Many partners/spouses/family members are critical of the fact that whoever in their family with Bipolar (or other mental illness) might not be working or is in and out of work “can’t hold a job down”. Often this is manifest by them saying “they’ve never worked”, “they’ve been unemployed for years”, “they don’t want to work” etc. Just read various entries in my blog and you’ll see these comments listed.

So, I’ve been researching work place discrimination. Is it true that all these people who are unemployed are “lazy”, “can’t be bothered” “unreliable” “don’t want to work” etc? Or is it that they can’t get work due to their history of mental illness?

Well, I’m posting some research for you all showing just how big a problem it is for people with mental health problems to work and to find work.  Here are some excerpts from Professor Thornicroft’s work “Actions Speak Louder than Word” report for the Mental Health Foundation.

20% of the general population are unemployed.

35% of physically disabled people are unemployed.

80% of people with mental health illnesses are unemployed.

This is the highest rate of unemployment amongst all categories of people and substantially higher than amongst physically disabled people (Nice to know I’m in a “category”).

It is clear that although the primary disability can affect a person’s ability to find and keep work, the flexibility of the employment environment also plays a large part in shaping how far people with diagnoses of mental illness are included in the workforce. The figures are formidable in England:

• 33% of people with mental health problems say that they have been dismissed or forced to resign from their jobs,
• 40% say that they were denied a job because of their history of psychiatric treatment
• 60% say that they have been put off applying for a job as they expect to be dealt with unfairly.Indeed for some people discrimination in the work place is far greater than in any other domain

But this unemployment rate is not due to people being “lazy”: One survey found that people with mental disorders had the highest ‘want to work’ rate i.e. 86% of people with mental illness wanted to find a job, compared to 52% of the disabled people interviewed wanted to find a job.

Why is finding and keeping a job so difficult for so many people with a diagnosis of
mental illness?
One explanation is that employers discriminate against applicants who declare a history of psychiatric treatment. In a study of 200 Human Resource Officers in UK companies, vignettes of job applicants were submitted which were identical except for the presence or absence of a diagnosis of depression. The mention of a mental illness significantly reduced the chances of employment, compared with a history of diabetes. This differential treatment was made based upon perceptions of potential poor work performance, rather than expectations of future absenteeism.

Similar results came from another national study of employers in Britain. Fewer that 40% said that they would
consider employing a person with a history of mental health problems, compared with 60% for people with
a physical disability, and about 80% for long-term unemployed people and lone parents 74;89;90. One possible check to such direct discrimination are the policies of Occupational Health departments, but fewer than half of employers in the UK, for example, have such staff.

A real dilemma faced by people with a history of psychiatric treatment is whether to disclose this when applying for a job. From what we have seen there are strong reasons to believe that disclosure will reduce the likelihood of success. On the other hand, failure to disclose may break an employment contract, and also mean that the person is not able to ask for modifications to the job to make it more manageable (usually called ‘reasonable adjustments’) under the Disability Discrimination Act.

So there is no easy solution to this dilemma, or how to describe gaps in the employment
history. One approach is to make a balance sheet of advantages and disadvantages of declaring a history of
mental illness, and to use this in making a decision.

The other is to become self employed where possible as this circumvents any need to disclose it at all!

Here is a definition of Stigma: “stigma projects the  fear and anxiety felt by members of the general population onto the person with the diagnosis. People with a diagnosis do not really carry a mark that sets them aside.”

So there is no mark on us and yet we are set aside. What are the reasons for this?

Do write in and let me know your employment experiences…..

Another dated article but again worth a look at. I’m going to go ferreting around to see if I can find Louis Appleby and find out what he’s managed to achieve in the 7 years since this article was published. ………..

Friday, 14 April, 2000, 11:21 GMT 12:21 UK

Psychiatrist leads mental health reform

Mental illness is a growing problem

A top psychiatrist has been appointed to spearhead the government’s drive to modernise mental health services.Professor Louis Appleby is to become National Director of Mental Health for the NHS in England.

He is currently Professor of Psychiatry at the University of Manchester and Director of the National Confidential Inquiry into Suicides and Homicides by People with Mental Illness.

This new post confirms that mental health and people with mental illness are a priority

Professor Louis Appleby, National Director of Mental Health

The National Service Framework for Mental Health, launched this month, sets seven national standards for mental health services.

The aim is to drive up quality and reduce variations in services to patients and service users.

It will include round-the-clock crisis teams for emergencies, more mental health beds and improved training for GPs.

Ministers also want to close a loophole which means dangerous psychopaths who are considered “untreatable” cannot be locked up unless they commit a crime.

The framework is backed by government funding of £700m over three years.

Professor Appleby said: “This new post confirms that mental health and people with mental illness are a priority to health and social services.

“It provides an excellent opportunity to improve the quality of services to the benefit of patients, service users and their families.

“Putting the National Service Framework into practice will ensure a modern and effective system of mental health care.”

