Physical health conditions are pervasive among individuals with serious mental illness
(SMI) living in the community. And many individuals with SMI are unemployed despite
their desire to work.
OBJECTIVE:
This study explored participants’ perceptions of physical and mental health conditions
as barriers to employment and the impact of such conditions on job-searching
activities.
METHODS:
The participants (n = 162) reported their mental and physical health
status and their employment-related activities and barriers over a 12-month study
period. Frequency analysis and Chi-square tests were conducted to examine the
relationship between the participants’ perception on physical or mental health
conditions as a barrier to employment and their conducted job-related activities.
RESULTS:
More participants reported physical health conditions than mental health conditions as
a barrier to job-related activities. Participants’ perception on physical health
conditions as a barrier to employment significantly decreased job-related activities,
while mental health conditions did not. In addition, more participants reported
long-term physical health conditions as a barrier than short-term ones. Participants
identified physical problems more frequently than mental health problems for limiting
their work or other activities.
CONCLUSIONS:
Integrating care of physical health conditions in mental health services should be
considered for improving employment participation and outcomes.
Akihito,S., Schaufeli,W.B.,
Kamiyama,K., &
Kawakami,N.
(2015). Workaholism vs. work engagement: The two different
predictors of future well-being and performance.. International
Journal of Behavioral Medicine, 22,
18–23. DOI: 10.1007/s12529-014-9410-x.
3.
Bertram,M., &
Howard,L.
E. (2006). Employment status
and occupational care planning for people using mental health services..
Psychiatric Bulletin, 30(2),
48–51. DOI: 10.1192/pb.30.2.48.
4.
Böckerman,P., &
Ilmakunnas,P.
(2009). Unemployment and self-assessed health: Evidence from
panel data.. Health Economics,
18(2), 161–179. DOI:
10.1002/hec.1361.
5.
Bond,G.
R., Drake,R. E., &
Becker,D.
R. (2008). An update on
randomized controlled trials of evidence-based supported employment..
Psychiatric Rehabilitation Journal,
31(4), 280–290. DOI:
10.2975/31.4.2008.280.290.
6.
Brunero,S., &
Lamont,S.
(2010). Health behaviour beliefs and physical health risk
factors for cardiovascular disease in an outpatient sample of consumers with a severe
mental illness: A cross-sectional survey.. International Journal
of Nursing Studies, 47(6),
753–760. DOI: 10.1016/j.ijnurstu.2009.11.004.
7.
Bünnings,C., Kleibrink,J., &
Weßling,J.
(2017). Fear of unemployment and its effect on the mental
health of spouses.. Health Economics,
26(1), 104–117. DOI:
10.1002/hec.3279.
8.
Burt,M.
R. (2012). Impact of housing and
work supports on outcomes for chronically homeless adults with mental illness: LAs
HOPE.. Psychiatric Services,
63(3), 209–215. DOI:
10.1176/appi.ps.201100100.
9.
CarneyC.
P., & JonesL. E.
(2006). The influence of type and severity of mental illness
on receipt of screening mammography.. Journal of General
Internal Medicine, 21,
1097–1104. DOI: 10.1111/j.1525-1497.2006.00565.x.
10.
Colpe,L.
J., Barker,P. R.,
Karg,R.
S., Batts,K. R., Morton,K.
B., Gfroerer,J. C.,
Stolzenberg,S.
J., Cunningham,D. B.,
First,M.
B., & Aldworth,J.
(2010). The national survey on drug use and health mental
health surveillance study: Calibration study design and field
procedures.. International Journal of Methods in Psychiatric
Research, 19(S1),
36–48. DOI: 10.1002/mpr.311.
11.
Correll,C.
U., Detraux,J., De
Lepeleire,J., & De
Hert,M. (2015).
Effects of antipsychotics, antidepressants and mood stabilizers on risk
for physical diseases in people with schizophrenia, depression and bipolar
disorder. World Psychiatry,
14(2),
119–136.
12.
Dixon,L., Postrado,L., Delahanty,J., Fischer,P., &
Lehman,A.
