March 23, 2020
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Physical health problems 'pervasive barrier to employment' for individuals with serious mental illness

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Ni Gao

Mental health services that included care of physical health conditions appeared to improve employment participation and outcomes among individuals with serious mental illness, according to study results published in Journal of Vocational Rehabilitation.

"Integration of medical, psychiatric and rehabilitation services for individuals with serious mental illness can help them better manage illness and promote wellness  specifically, occupational wellness,” Ni Gao, PhD, associate professor in the department of psychiatric rehabilitation and counseling professions at Rutgers School of Health Professions, told Healio Psychiatry.

According to Gao and colleagues, individuals with serious mental illness are at increased risk for poor physical health, especially when accounting for reduced life expectancy of up to 25 years among this population. Prior research has shown that employment may be vital for improving and maintaining mental and physical health, although data regarding poor physical health as a barrier to employment engagement are limited. Despite a desire to work, many individuals with serious mental illness remain unemployed.

The researchers sought to explore perceptions of mental and physical health conditions as barriers to employment and the impact of these conditions on job-searching activities among 162 individuals with serious mental illness. Over 1 year, they met with the study participants, who lived in supportive housing programs. At each meeting, the researchers assessed participants’ physical health and employment-related activities, including the number of applications submitted, interviews they had attended, job offers that were made and self-identified barriers to obtaining a job. They conducted frequency analysis and chi-square tests to examine the relationship between the participants’ job-related activities and their perceptions of physical or mental health conditions as a barrier to employment. Nearly half of the participants had a high school diploma and 27% were college-educated. Approximately 60% had been unemployed during the previous 5 years, but all stated a desire to seek employment when enrolled in the study.

Results showed that participants were more likely to report physical health conditions vs. mental health conditions as a barrier to job-related activities. Specifically, 10.7% to 26.1% of the participants reported their long-term physical health problems as a barrier to job-related activities, whereas 2.1% to 9.3% reported a short-term physical health issue as a barrier. Further, 0% to 1.5% reported long-term mental illness as a barrier, and 3.5% to 11.6% reported a short-term mental illness as a barrier.

Perception of mental health conditions as a barrier to employment did not significantly reduce job-related activities, whereas perception of physical health conditions did. Moreover, participants were more likely to identify physical problems than mental health problems as limiting their work or other activities.

"We knew from previous studies that individuals with serious mental illnesses also have higher comorbidity of chronic health conditions, particularly related to metabolic syndrome and smoking, as well as higher premature mortality of 10 years to 15 years compared with the general population," Gao told Healio Psychiatry. "However, we were surprised that the physical health conditions are negatively affecting their job seeking activities to the degree that they identified as more serious than their mental health conditions." – by Joe Gramigna

Disclosures: The authors report no relevant financial disclosures.