Announcing the appointment on Friday, health minister John Hutton said Professor Appleby had a wealth of clinical and academic expertise.

“He will provide clinical leadership and galvanise expertise in the mental health field.”

Huge challenge

Cliff Prior, chief executive of the National Schizophrenia Fellowship, said Professor Appleby faced a huge challenge.

This is a tsar who needs to start a revolution

Cliff Prior, chief executive, National Schizophrenia Fellowship

He said: “He must make sure that people with severe mental illness and their carers get the help they need quickly and effectively.

“He must also make sure that mental health is at the forefront of the Government’s mind when they are allocating the extra resources promised for the NHS – this is a tsar who needs to start a revolution.”

Rabbi Julia Neuberger, chief executive of the health watchdog, The King’s Fund, said mental health was a complex issue related to problems such as poverty, unemployment and bad housing.

She said: “The mental health ‘tsar’ will have to be able to coordinate Government policies on benefits, access to work, criminal justice and housing.

“These are the issues that most affect people with mental illnesses, who suffer high levels of discrimination, isolation and poverty in Britain today.”

Around one in seven people suffer from a mental health problem, including anxiety and depression.

Four in 1,000 have a severe mental condition like schizophrenia and 11,500 people are detained in hospitals or homes under the Mental Health Act.

Around 1,000 mentally ill people in England and Wales commit suicide every year and 25 commit a murder.

Mental health has been identified as one of three top priorities by the Department of Health.

Professor Appleby’s appointment follows that of Professor Mike Richards as National Director for Cancer and Dr Roger Boyle as National Director for Coronary Heart Disease.

As you know, I am researching issues surrounding mental health discrimination, so whenever I find something interesting, I will post it onto my blog. So I googled “mental health discrimination” and this was one of the first 3 items listed: an article from the BBC. This article is out of date (7 years actually!) but still worth reading. What I am amazed about though is the fact that it is such an old article yet is one of the first 3 listed on google. Does this mean that there is no later research/reports on mental health discrimination or just that google has listed articles with no particular date/relevance order?

It doesn’t specify any particular mental health condition, such as Bipolar, but does refer to a fact that we all know: that 1 in 4 people suffer mental health problems at some point in their lives. Mmmm, I wonder how many people own up to that?

Anyhow, I’ll carry on researching and leave you guys to read…………..

Monday, 24 April, 2000, 23:30 GMT 00:30 UK

Mentally ill ’suffer discrimination’

GPS are not always sympathetic, the report says

People with mental health problems suffer discrimination from family, friends and health professionals, according to a report.The Mental Health Foundation (MHF), which publishes the Pull Yourself Together report on Tuesday, says that action must be taken to tackle the stigma in society surrounding mental illness.

The report, issued to mark Health Action Week, asked people with experience of mental health problems to reveal what kind of discrimination they had suffered or witnessed.

Seventy per cent of those who took part had experienced discrimination in response to their own mental distress, or that of a friend or relative.

GP comments to mentally ill people

Snap out of it I can only help if you’re suicidal

And 44% reported discrimination from their GPs – even though they are supposed to be the first point of call for help. Nearly a fifth of people felt that they could not tell their GPs about their mental health problems.

Some also reported that GPs had attributed physical health problems to symptoms of mental illness.

Family problems

Many people had received unhelpful or damaging advice from relatives, such as “pull yourself together”. Other sufferers said they were thought to be acting, or were considered stupid or unreliable.

Three-quarters of respondents said they would not disclose mental health problems on application forms for jobs for fear of discrimination. More than half would not tell their work colleagues.

If people are experiencing discrimination or are being told to ‘Pull yourself together’, then their chances of accessing good support are diminished

Ruth Lesirge, director, Mental Health Foundation

Ruth Lesirge, MHF director, said the report highlighted the stigma and discrimination faced by people with mental health problems, and also raised serious questions about the role of the GP.

She said: “It is the doctor who can ensure that you receive appropriate services and treatment. If people are experiencing discrimination or are being told to ‘Pull yourself together’, then their chances of accessing good support are diminished.

“With one in four of the UK population experiencing mental health problems in any one year, we have to change our attitudes and build on the good services and support that are available.”

The MHF recommends:

• All GPs should have ongoing training to develop their understanding of mental health problems
• The new Disability Rights Commission should give priority to addressing discrimination in relation to people with mental health problems
• The Government and all agencies which promote mental health should join together to deliver a comprehensive anti-discrimination campaign

Dr Hamish Meldrum, a senior member of the British Medical Association’s GP committee, said: “If GPs are saying things inappropriately I am not going to condone it, but true discrimination is extremely rare.”The more serious problem is the lack of overall resources that have been made available to fund mental health care in the community.

“GPs are under severe time pressures and do not have adequate access to back-up services.”

Pull Yourself Together is based on the responses of 556 people to a postal survey.