Severe mental illness and work: What can we do to maximise the employment opportunities for individuals with psychosis?

摘要

Background: Earlier this year, the Australian and New Zealand Journal of Psychiatry published the results of the 2010 Survey of High Impact Psychosis (SHIP) (Morgan et al., 2012). This survey provided a snapshot of how Australia's mental health services have changed over the 12 years since the first national psychosis survey (Jablensky et al., 1999). The decreased use of inpatient admissions together with a greater use of community mental health clinics and rehabilitation services suggested Australian mental health services had shifted towards a more recovery-focused model of care, with the proportion of respondents feeling satisfied with their own level of independence rising by 23% (Morgan et al., 2012). However, this apparent shift appears to have neglected one of the key measures of social functioning, namely employment. The proportion of Australian adults with a psychotic disorder who are in employment (either part-time or full-time) remains stuck at 22%, with no improvement over the 12 years between surveys (Waghorn et al., 2012). This is despite national unemployment rates decreasing over the same period and a dramatic expansion in employment services for those with disabilities. This compares with European rates of employment in people with schizophrenia of 11.5% (France) and 30% (Germany), with