The public’s preconceptions about psychosis makes it rather difficult for those living with the condition to gain employment and achieve their goals, a new Australian study finds.
The study, published today in the Australian Journal of Psychology set out to examine the barriers there were to employment for people with psychosis.
What is Psychosis?
Psychosis is an umbrella term that is used to describe the state of an individual when he or she experiences things that do not exist and/or believes things that have no basis in reality. During a psychotic episode, one might experience hallucinations and/or delusions, or may see and hear things that do not exist. Understandably, this can be incredibly frightening for the individual, and sometimes can cause complications with themselves and others. In addition to the clinical impacts of psychotic conditions, the barriers to employment for people living with psychosis are numerous and varied (Rosenheck et al., 2006).
The classic signs and symptoms of psychosis are hallucinations, delusions (false beliefs, especially based on fear or suspicion of things that are not real), disorganization in thought, speech or behaviour, disordered thinking, catatonia and difficulty concentrating (American Psychiatric Association, 2013). Psychosis may come on swiftly or slowly, depending on the cause. Mild, or initial symptoms of psychosis may include general anxiety, feelings of suspicion, depression, distorted perceptions, obsessive thinking, and sleep problems.
In this study, people with psychosis, employers, caregivers, health professionals, and community members were interviewed. The main barriers they found were what the researchers called ‘myths about psychosis’ including the belief that employment is too stressful for people living with psychosis. It was also presumed that people with psychosis are not interested or are incapable of working effectively in competitive employment.
The Ten Myths
Overall, ten ‘myths’ were found regarding the public’s perception of people living with psychosis:
1: People living with psychosis can’t work.
2: Work is too stressful for people living with a psychotic condition and is likely to precipitate relapse.
3: People living with psychosis don’t really want to work.
4: People living with psychosis can only work in sheltered workshops.
5: People living with psychosis can only perform menial jobs.
6: People living with psychosis are not interested in career progression.
7: People living with psychosis can’t work full-time.
8: Employees living with psychosis are a liability/ risk to employers.
9: People living with psychosis must be symptom-free before they can work.
10: De-stigmatisation must occur first before employment of people living with psychosis will be possible.
A History of these Myths
A number of studies have been conducted regarding the public’s perception of people with psychosis. In 2009, a study by Marwaha, Balachandra, and Johnson found that “most mental health clinicians had low expectations in relation to the employment of people with psychosis, believing the majority of their patients were capable of doing some type of work but that two thirds of their caseload would only be capable of working in volunteer roles or sheltered employment.” It was also found that clinicians tended to believe that the stress of working might lead to a relapse. One must consider that clinicians’ perceptions may be influenced by their disproportionate exposure to more severe and/or chronic presentations in clinics and hospitals.
Commonly held negative social stereotypes regarding people living with psychosis persist throughout both Western and non-Western countries. Indeed, a crosscultural comparison of employer concerns about hiring people with psychosis, conducted by Tsang et al. (2007) found that employers in China were significantly more likely to perceive people with psychotic disorders as having a weaker work ethic and less loyalty to the company. In comparison, US employers were more concerned that disorganised thinking might interfere with their task related performance.
What can we do?
The authors of this study believe that public and professional beliefs may constitute significant barriers to the employment of people living with psychosis. They suggest that widespread education is needed to overcome common myths and stereotypes about psychosis. As the study concludes, “little attention has been paid to the importance of positive attributes of people living with psychosis and the support that might be needed to harness and actualise these qualities in the modern workforce.”
Evidently, these harmful, preconceived ideas about people with psychosis need to be challenged if said people are to receive appropriate support to achieve their vocational goals.