(1999). The association of medical comorbidity in
schizophrenia with poor physical and mental health. The Journal
of Nervous and Mental Disease, 187,
496–502.
13.
Drake,R.
E., Bond,G. R., Goldman,H.
H., Hogan,M. F., &
Karakus,M.
(2016). Individual placement and support services boost
employment for people with serious mental illnesses, but funding is
lacking.. Health Affairs,
35(6), 1098–1105. DOI:
10.1377/hlthaff.2016.0001.
14.
Drake,R.
E., Skinner,J. S.,
Bond,G.
R., & Goldman,H. H.
(2009). Social Security and mental illness: Reducing
disability with supported employment.. Health Affairs,
28, 761–770. DOI: 10.1377/hlthaff.28.3.761.
15.
Druss,B.
G., Bradford,D., Rosenheck,R.
A., Radford,M. J., &
Krumholz,H.
M. (2001). Quality of medical
care and excess mortality in older patients with mental disorders.
Archives of General Psychiatry, 58,
565–572.
16.
Dunstan,D.
A., Falconer,A. K., &
Price,I.
R. (2017). The relationship
between hope, social inclusion, and mental wellbeing in supported
employment.. The Australian Journal of Rehabilitation
Counseling, 23(1),
37–51. DOI: 10.1017/jrc.2017.5.
17.
Gonzalez,M., Benitez,V., &
Martin-Martin,J.
J. (2018). Long term
unemployment, income, poverty, and social public expenditure, and their relationship
with self-perceived health in Spain (2007–2011).. BMC Public
Health, 18(1), 133. DOI: 10.1186/s12889-017-5004-2.
18.
Hiswals,A.S.,
Marttila,A., Malstam,E., &
Macassa,G.
(2017). Experiences of unemployment and well-being after job
loss during economic recession: Results of a qualitative study in east central
Sweden. Journal of Public Health Research,
6(3), 995. DOI: 10.4081/jphr.2017.995.
19.
Juliá,M., Vanroelen,C., Bosmans,K., Aerden,K.
V., & Benach,J.
(2017). Precarious employment and quality of employment in
relation to health and well-being in Europe.. International
Journal of Health Services: Planning, Administration Evaluation,
47(3), 389–409. DOI:
10.1177/0020731417707491.
20.
Kisley,S., Sadek,J., MacKenzie,A., Lawrence,D., &
Campbell,L.
A. (2008). Excess cancer
mortality in psychiatric patients. Canadian Journal of
Psychiatry, 53,
753–761.
21.
Kukla,M., Bond,G.
R., & Xie,H.
(2012). A prospective investigation of work and nonvocational
outcomes in adults with severe mental illness.. Journal of
Nervous and Mental Disease, 200(3),
214–218. DOI: 10.1097/NMD.0b013e318247cb29.
22.
Laursen,T.
M., Munk-Olsen,T.,
Agerbo,E., Gasse,C., &
MortensenP.
B. (2009). Somatic hospital
contacts, invasive cardiac procedures, and mortality from heart disease in patients with
severe mental disorder.. Archives of General
Psychiatry, 66, 713–720. DOI:
10.1001/archgenpsychiatry.2009.61.
23.
Lawrence,D., &
Kisely,S.
(2010). Inequalities in healthcare provision for people with
severe mental illness.. Journal of Psychopharmacology,
24(11), 61–68. DOI:
10.1177/1359786810382058.
24.
Mcginty,E., Kennedy-Hendricks,A.,
Linden,S., Choksy,S., Stone,E., &
Daumit,G.
(2018). An innovative model to coordinate healthcare and
social services for people with serious mental illness: A mixed-methods case study of
Maryland’s Medicaid health home program.. General Hospital
Psychiatry, 51, 54–62. DOI:
10.1016/j.genhosppsych.2017.12.003..
25.
McIntyre,R.
S., Soczynska,J. K.,
Beyer,J.
L., Woldeyohannes,H. O.,
Law,C. W.
J., Miranda,A., Konarski,J.
Z., & Kennedy,S. H.
(2007). Medical comorbidity in bipolar disorder:
Reprioritizing unmet needs. Current Opinion in
Psychiatry, 20(4),
406–416.
