population is employed. In Europe, the employment rate ranges from 8 to 30 percent.

The goal of the study, which appeared in this year's July issue of the British Journal of Psychiatry, "was to examine employment patterns and variables associated with working in the largest representative sample to date of people with schizophrenia resident in Germany, France and the UK."

The researchers of the study examined data collected from the European Schizophrenia Cohort Study, and found the following results:

  • Similar numbers of participants were living alone in each country, but more German respondents were living with partners and/or children, and more French respondents with their parents.
  • It was found that the overall employment rate of participants was 21.5%, but varied between countries and sites, with rates of 12.9% in the UK, 11.5% in France and 30.3% in Germany. This compares with general population employment rate of 71% in the UK, 62.2% in France and 65.4% in Germany in the year 2000.
  • The German centres had the highest proportion of people supporting themselves entirely through work. The number of people in each centre who had never worked was low, apart from in Marseille.
  • The most common type of jobs were ‘elementary’, such as cleaning and labouring, and ‘skilled trade occupations’, such as plumbing and metalwork. The proportion of people in official or managerial positions was very small.More people in Germany were doing sheltered or voluntary work. The German centres had more vocational services, and more placements provided within them, than the other 2 countries.
  • The researchers also found that employment was linked to the following factors: drug use, living alone versus with family, severity of psychopathology, earlier onset of the illness, area of residence and possessing an educational degree.

    The authors commented on the low levels of employment that this study and other recent studies have demonstrated are present in the UK; the authors stated that the employment rates for people suffering from schizophrenia are alarmingly low in both London and France, equivalent to about a third of the employment rate for people suffering from schizophrenia in Germany. This information is particularly worrisome when considering the social isolation and exclusion the mentally ill community experiences, i.e., a lack of employment could be a contributing factor to this problem. In addition, lower employment rates for the mentally ill have also created higher welfare costs for the three examined countries.

    Possible explanations for the low employment rates could be a paucity of low-stress and undemanding jobs, stigma associated with mental illness in the workplace, and as the authors found, drug use. Apparently, the dual diagnosis of mental illness and drug addiction was found to be of particular hindrance to employability, which the authors state, helps explain the results of past studies demonstrating that people with a dual diagnosis of mental illness and drug addiction are more likely to feel or experience social isolation.

    Source: UK Royal College of Psychiatrists


    I was born in Germany and I worked productively for many years until my doctor told me it was okay to go off of my Zyprexa. Everything was downhill from that point forward. However, because I was a good employee and my behavior was clearly linked to my doctor's decision, I am eligible and will probably receive a disability retirement from my job.

    The new medicines are better and better. I think an implant or a cure is only a few years off. The scourge of schizophrenia may well become a phenomenon (albeit a horrible one) of the past.

    One thing about the new medicines: They don't make you nearly as sleepy as the older ones. When I tried 6mg of the new stuff, it had almost no side effects. I was so used to sleeping long hours that I almost didn't no what to do with myself once I had all of this amazing energy. Part of the problem for me was that I wasn't allowed to work as I was on administrative leave because of my behavior off Zyprexa. I had to go on a higher dose (9mg), and that keeps me out of trouble. You win some, you lose some. Schizophrenics in the past had nothing of what I had, like being an armed federal officer, and a successful one at that.

    Posted by: hmmned at December 4, 2007 03:36 PM

    Could be something to do with the language, in English the patient whan asked would say "I could work" in German it would be something like "I must work" therefore german speakers probably have more drive and are able to override more stress.

    Posted by: Josh at December 5, 2007 05:31 AM

    Could be something to do with bratwurst and pilsner and busty maidens at beer festivals…think about it.

    Posted by: Hans at December 5, 2007 10:37 AM

    It could be that the uk goverment treat its people like they are all mentally ill the red tape around mental illness in the uk is ridiculous.The goverment at one stage wanted people locked up just in case they may hurt someone in the furture.If your mental don't come to England.

