Working Towards Recovery: The Benefits of Employment

Written by Natalie Tran and Edited by Mehr Bawa

Simply the thought of unemployment can cause stress and anxiety, since stable employment is often the root of financial well-being. Unfortunately, this nightmare is a reality for many Americans with disabilities, which, by legal definition, have physical and mental impairments that greatly inhibit function in one or more major life activities [1]. In 2019, only 19.3% of those with disabilities were employed, and the unemployment rate for this demographic was around 7.3%, meaning only 7.3% of those with disabilities who wanted to work were hired [2]. For reference, in the midst of the 2008 recession, the unemployment rate of the United States as a whole was 7.3% [3]. 

These statistics are especially troubling because, aside from offering financial stability, employment can facilitate recovery from or coping with mental afflictions. Recovery from mental health afflictions requires fulfillment of five fundamental dimensions: functional, social, existential, clinical, and physical [4]. The functional dimension requires active participation in every-day activities and feelings of usefulness, which can be filled by incorporating employment as a daily routine. The physical dimension details a reduction in symptoms based on psychological adjustments to feelings of control over themselves, an attribute seen in participants with schizophrenia who participated in a work-as-therapy program [5]. Opportunities to achieve fulfillment in social and existential dimensions, which are based on developing a positive social network, self-esteem, self-direction, and responsibilities, are offered in a work environment as well. Therefore, through employment, those with mental impairments can overcome several aspects of their disability and gradually work towards recovery and stability in their mental states [6]. 

Despite the high unemployment statistics, there are programs that support those with severe mental disabilities, allowing them access to therapeutic employment and jobs of their choosing through programs implementing Individual Placement and Support (IPS) [7]. Those with psychiatric disorders who were involved in IPS self-reported visiting hospitals less often than when they were not working. They had also reported perceived improvements in their outlooks on life, self-esteem, and relationships with others, which are all signs of recovery according to the five dimensions [8]. However, the caveat to this rehabilitation method is the participant’s perception of the experience. If the participant has a negative association with employment, then no benefits can be derived; positive attributions will produce positive outcomes [9]. A lack of positive association would demotivate participants from engaging in beneficial activities provided by the employment. Since the job can only provide opportunities, it is up to the participant to derive meaning from these opportunities.

References:

1. “42 U.S. Code § 12102 – Definition of Disability.” Legal Information Institute, Legal Information Institute, 2008. www.law.cornell.edu/uscode/text/42/12102
2. “Persons with a Disability: Labor Force Characteristics Summary.” U.S. Bureau of Labor Statistics, U.S. Bureau of Labor Statistics, 26 Feb. 2020, www.bls.gov/news.release/disabl.nr0.htm. 
3. Cunningham, Evan. “Great Recession, Great Recovery? Trends from the Current  Population Survey : Monthly Labor Review.” U.S. Bureau of Labor Statistics, U.S.Bureau of Labor Statistics, 1 Apr. 2018, www.bls.gov/opub/mlr/2018/article/great-recession-great-recovery.htm.
4. Whitley, R., Drake, R.E., (2010). Recovery: A Dimensional Approach. Psychiatric Services, 61:1248-1250.
5. Frank, A., (2016). Vocational Rehabilitation: Supporting Ill or Disabled Individuals in (to) Work: A UK Perspective. Healthcare (Basel), 4:46. 
6. Lehman, Anthony.F., (1995). Vocational Rehabilitation in Schizophrenia. Schizophrenia Bulletin, 21:645-656. 
7. Bond, G.R., Drake, R.E., Becker, D.R., (2012). Generalizability of the Individual Placement and Support (IPS) model of supported employment outside the US. World Psychiatry, 11:32-39.
8. Becker, D., Whitley, R., Bailey, E.L., (2007). Long-term employment trajectories among participants with severe mental illness in supported employment. Psychiatric Services, 58:922-928.
9. Bond, G.R., Resnick, S.G., Drake, R.R., (2001). Does competitive employment improve nonvocational outcomes for people with severe mental illness? Journal of Consulting and Clinical Psychology, 69:489-501.