Blog by Associate Professor Eoin Killackey, Orygen Youth Health Research Centre, Melbourne
Employment, education and young people
A/Prof Eoin Killackey, Orygen Youth Health Research Centre, University of Melbourne
Here’s some things that I think are really interesting: 1) as a student psychologist and in my early clinical career I was encouraged to tell people with mental illness to take time off work or school, or to quit altogether – until they got better – this still happens; 2) In many countries, people with psychological and psychiatric disabilities (the statisticians words rather than mine) are the fastest growing and now the largest group receiving disability pensions;
3) Amazingly the costs associated with people with mental illness being unemployed make up over half the total costs of illness, and; 4) even when people with mental illness are employed, they tend to get less pay for the same jobs as people without mental illness.
Here though is the most remarkable fact. Despite the ongoing lay belief that the best thing for people with mental illness is to take time out from the stresses of work and recover, it turns out that young people with psychosis and other mental illnesses really want work to be a part of their recovery.
Two studies in the last few years have shown this. One was conducted in the USA and the other in India. In both, young people coming to a first episode psychosis service were asked what their goals for their time with these services would be. Imagine if you had psychosis for a moment. Imagine that you had frightening ideas or heard, saw, smelt, felt or tasted things that nobody else could. Surely getting that under control would be a number one aim? Actually not. In two very different places this is the top-5 list of things that young people wanted help with from an early psychosis service.
USA (Ramsay et al 2012) India (Iyer et al, 2011)
Housing Symptom relief
Health Living Situation
This finding that people with psychosis and other severe mental illnesses want to work is actually not a new finding. It has been a well-known fact for a long time. In an article in the American Journal of Psychiatry from 1918 an outpatient clinic is described that included a vocational rehabilitation worker.
So why despite the desire to work are people with mental illness so unemployed? There are services in many countries that support people with disabilities back into employment. Consistently these services don’t do a great job of helping people with mental illness return to work.
Luckily, there are a number of approaches that do help. In particular is an approach called Individual Placement and Support (IPS). Trials of IPS have shown that over 80% of people with psychosis can return to employment, education or training. While IPS has mainly been used in the past with older people who have a longer history of mental illness, more recently it has been used with younger people. In its use with younger people IPS has been adapted to include continuing or reconnecting with education as a vocational outcome. This is important because young people need more education now to enter the workforce than in the past, and it is also well known that the more education that a person has the less likely they are to become unemployed and the more money they are likely to earn.
In Brighton at IAYMH along with my colleague Gina Chinnery, I will be presenting a workshop all about employment and education and young people where we will discuss all the research, but more importantly the practical tips for ensuring that employment education and training is a central part of a young person’s recovery from mental illness.