Does employment promote the process of recovery from schizophrenia? A review of the existing evidence

Conclusion:

The current review reports promising, but not conclusive, results in the improvement of quality of life, social functioning and other indicators of recovery, but there is still a need for high quality, long term follow-up, randomized studies to further investigate this relationship.

Source:

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I saw this a coupla days ago. I tried to see if I could get into the body text, but none of the “keys” I have would open it.

I have to say that it’s crucial to understand that high-stress occupations are not a good idea for anyone in the schizophreniform or bipolar spectrums… because autonomic stress is about the worst thing there is for sz. (The drugs we all take are pointedly designed to reduce it.)

In most cases, benefits will accrue from jobs that are productive but closer to being “occupational therapy.” This is not 100% true, but it’s probably the case 75 to 85 percent of the time, based on case observation for more than a decade.

That said, if anybody has a key to the Journal of Occupational Medicine and Environmental Health, let’s have a look at the Discussion and Conclusion sections.

Mortimer? Future me is writing articles to younger me? Oh â– â– â– â– 

JK I just dont see the name Mortimer very often at all

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http://ijomeh.eu/Does-employment-promote-the-process-of-recovery-from-schizophrenia-A-review-of-the-existing-evidence,2331,0,2.html has a link that allows you to open or save a 12 page PDF.
Unfortunately précis was never one of my strong points . It at first goes into various definitions of recovery. Then it mentions social cognitive and neurocognitive deficits and that while medication has a significant effect on psychotic symptoms it doesn’t have a great impact on social skills or social cognitive deficits. Antipsychotics have little effect on social and emotional aspects of the illness.
It then says different forms of non pharmalogical treatment such as different forms of employment(training patients in the area they are impaired) may hold more promise of recovery(however defined) It then asks the question. " Could employment be a factor that facilitates recovery?"
It then mentions improved self esteem,self identity,as well as satisfaction in being able to provide a financial contribution.
There is then mention of two approaches to employment for patients-(1) train then place and (2) place then train. The first refers to prevocational training which prepares someone for employment in an open and competitive market. It include training in general skills, unpaid positions and different forms of sheltered employment. However new evidence,it says, supports" place then train"(or supported employment). Which focuses on getting people into employment first and then training for successful performance in their respective positions. It then says the most well known form of this approach is Individual placement and support(IPS) and goes into an explanation of what IPS entails. Saying that the goal is employment in the open market.
It then says that what is unclear however is what psychosocial outcomes can be positively influenced by being in employment and that it is crucial to investigate this area as some deficits that can impede recovery may be effectively addressed by such psychosocial interventions.

Results: Positive effect of supported employment was seen not just in areas directly related to employment but also independence,recognition, neurocognitive performance and social functioning. Satisfaction with life was comparable to that of healthy people. Authors stress continuity of work rehabilitation in sustaining clinical benefits.

It then mentions possible risks of IPS(Individual placement support). of returning to work without previous lengthy training and preparatory phase. It is argued that stress related to new and challenging experience may lead to a deterioration in an individual’s mental health. However IPS studies report lower risk of hospitalisation, enhanced mental status, and life satisfaction compared to vocational service users.

It then went on to mention competitive employment and that it may be beneficial for general well being,self esteem,network sizes, satisfaction with leisure and decline of use of outpatient services.

There is more but my précis skills are lacking and I am mentally exhausted. Could you carry on where I left off @notmoses ?( page8).

Being a political animal I do wonder how much this is influenced by predominant neo liberal thinking and whether the work is good for you even if it is very low paid(as will be the case for many with serious mental illness) philosophy is as true as is made out. In the current climate such approaches could be seen to foster a patch em up approach so just fit for employment rather than a comprehensive attempt to tackle problems. It also leads to a draconian attitude re welfare reforms and the disabled.

I saw this somewhere in the last two or three days. (Where the fuck…?) Oh, well. But, yes, this is obvious on its face… and that’s what I thot when I saw it the first time.

Place-Then-Train has been around for a while. (Maybe 20 years?) I read about it in a textbook on employment of the physically and mentally handicapped at least ten years ago. The book pitched it in the workplace as relatively simple to administrate once a senior human resources person took a (semester-length? less?) course and then used the syllabus to tech the essentials to managers and supervisors.

PTT made a lot of sense to me then because I was seeing it through the filter of concerns about the employment of people with traumatic brain injuries, organic developmental deficits and/or very low IQ. But it does seem now that it would work for people with well-managed sz, so long as the managers could be de-sensitized to the periods of paranoid delusion that will unavoidably occur under stress for many sz pts.

Thx for finding this.

I agree with the stress of work, but it`s also important ( at least to my son ) to be able to earn some money on his own-or do something that has some meaning for him.
one of the reasons he is moving to a more urban area.
He picks up the energy there, and his art classes are there, and a lot of chances to do under the table jobs.-**