    Posted by: terratag at December 6, 2007 02:59 AM

    In California, where I used to work, there were a number of Mexicans with developmental disabilities that were put to work performing menial work. They worked hard, and they were well-supervised. In Germany, the people are known for their hard work, so the schizophrenics no doubt imitate the 'normal people.'

    Posted by: hmmned at December 6, 2007 03:15 PM

    I am happy to hear this news and I can testify that the German system works well to keep people working despite any health problems. Part of the solution is the fact that we have universal health care and a social safety net ensures people who encounter problems can meet basic needs. If you have a problem and cannot work, you can wait until you're fit again and then rejoin the work force.

    I am working full time since my diagnosis and start of treatment. I had breaks in between due to hospitalizations and loosing jobs but I always rebounded.

    Its ironic that Germany who used to gas the mentally ill is nowaways a example of how to do it right and the countries who had enduring democratic republics like France and USA are behind us now.

    Posted by: Deutsch at December 7, 2007 08:34 AM

    Hilter was the first to use psychiarty to brain wash hes people.

    Posted by: terratag at December 7, 2007 11:18 AM

    Saying that i don't think Blairs Britain was any better we are all brain washed from kids.

    Posted by: terratag at December 7, 2007 11:32 AM

    "It was found that the overall employment rate of participants was 21.5%, but varied between countries and sites, with rates of 12.9% in the UK, 11.5% in France and 30.3% in Germany."

    30.3%, not 35%

    Also, from wikipedia:

    "Additionally the percentage of so called "long-term sick" in Germany is significantly lower than in the United Kingdom, Sweden or the United States, countries with very low official unemployment rates. Financial support for sickness in these countries normally lasts longer, is easier to reach or is higher than aid for unemployment. Experts believe that many of these "long-term sick" are in reality discouraged workers, who have no perspective in the job market. Most of these people in Germany are registered as unemployed, because unemployment aid is not limited in duration and being "sick" is not more lucrative."

    So it seems that those when people get sick in the UK, the US, and other countries they apply for disability while in Germany they just file for unemployment. Maybe that's why Germany's unemployment rate is higher than in other countries and their number of people on disability is lower.

    Posted by: Malvok at December 7, 2007 12:11 PM

    I dont think the unemployment rate in Germany is increased too much by people who are long term ill. The real problem with unemployment is a lot of structural change, industries going elsewhere due to our high personnel costs including the taxes. The safety net that we have needs to be financed I guess. We have a lot of long term unemployed on the dole and this is a problem because the system itself does not set the incentives to go back to work in jobs which are low pay. For some low skilled people it just does not make any difference whether to work or be on the dole financially. Many people also collect dole and work on the black market getting extra income.
    But, anyway back to the topic. According to the study, the statistics say that more sz people are in employment in Germany than elsewhere. That is they are not counted in unemplyoment support and not counted in disability collection. They are supporting themselfs. This is what the study says. There is no statistical falsification here. I believe some factors in this success are:

    -unniversal healthcare, also for people who are unemployed
    -flexible laws of hospitalisation by court order
    -case workers who look after people who are in need of supervision to take meds, make decisions, etc (they will be on your case until you show that you can do on your own again)
    -half way houses/group homes with connection to protected working arrangements
    -if you work continuously for three years you are eligible for up to one year of unemployment support of 70% of your last pay check
    -After one year unemployed you get a basic life support of about 500 EUR per month in cash and housing
    -Anybody is able to get this 500 EUR per month life support and housing no matter how long you have worked in your last employment
    -There are programmes in place to qualify long term unemployed people and make them ready for the job market, by professional skills training measures, language courses, etc.
    -The unemployment offices continuously monitor your case and try to connect you to jobs that you can qaulify for
    These are just a few things that help to get over crisis in ones life and pick up again after you deal with it.

    Posted by: Deutsch at December 7, 2007 11:31 PM

    That's great, there is no discrimination, even if I think they aren't working as good as the others, but with a lower salary I'm sure they are ok with it.

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