National Survey of Professionals and Managers with Psychiatric Conditions:
A Portrait of Achievements and Challenges
Marsha Langer Ellison, Ph.D.,
Zlatka Russinova, Ph.D.,
It is well known that many people with psychiatric conditions make outstanding contributions to society through their lives and livelihood. Nonetheless, professionals in the mental health system, employers, and the public often cast a dispirited and pessimistic eye to those who, despite a severe mental illness, aspire to careers as professionals or managers. People with psychiatric conditions often discuss being told that they will “never work again,” or that they must resign themselves to the simplest, least rewarding, and lowest paying work. Even professionals in the psychiatric rehabilitation field have developed work entry systems that peg their clients into low wage and menial work, the three f’s “food, filth, and filing.” These attitudes persist despite well-articulated approaches in rehabilitation that emphasize understanding the true aptitudes, talent, and aspirations of people with any disability.
The Center for Psychiatric Rehabilitation at Boston University has conducted a national survey with nearly 500 individuals who have held a professional or managerial job after experiencing psychiatric problems. This study sheds light on the circumstances surrounding those who have attained managerial and professional employment while having or having had a psychiatric condition. Although the study is not based on a representative sample, the survey results help demonstrate that people with psychiatric conditions hold well paying positions with significant responsibilities. This evidence helps to break preconceptions of vocational rehabilitation that is oriented toward low wage or dead-end employment.
These study results carve out new territory by presenting the achievements of people who have had serious mental illness and who have succeeded in acquiring and maintaining well paying, high level careers. This research provides a map of hope for others who are combating personal and societal barriers as well as stereotypes about the impact of mental illness on careers.
The survey explores how people with psychiatric conditions obtain and retain professional or managerial levels of employment. Details of findings are presented below.
Work achievements of survey participants
Overall participants portray considerable success in their work status.
- Seventy-three percent of all participants reported full-time employment. Another 6 % of all participants have been self-employed.
- Sixty-two percent of all participants have held their current position for more than two years. Twenty-nine percent of all participants kept the same job for more than five years.
- The yearly income of most participants (79%) was above $20,000. The income of 35% of all respondents was above $40,000, and 22% made more than $50,000 per year.
- More than half of all participants (61%) are satisfied with their current job and are not presently considering a job change.
- The sample was well educated with 83% having a college degree or higher attainment.
Nature of psychiatric condition
This employment was attained by individuals who had and/or who continue to have significant psychiatric problems. Participants in the survey have learned how to maintain a professional or managerial career despite the challenges of a serious psychiatric condition:
- The psychiatric diagnosis of study participants shows no significant relationship to their professional status, educational attainment and current employment. Participants in the survey have reported various psychiatric conditions: of the 458 individuals who reported their psychiatric diagnosis, 43.5% reported bipolar illness, 29% – major depression, 11.5% – schizophrenia /schizo-affective disorder 10% – post traumatic stress disorder/dissociative identity disorder, and 6% – anxiety/other disorders.
- Seventy-eight percent of all participants have been hospitalized in the past for psychiatric reasons; of them 64% have been hospitalized three or more times.
- Twenty-five percent of the participants have been hospitalized in the past three years.
- Thirty-four percent of all participants received social security benefits for their disability at some time in their lives.
- Eighty-eight percent of all participants are currently taking psychotropic medications; of them 80% take medications continuously and 8% take them intermittently.
The supports people used to maintain their employment were much like those of other managers and professionals. Reasonable accommodations were not costly and often came informally or with the nature of the job.
- Most individuals (62%) use the strategy of ‘taking a break’ as a means of coping with stress at the work place.
- Supports to help keep the job that were most frequently mentioned were: use of medications (49%), support of spouse/partner (34%), and support of psychiatrist/therapist (33%).
- Aspects of the job that most frequently contributed to job tenure were interest in and satisfaction with job duties (73%).
- Participants attributed their job tenure to their performance (56%), to their own drive and will power (53%), and to their ability to manage their condition (50%).
- Common accommodations used were flexibility to modify daily duties (49%) and flexible schedules (33%). However, in general accommodations were not formally negotiated and for many they were received irrespective of their psychiatric condition.
- Once the psychiatric condition was disclosed, the most frequently acquired accommodations were flexibility in which hours were worked (19%); permanent modifications to work schedule (18%); how many hours were worked (15%); and extra feedback or supervision time (15%).
- Among the interpersonal experiences that challenge the ability to work was feeling like they have to fit in and act like everyone else (41%) and having to assert themselves regarding job responsibilities (39%).
- Most study participants (74%) also reported feeling tired on the job.
- A high majority (86%) of the individuals in this sample had disclosed the nature of their psychiatric condition on the job, and many had done so with few or no regrets (63%).
- A majority of the study participants reported receiving some benefits from disclosing such as having more understanding or support on the job (44%). However, 27% of the study participants who did disclose their condition expressed some regrets about disclosing; 15% of the study participants chose not to disclose.
Project Media Coverage
Results of the study on professionals and managers with psychiatric disabilities were publicized through a press release (below). This document was reprinted and expanded in numerous media outlets. This included Internet health and mental health websites, radio announcements in several cities, talk shows, including on in Boston and one on NPR (Grand Rounds, MI) as well as announcements in popular and mental health magazines and professional newsletters. Printed reports and articles referencing the study appeared as follows:
- Massachusetts Psychologist
- Community Support Network News
- The Detroit Free Press
- The Arizona Republic
- The National Alliance for the Mentally Ill Advocate
- The Boston University Bridge
- The Management Review
- The New York Times (Letters to the Editor)
- Medical Tribune News
- McMan’s Depression and Bipolar Weekly (online edition)
- Mental Health Net (online edition)
- Psychiatric News
- The Sun-Sentinel Ft Lauderdale
- The Boston Business Journal
- Self Magazine
- Empowerment Newsletter
- Ivanhoe’s Medical Breakthroughs— News Flash
- The Wall Street Journal
- Boston Herald
- The Journal of Addiction and Mental Health
- IT Recruiter
- My Prime Time (online edition)
- The Knoxville News Sentinel (online edition)
- The Bergen Record (NJ) (online edition)
- The Sacramento Bee (online edition)
- The Philadelphia Inquirer
- Milwaukee Journal Sentinel
- Herald News (Passaic County, NJ)
- The Challenger (Newsletter for NAMMI chapter for the Buffalo/Erie Counties)
Publications on this project are presently in production and a press release is available. Please contact the Project Co-Directors to receive materials.
A press release of research findings from June 2000 is available: