Mentally Ill People and Their Re-Introduction Into the Workforce - Article Example

A Critical Review of Tsang et al In the article “A cross-cultural study of employers’ concerns about hiring people with psychotic disorder: implications for recovery,” the authors attempt to discuss the difficulties that people with serious mental illnesses have in being discriminated against by employers, and how it is difficult for complete recovery by these individuals if they are to able to properly re-enter the workforce as this is a key aspect of recovery. The question in particular that the authors attempt to answer is whether there are any differences in the perception of employers in regard to individuals with serious mental illness in western and non-western societies. The lay theory proposed in the article states that people who suffer from psychotic disorders are discriminated against when seeking employment, and that the culture in China discriminates against these people to a greater degree than a western culture such as the U.S. There have been many inquiries into the difficulties of people with mental illnesses, though this was the first to examine the differences of perception in different cultures. This is the context within the which this article exists. Jason Robert, a researcher from Arizona State University, says on the subject of mental illness that it is necessary to take into consideration biological and socio-cultural factors when making a diagnosis: “My claim is that gene maps and brain scans will likely not be able to offer universal, culture-free representations of the essence of mental illness. That is, mental illness is subject to biological and socio-cultural factors, such that isolating any of these as core elements will almost always miss the mark at the expense of patient care”. Without fully taking into consideration the cultural norms of the society of the person who is being diagnosed with a mental illness, this research states that it will simply not be possible to make the appropriate diagnosis and prescribe the proper medication for the recovery of the patient. Whereas studies before treated mental illness the same across different cultures, brain scans being used as the basis for diagnoses at times, this theory states that personalized medication would most benefit the patients once all aspects of the patient’s situation are taken into consideration. Jean Campbell writes in the journal article “Unintended consequences in public policy” that the American Disabilities Act tries to balance the rights of people with mental illnesses with those not affected with mental illnesses to protect themselves from any possible harm (2). It goes on to state that the ADA, while meant to protect people with disabilities, actually allows additional discrimination to be sanctioned against people with mental illnesses. It allows employers to fire or refuse to hire people that they view as a direct threat to the safety of their other workers. As the field of people with disabilities is broad and it is difficult to create one body of legislature to apply fairly to all people with disabilities, people with mental illnesses now have to deal with sanctioned stereotyping when dealing with the job hiring process. This promotes discrimination as people who are not professionals are given the opportunity to make value judgments about whether individuals are dangerous to other employees based solely on a mental illness. John F. Fielder states in Mental Disabilities and Americans with Disabilities Act: A Concise Compliance Manual for Executives that many of the misperceptions about people with mental illnesses comes form the fact that most people do not know what it means to have a mental illness (9). It lists many fears and stereotypes about mental illnesses and then goes on to point out inconsistencies in them. For instance, he states that people believe that there is a way to predict how well people will perform at their jobs based on their mental health, but he states that there has been no direct correlation found in any studies. He also states that the act will penalize organizations that fail to follow it, but it does not provide any guidelines by which to adhere to the act. Masaki Yamada writes in Predicting Rehospitalizations of Persons with Severe Mental Illness that there are approximately four million people in the U.S. that have severe, persistent mental illness (SPMI). There is a high rate of people with SPMI that have frequent hospitalizations, developing a sort of revolving door pattern. There are studies looking into particular reasons as to the factors increasing hospitalizations, but nothing definite has been found yet. Gender, for instance, does not seem to play a role in frequency of hospitalizations. There are no findings, also, that explain what exactly it takes for a person to assign themselves to mental health facilities. Carol T. Mowbray states in Living Arrangements and Social Support, mothers that suffer from mental illnesses functioned better in taking care of their children in extended family households than by themselves or with just their spouse. Many married women with mental illnesses reported a high incident of marital conflict which probably lead to a decrease in functioning. It would also appear that age, such as being a teenage mother, and ethnicity were variable factors in mothers’ abilities to function within an extended family household. Daniel F. K. Wong states in Crucial Individuals in the Help-Seeking Pathway of Chinese Caregivers of Relatives with Early Psychosis in Hong Kong that the Chinese as an ethnicity delay getting help for mental illnesses longer than any other group. People with longer periods without treatment have been shown to be less responsive to therapy. It was found that many parents did not want to recognize genuine mental illnesses in their children. The author stated that social workers of different cultural background needed to be educated in the Chinese social issues that lead them to not seek help. Richard Warner devotes a chapter of his book Recovery from Schizophrenia: Psychiatry and Political Economy to the idea that re-introduction into the workforce is necessary in the full recovery of people with this disorder. He points out how times of economic hardship have led to increased numbers of people being hospitalized for mental illness, and that people with schizophrenia are less likely to be re-hospitalized or have longer periods without hospitalization if they have steady work available to them. It is later stated that many people with mental illnesses are given disincentives to work due to low wages and would benefit from an increase in the minimum wage. Geoff Waghorn and David Chant released a study that described factors for those suffering from mental illnesses being able to find and keep employment. The highest indicator was the number of occurrences of hospitalization. People with a single hospitalization were far less likely to have trouble finding employment, while people with frequent or numerous previous hospitalizations suffered from more discrimination. There was also a correlation between hospitalizations and absenteeism from work. The study went on to say that more research into individual reasons for vocational recovery was needed to provide more solid evidence. Anthea Bill states in the study, “Employment Programs for People with Psychiatric Disabilities,” states that their needs to be change in the laws regarding employment opportunities for people with disabilities. Labor markets with scarcity of jobs make employment opportunities for people with mental health problems difficult as they are unable to find work that meets their particular needs. This study suggested that governments create minimum wage public sector jobs in particular for those that suffer from mental illness. It was suggested that these jobs be created with mind to the particular needs of mental health disorders, such as irregular working hours and wage subsidies. Joe Marrone and Martine Gold published findings about the stereotypes associated with people with psychiatric disabilities, in particular schizophrenia. For instance, they dispelled the myth that schizophrenics are on a life-long downward spiral; over long-term treatment these patients have shown a great increase in their ability to function. Also, many mental health patients dislike being put in the same treatment programs as people with mental retardation as the two conditions are greatly different. The mental retardation patients need to work on cognitive skills with mental health patient only need to work on their inter-personal relationship skills. These are the kinds of differentiations that need to be made in order to properly treat both conditions. Evaluation: The proposed reason for this extra discrimination in China stems from Confucianism, Taoism, Buddhism, and Chinese folk beliefs. It is expressed in these beliefs that people that suffer from symptoms of a mental illnesses are being punished for breaking rules; in other words, people with psychotic disorders are further discriminated against because it is believed that their condition is their fault. In order to test their theory, the researchers interviewed one hundred people who were in a managerial position where hiring of employees was involved. Forty people were from Chicago, thirty people were from Beijing, and thirty people were from Hong Kong. Chicago and Beijing were picked as representatives of western and eastern cultures, respectively, and Hong Kong was chosen as an intermediary that embraces both eastern and western culture. A more appropriate third location would have benefited the study, or perhaps another city from another country would have benefited the study. Also, it would have benefited the study to interview Chinese living in America and Americans living in China to see what sort of differences would have been found. As it was, the study found that their initial conclusion was correct. In both cultures people showed a tendency to be afraid if hiring people with psychotic disorders because of a perceived danger to other employees. Both Beijing and Hong Kong stated a tendency to be more discriminatory against people with mental illnesses. For purposes of the study, the interviewees were questioned on people with psychotic disorders without a proper definition being provided with. Even among employers that