Mangurian,C.,
Niu,G., Schillinger,D.,
Newcomer,J., &
Gilmer,T.
(2017). Understanding the cost of a new integrated care
model to serve CMHC. Patients who have serious mental illness..
Psychiatric Services, 68(10),
990–993. DOI: 10.1176/appi.ps.201700199.
28.
Milfort,R., Bond,G.
R., McGurk,S. R., &
Drake,R.
E. (2015). Barriers to
employment among social security disability insurance beneficiaries in the mental health
treatment study. Psychiatric Services,
66(12),
1350–1352.
29.
Mojtabal,R.
(2011). National trends in mental health disability,
1997–2009.. American Journal of Public Health,
101(11), 2156–2163. DOI:
10.2105/AJPH.2011.300258.
30.
Naslund,J.
A., Aschbrenner,K. A., &
Pratt,S.
I. (2017). Association between
cardiovascular risk and depressive symptoms among people with serious mental
illness.. Journal of Nervous and Mental Disease,
205(8), 634–640. DOI:
10.1097/NMD.0000000000000669.
31.
Nishi,D., Suzuki,Y., Nishida,J., Mishima,K., &
Yamanouchi,Y.
(2017). Personal lifestyle as a resource for work
engagement.. Journal of Occupational Health,
59(1), 17–23. DOI: 10.1539/joh.16-0167-oa.
32.
Parks,J., Svendsen,D., Singer,P., &
Foti,M.
(Eds.). (2006). Morbidity and mortality in
people with serious mental illness. Alexandria, VA: National Association of State Mental
Health Program Directors (NASMHPD) Medical Directors Council.
Romain,A.
J., Marleau,J., &
Baillot,A.
(2017). Impact of obesity and mood disorders on physical
comorbidities, psychological well-being, health behaviours and use of health
services.. Journal of Affective Disorders,
225, 381–388. DOI: 10.1016/j.jad.2017.08.065.
35.
Salkever,D.
S., Karakus,M. C.,
Slade,E.
P., Harding,C. M.,
Hough,R.
L., Rosenheck,R. A.,
Swartz,M.
S., Barrio,C., &
Yamada,A.
M. (2007). Measures and
predictors of community-based employment and earnings of persons with schizophrenia in a
multisite study. Psychiatric Services,
58(3),
315–324.
36.
Schmitz,H.
(2011). Why are the unemployed in worse health? The causal
effect of unemployment on health.. Labour Economics,
18(1), 71–78. DOI: 10.1016/j.labeco.2010.08.005.
37.
Shuel,F., White,J., Jones,M., &
Gray,R.
(2010). Using the serious mental illness health improvement
profile [HIP] to identify physical problems in a cohort of community patients: A
pragmatic case series evaluation.. International Journal of
Nursing Studies, 47(2),
136–145. DOI: 10.1016/j.ijnurstu.2009.06.003.
38.
Substance Abuse and Mental Health Services
Administration (SAMHSA). (2017). Key substance use and
mental health indicators in the United States: Results from the 2016 National Survey on
Drug Use and Health (HHS Publication No. SMA 17-5044, NSDUH Series H-52).
https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.pdf.
39.
Sumner,R.
C., & Gallagher,S.
(2017). Unemployment as a chronic stressor: A systematic
review of cortisol studies.. Psychology & Health,
32(3), 289–311. DOI:
10.1080/08870446.2016.1247841.
40.
Xiong,G.
L., Bermudes,R. A.,
TorresS.
N., & HalesR. E.
(2008). Use of cancer screening services among persons with
serious mental illness in Sacramento county.. Psychiatric
Services, 59(8),
929–932. DOI: 10.1176/ps.2008.59.8.929.
41.
Zandara,M., Garcia-Lluch,M.,
Pulopulos,M.
M., Hidalgo,V., Villada,V., &
Salvador,A.
(2016). Acute stress and working memory: The role of sex and
cognitive stress appraisal. Physiology & Behavior,
164(A), 336–344. DOI:
10.1016/j.physbeh.2016.06.022.
