Chapter One

Geoff Waghorn and Chris Lloyd

Chapter overview

This chapter explores the impact of mental illness on employment. It goes on to talk about the value of employment and how people with a mental illness have both the capacity and the desire to work. There are a number of barriers to employment, ranging from the nature of the disorder, stigma and career immaturity. Today, recovery is an important concept and we talk about how employment and education contribute to recovery. We conclude the chapter by examining evidence-based interventions that will assist people in achieving their goal of competitive employment.

Introduction

There is substantial evidence that the vocational rehabilitation needs of people with mental illness are not being adequately addressed. Labour force non-participation and unemployment levels of 75-90% are found in the USA (Hughes, 1999), 61-73% in the UK, and reach 75-78% among people with psychotic disorders in Australia (Waghorn et al., 2004a). In countries with developed market economies, people with mental illness experience difficulties in achieving the basic right to work (Harnois & Gabriel, 2000). They are also sensitive to the negative effects of unemployment and the loss of purpose, structure, roles, status and sense of identity, which employment provides (Boardman et al., 2003). Employment enables social inclusion in the wider community and represents an important way in which people with mental illness can meaningfully participate in society. People with mental illness need the same opportunities to participate in life activi