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David Baxter

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Don't Assume Recovery Makes Us Fit For Work, Say People With Mental Illness
22 Jun 2007

People who recover from mental illness must be allowed the option of turning down opportunities for social inclusion including going back to what is often a 'brutal and competitive workplace, the Royal College of Psychiatrists were told. Far from supporting their continued recovery, getting back to work frequently makes people feel 'degraded, belittled and dissatisfied', thereby undermining their mental health, a service user warned psychiatrists.

The conference saw the launch today by College President, Professor Sheila Hollins of a major strategy statement, A Common Purpose - Recovery in Future Mental Health Services, giving psychiatric services the focus of helping people 'to live as well as possible'.

Psychiatrists heard that new tools were being developed to measure personal recovery by service users and the development has been welcomed by the Mental Health Czar for England, Professor Louis Appleby.

But the new focus should not be used by the Government to force former service users to seek paid employment, warned former psychosis sufferer, Maurice Arbuthnott, service user representative on the College's and a member of its Recovery and Rehabilitation Research Group.

'While the new interest in measuring and quantifying recovery among mental health service users may be entirely philanthropic, a Government obsessed with cutting expenditure on welfare benefits for the disabled could use such findings to review and redefine service users' entitlement to incapacity benefit and disabled living allowance,' Mr Arbuthnott warned.

Many former service users are 'happy to be disengaged from the mainstream of society as a way of coping with their condition,' Mr Arbuthnott told the meeting. 'They may spend the day in their accommodation watching television for most of the time, broken by visits to the supermarket and a trip to the post office to collect their benefit. They feel safe, happy and secure with the minimum of social engagement. Who is to say that such service users have not achieved their own recovery goals and have not recovered?'

Mr Arbuthnott who is currently on invalidity benefit has had three episodes of psychosis, each involving several months of hospitalisation after which he was discharged long before he had achieved recovery. After one of these episodes, he was employed by a health charity as an administrator for five years - a period of time which ended with his return to hospital after a further psychotic episode.

'Recovery, like the concept of well-being, happiness or contentment, means different things to different to different people. For some, it means being able to contribute to society and to achieve socially through work, education and relationships. Many service users are offered work that is demeaning and erodes self esteem. The stress of work and the friction and tension of work politics can be counter productive to maintaining a state of recovery,' he said.

Professor Sue Bailey, Registrar of the Royal College of Psychiatrists, said that the job of psychiatrists is to support service users along their personal road to recovery. 'Whilst we hope that means they will return to work that is fulfilling, we very much hear the voice of users such as Mr Arbuthnott.'
 

Halo

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Great post David and I found that the following sentence has certainly rang true for me at times:

The stress of work and the friction and tension of work politics can be counter productive to maintaining a state of recovery
 

Misha

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I'm really struggling with whether or not or when to go back to work. I want to be contributing to society, but I can do that through volunteer work. I know that I can not handle the stress of full time work, but I don't think I can handle the stress of not being able to pay my rent for much longer either. So I have to do something!! It's kind of a no-win situation. I can make $400 a month totally exempt on top of my provincial disability amount, but after that 50% gets deducted from my disability cheque so it's like making half the money, which is hardly motivating. And in Edmonton's job market, there are no jobs with such limited hours. AAAAAAHHHHHHHHHHHHHH!!!!!!!!!!!!!

But in keeping on topic, I'm doing really well in my recovery right now, I feel better than I ever have in my life, but does that mean that I should jump back into normal life or that I should maintain things as they are right now to keep things going well? Who knows? Not me, that's for sure. Too few answers.
 

David Baxter

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I want to be contributing to society, but I can do that through volunteer work. I know that I can not handle the stress of full time work, but I don't think I can handle the stress of not being able to pay my rent for much longer either. So I have to do something!! It's kind of a no-win situation. I can make $400 a month totally exempt on top of my provincial disability amount, but after that 50% gets deducted from my disability cheque so it's like making half the money, which is hardly motivating.

I agree totally.

This is the dilemma facing anyone on disability. It's frustrating, demotivating, and in my opinion just plain dumb.

The logical way to do it would be to deduct a certain percentage of what the individual makes in addition to the disability amount, so that going back to work, whether part-time or full-time, actually benefits the individual financially. For example, if you make an additional $1000 per month from employment, perhaps $100-300 could be deducted from your disability cheque for that month ([$1000 - $400] * 20-50%). The system could even set a cap so that after a certain point the disability cheque would be at zero.

But for some individuals, the drug benefits are as important or more important. Someone with schizophrenia may easily be paying $800 - $1000 per month or more for medications. If the individual is stabilized, s/he may be capable of working at least part-time but if s/he loses the drug plan that comes with provincial disability, there would be no way to sustain the necessities of life on a part-time salary.

That condemns many individuals to remaining idle, with the consequent restrictions on social contact and self-esteem. That's neither therapeutic nor humane.
 

Misha

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That's basically how my disability plus income works. My base amount is $1000 a month (actually $1050),
So if I make $400 on top I get $1000 + $400 = $1400
if I make $600 on top I get $900 + $600 = $1500
if I make $2000 on top I get $200 + $2000 =$2200
which eventually weans me off. I still get medical coverage even when my dollar amount is zero as long as I demonstrate financial need for drug coverage.
I guess it is a good system but it doesn't help me know when I'm ready to work that's for sure.
 

David Baxter

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To be honest, that's better than I thought. I didn't think it was that good in Ontario.

You're right, though. It doesn't help you decide when you're ready for work. Perhaps your doctor or therapist could help you with that question?
 

ThatLady

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I've never been able to wrap my head around the idea that we should punish people for trying to better themselves. Being on disability isn't easy in many, many ways. If one can get to the point where one can step into the world, even for a couple of hours two or three days a week, that will assist the person to gain self-confidence, self-respect, and more financial stability. How in the heck can we perceive that to be a bad thing? It's a good thing, darn it! Don't punish effort!
 

ThatLady

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Are there, perhaps, things you could do for a few hours a day - maybe, two days a week? Jobs like that are sometimes difficult to find but, perhaps, volunteer work would give you the opportunity to try the waters to see how you adjust to a work-type environment. :)
 

Misha

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I am still on lunch and supper meal support at the hospital so would have to work around that, so I am thinking of starting some very part time work in september, probably just making my $400/month that's totally exempt. But it'll be hard in Edmonton's job market to find something that part time; everyone seems to be hiring full-time only. And I don't want to deal with the whole stigma at work thing either. Soooo not looking forward to that. Been off work for 2 years so I know there's gonna be questions. And I know I'm going to have small "crashes" even if I do well, "sick days" I guess you could say. Anxiety or whatever. Nothing goes perfect. Aahhhh.. Ok, I'm going to end this post it is freaking me out now.
 

David Baxter

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Just take it a step at a time, Misha. If you start trying to imagine all of the obstacles or pitfalls or possible negative things all at once, that would overwhelm anyone.
 

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