have previously hired people with mental illnesses, there was still a general attitude suggesting that the employers had common misperceptions about psychoses and the fact that these are treatable conditions that require people to re-enter social settings such as the work environment in order to fully recover from their conditions. This article does do much to explain differences in perceptions of mental health disorders in employers in western and non-western cultures; however, it does not take into consideration the findings of Jason Robert as previously stated. Mental health disorders cannot be simplified down into brain scans. When diagnosing patients, their culture must be taken into consideration. What this study does is to try to say that mental illnesses are the same whether found in a western culture or a non-western culture, and that the only differences are the perceptions of other the people in that particular culture. How could it not be taken into consideration that a person might believe that he or she has a particular disorder because they are at odds with some fundamental rules that they believe they should govern their lives by? Also, the interviewers only interviewed people that came from lower level job classes and non-governmental positions. The reason for this was to exclude people that would answer based on official regulations; this drastically limited the scope of their research. People hiring for jobs in higher paying positions would more than likely be more educated, and a higher lever of education would mean that the interviewees could have been better informed on various mental illnesses and less likely to answer based on stereotypes. The study was limited to interviewing management positions that would be in charge of hiring; the study had no findings on the actual ratio of the hiring of people with mental illnesses. The study mentioned previously, “Employment Programs for People with Psychiatric Disabilities,” stated that jobs should be created for people with mental illnesses. Both of these studies, by concentrating on jobs low-level jobs, are setting themselves up to only comment on jobs that could be worked by more serious cases of mental illnesses. There is no data on people with less severe psychiatric disorders who have been able to function well enough in society to have been able to find a well-paying job. It should be researched if the same level of discrimination would occur in the workplace if fellow co-workers were to find out that a person that they had known for some time did in fact have some sort of psychiatric, and if the level of fear of violence would be on the same scale. To summarize, there needs to be a wider ranging investigation in the perception of people with psychiatric disorders. As stated in numerous articles, it is of the utmost importance that people suffering from mental health problems be re-introduced into the workforce in order for their complete recovery. The reason behind this was not stated in the selected literature, but the over-whelming evidence for it makes this insignificant for general purposes. It would be beneficent to find the particular correlation between the two so jobs can be created around these particular needs. The article does do much to add to the literature of the problem of employment for people with psychiatric disorders, but there need to be additional studies in order to broaden the rather limited approach that this study took. Works Cited Arizona State University (2008, February 20). Mental Illness Is Subject To Biological And Sociocultural Factors, Bioethicist Says. ScienceDaily. Retrieved March 26, 2008, from http://www.sciencedaily.com­ /releases/2008/02/080216142152.htm Bill, Anthea, Cowling, Sally, Mitchell, William, & Quirk, Victor (2006) Employment programs for people with psychiatric disability: the case for change. Australian Journal of Social Issues, vol. 41. Campbell, Jean (1994) Unintended consequences in public policy: person with psychiatric disabilities and the Americans with Disabilities Act Policy Studies Journal, vol. 22 Fielder, John F. (1994) Mental disabilities and the Americans with Disabilities Act: A Concise Compliance Manual for Executives. Quorum Books. Marrone, Joe, & Gold, Martine (1994) Supported employment for people with mental illness: myths & facts. The Journal of Rehabilitation, vol. 60. Mowbray, Carol T., Bybee, Deborah, Hollingsworth, Leslie, Goodkind, Sara, Oyserman, Daphna (2005) Living arrangements and social support: effects on the well-being of mothers with mental illness. Social Work Research, vol. 29. Waghorn, Geoff, Chant, David (2002) Clinical and non-clinical predictors of vocational recovery for Australians with psychotic disorders. The Journal of Rehabilition, vol. 68. Warner, Richard (2004) Recovery from schizophrenia: psychiatry and political economy. Brunner-Routledge. Wong, Daniel F.W. (2007) Crucial Individuals in the help-seeking pathway of Chinese caregivers of relatives with early psychosis in Hong Kong. Social Work, vol. 52. Yamada, Masaki M., Korman, Maurice, Hughes, Carroll W. (2000) Predicting rehospitalizations of persons with severe mental illness. The Journal of Rehabilitation, vol. 66. Read More