Exploratory study of the relationship between sustained employment and psychosocial adjustment of people with psychiatric disabilities

Zlatka Russinova, Ph.D.
Principal Investigator

Nancy Wewiorski, Ph.D.
Project Director

Project Mission

The objective of this study was to explore the relationship between successful employment of people with psychiatric disabilities and their overall level of psychosocial adjustment.

Project Goals

Goal I
To gather information about the capacity for people with psychiatric disabilities to sustain competitive employment; about the patterns and types of competitive employment maintained; about the factors related to successful employment, including supports, disclosure, job satisfaction, work motivation, reasonable accommodations, and coping strategies used at the work place.

Goal II
To study the quality of life of successfully employed mental health consumers.

Goal III
To examine the level of empowerment of mental health consumers who have sustained competitive employment.

Goal IV
To explore the level of social connectedness of successfully employed consumers, including relationships with family and friends, and reliance on a broader social support system.

Goal V
To study the changes occurring over a two-year period of time in the vocational and psychosocial functioning of consumers who have sustained competitive employment.

Expanding the Longitudinal Study

Funds through the Rehabilitation Research and Training Center for Rehabilitation of Persons with Long-Term Mental Illness awarded by National Institute on Disability and Rehabilitation Research (NIDRR) to the Center for Psychiatric Rehabilitation in October 1999 were obtained for continuing this longitudinal study for an additional three years of follow-up of the respondents who enrolled at baseline. In this way, this study was expanded into a 5-year longitudinal study that will provide consistent information about a phenomenon that has not been studied systematically in the field of psychiatric rehabilitation.

Summary of Findings From Baseline Assessment

Demographics

· 696 individuals who met the study eligibility criteria for presence of both a serious
psychiatric condition and sustained employment in the two years prior to enrolling in the
study completed the baseline assessment instrument (Survey I).

· 73% of all participants were female.

· 92% of all participants were white.

· 29% of all participants were single, never married while the rest were either currently
married or in a relationship with a significant other, divorced, separated or widowed.

· 43% of all participants had a graduate or a professional degree, 34% had finished college,
17% had attended some college, 4% had completed high school, and 2% had not completed
high school.

Employment Outcomes

· 74% of all participants were continuously employed for the 24 months prior to completing
the baseline assessment survey, 17% were employed for 18 to 24 of the past 24 months, and
9% were employed for 12 to 18 of the past 24 months.

· 74% of all participants were working 35 or more hours per week at the time of baseline
assessment, 17% worked between 20 and 34 hours per week while 9% worked between 10
and 19 hours per week.

· 53% of all participants had professional or technical jobs, 24% had
managerial/administrative jobs, 11% had clerical/administrative support jobs, 6% had
service jobs, 4% had jobs in marketing or sales, and 2% had jobs in production,
construction, transportation, or repair.

· 8% of all participants held a job in a mental health self-help or advocacy setting, 23% were
in a mental health setting, 18% were in a health or human services setting (not mental
health), and 51% were in a non-helping organizational setting.

· 22% of all participants earned less than $10 per hour in their primary job, 46% earned $10-
20 per hour, 21% earned $20-30 per hour, and 11% earned more than $30 per hour.

· 30% of all study participants had a total yearly income of less than $20,000 for the year
prior of enrolling in the study, 38% had a total yearly income of $20,000-40,000, and 32%
total yearly income of more than $40,000.
Psychiatric Condition

· 31% of all participants were first diagnosed with a serious psychiatric condition before the
age of 21, 37% between the ages of 20 and 30, and 32% after age 30.

· 80% of all participants had at least one psychiatric hospitalization in the past.

· 33% of all participants had one or more psychiatric hospitalizations during the two years
prior to enrolling in the study.

· 16% of all participants were receiving disability income at the time of entering the study.· 95% of all participants were taking psychotropic medications at the time of entering the
study.

· 17% of all participants reported a diagnosis of schizophrenia or schizo-affective disorder,
42% bipolar disorder, 28% major depression disorder, 11% post-traumatic stress disorder or
dissociative disorder, and 2% anxiety or other disorder.

· Psychiatric diagnosis was not associated with participants’ ability to sustain employment
during the two years prior to entering the study. However, diagnosis was associated with
participants’ occupational status, the number of hours they worked per week, and the salary
they earned per hour. On average, the group of participants who reported a diagnosis of
bipolar disorder had a higher occupational status, worked more hours per week, and earned a
higher salary per hour than the other diagnostic groups. At the same time, the group of
participants who reported a diagnosis of schizophrenia or schizo-affective disorder, on
average, had a lower occupational status, worked fewer hours per week, and earned a lower
salary per hour than the other diagnostic groups.

· 82% of all participants had disclosed having a psychiatric condition at their workplace.

Quality of Life

· On a scale of 1 to 10, participants rated their well-being 2 years ago at “5,” on average, rated
their current well-being at “7,” on average, and predicted their well-being 2 years in the
future at “8,” on average.

· At work, 21% of all participants experienced “very high” stress, 32% “high” stress, 35%
“moderate” stress, 9% “low” stress, and 3% “very low” stress.

· Study participants used the following strategies to cope with symptoms at work: 62% took a
break, 54% kept quiet or withdrew, 43% stretched or exercised, 35% talked with a
coworker, 32% went to a private space, 32% prayed, 32% had a snack, 30% meditated or
relaxed, 30% called a friend, 27% took medication, 26% listened to music, 26% called a
counselor or sponsor, and 10% napped.

· 43% of study participants owned their own house or condo, 34% rented a house or
apartment, 7% lived in subsidized housing, 5% lived in housing owned by relatives, 1%
lived in a group home or halfway house, and 10% had other housing arrangements.

· 42% of study participants lived with a spouse or significant other, 37% lived alone, 21%
lived with children, 7% lived with parents or siblings, and 5% lived with roommates.

· 68% of study participants got together with family at least monthly, 92% had phone contact
with family at least monthly, and 53% were satisfied with their family relationships.

· 84% of study participants got together with a friend at least monthly, 90% had phone contact
with a friend at least monthly, 38% were satisfied with the amount of their friendships, and
59% were satisfied with the quality of their friendships.

Related Article

Russinova, Z. (1999). Providers’ hope-inspiring competence as a factor optimizing psychiatric rehabilitation outcomes. Journal of Rehabilitation, 65(4), 50-57.

For additional information regarding this study, please contact the Principle Investigator, Zlatka Russinova, Ph.D.; zlatka@bu.edu.