Guest Column with Eoin Killackey

August 11 / 68

Associate Professor Eoin Killackey is a Principal Research Fellow and Clinical Psychologist at Orygen Youth Health.

In 2001 a government report noted that people with mental illness were the largest disability group accessing government funded disability employment services, however they were also the group that had the poorest employment outcomes, with only about one in five finding employment through these services. This reflected what other statistics have consistently shown, which is that despite the desire to work in a normal job being the number one goal of people with mental illness – more desired even than the goal of stable mental health – that between 75 per cent and 95 per cent of people with serious mental illnesses will actually spend most of their working lives unemployed and living on welfare benefits. Employment for people with mental illness is important because not only does it lead to a huge economic saving for the community, it directly addresses the social exclusion which people with mental illness suffer more than almost any other group in the community. 

While there have been employment programs for people with mental illness going back even into the asylum era, only supported employment has been shown to be successful. Most programs work on the principal of training people for work and then getting them into work. Supported employment works from the principal that the best place to learn about work is at work. Consequently it helps people find jobs first and then supports them to stay there. Studies in people with chronic illness have shown that about 60 per cent can return to employment through this process. 

Working at the Centre for Youth Mental Health, we wanted to see if we could create a better outcome by intervening early in the course of mental illness. Most mental illness has its onset between the ages of 15 and 25, which is also the stage of life in which education and training are being completed, and the transition to participation in the labour force is occurring. The onset of mental illness often derails this process. Missing out on employment at this stage leads to a greater chance of unemployment later. We wanted to see if applying a highly defined form of supported employment called individual placement and support at this time led to a better outcome.

We found that we were able to get 85 per cent of young people with psychotic illness back to work or school with our intervention. In the control group, who accessed the government funded employment agencies, no-one got a job. Since then our results have been replicated in a group of young people with psychosis in Los Angeles where 83 per cent returned to school or work.

The Australian Mental Health Minister recently made comments to the effect that the situation has not changed for people with mental illness with respect to employment since the report mentioned above in 2001. Our research shows that there is a way to address this which has beneficial results for the government, the community, but most of all for the person with psychosis who wants to return to, or enter the workforce or education. 

 

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