Myth vs. Fact: Transcending barriers in the work place

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Everyone has been made for some particular work, and the desire for that work has been put in every heart.

Rumi Vaclav Nijinsky: a ballet dancer and choreographer with schizophrenia.

John Nash: an American Mathematician and Nobel Prize winner with schizophrenia.

Brandon Marshall, an NFL wide receiver for the Chicago Bears, with borderline personality.

John Adams and Abraham Lincoln: U.S. Presidents with depression.

Mike Wallace, Dick Cavett and Johnny Carson: TV personalities with depression.

Carrie Fisher, Patty Duke and Catherine Zeta Jones: actresses with bipolar disorder.

There are many lists of both current and historical public figures with mental illness who enriched and enrich the lives of all of us through their work. Many have talked or written about their experiences with mental illness and its effect on various aspects of their lives, including their work.

Elyn R. Saks wrote of her journey in a New York Times article (January, 2013) titled, "Successful and Schizophrenic." She described her prognosis as "grave" following her diagnosis and employment prospects limited to "menial jobs." She explains, "Then I made a decision. I would write the narrative of my life." She became a "chaired professor at the University of Southern California Gould School of Law."

Saks, like many people with mental illness, was diagnosed at a younger age, before her career had sprouted roots. Others careers or paths to employment such as education are interrupted by the onset of symptoms. Some, like Mike Wallace, have their first episode of illness brought on by an unanticipated event.

Employment should be a basic right, providing people with a sense of belonging and empowerment. Although having a mental illness can pose challenges at times, it does not preclude one from working. As with other illnesses, there may be times when symptoms make it difficult to follow through with responsibilities and it is during such times that supportive programs are of benefit.

The National Alliance on Mental Illness'(NAMI), "Road to Recovery: Employment and Mental Illness," (2014) discusses impeding factors to seeking work. Health coverage is imperative to anyone who has an illness whose symptoms might reemerge, and mental illness is no exception. Many people with mental illness fear they'll get a job, loose SSI/Medicaid and/or SSDI/Medicare, then loose the job and be left with no money to live and no health insurance. It's a powerful fear. It's possible to combine entitlements like SSI and SSDI with part-time employment and not loose public health insurance.

There are different types of employment supports offered to those with mental illness. The nonprofit Clubhouse is one such organization. The first Clubhouse began in New York City in 1948, initially functioning as a support group formed and run by people with mental illness who were discharged from a local psychiatric hospital. The group called themselves WANA (We Are Not Alone). WANA purchased the first Clubhouse, christened Fountain House.

Today, Clubhouses are run by both members and staff. They are comprised of voluntary membership and focus on employment while encouraging the building of relationships through social gatherings, friendship and support. They also help members obtain housing and education. They point people in the direction to access healthcare and treatment, but delivering treatment is not part of the model.

Members participate in a "work-ordered day" entailing all of the functions needed to sustain the Clubhouse itself. People are not reimbursed for these efforts but participate as members of a community. Skills needed in the workforce are accrued in the Clubhouse. When ready, members take the first step through a Transition Employment Position (TEP). Clubhouses offer employment support and have been studied and found to be effective. They assist with resume writing and other aspects related to job searches. Clubhouses are dependent on both government and private funding.

According to Clubhouse International, "A clubhouse community offers respect, hope and the opportunity to access the same worlds of friendship, housing, education and employment as the rest of society." Both the Fountain House in NYC and the Genesis Club in Worcester, Mass., serve as models for other Clubhouses around the world.

Employment is fundamental in helping to provide a sense of purpose. It enables people with mental illness not to be defined by their diagnoses, but empowered by their capabilities and passions, therefore contributing to the fabric of society.

Carolyn Sacco, RN has worked as a nurse in psychiatry since 1985, in inpatient hospital, outpatient clinic, and home settings. Jeffrey Geller, MD. MPH is professor of psychiatry at the University of Massachusetts Medical School. He also treats in- and outpatients.


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