Psychosis (young people)

Working and psychosis

A few people we spoke to were employed, or were doing training. Some were working in the field of mental health, often in peer support, while others were working in another specialist area that interested them (for example Green Lettuce worked in IT and Joseph was a gardener). Many had done, or were considering, volunteering.
Finding employment after having experienced psychosis could be challenging, either because people felt too unwell and uncertain about the future or because they worried about discrimination. People often had “gaps” in their CV when they were receiving treatment or too unwell to work or study, and this made it harder to compete in the job market. Andrew Z was unemployed for a year and was “applying for work for like eight hours a day and no success… not getting to the interview stage”. He thinks not having completed his degree made a difference to his job prospects.

Most people wanted to work and said that being “active” was important, as keeping their mind busy could help them manage some psychotic experiences such as voice hearing: Joe explained “boredom is not good for me… doing something that I hate is better than sitting at home on my own in the quiet not doing anything. Because that way, quite literally, madness lies”. Lucy felt that her “identity was in work, and being good at [her] job”. But not everyone wanted to work. Chapman isn’t legally permitted to work because his application for asylum is still being processed, but says that anyway he would want to wait until he “gets better”. 

Some recognised that their mental health experiences added to what they could offer at work.
Work life and psychosis
Psychosis had started for a few people while they were in employment.
Those who were working when they had their first psychotic experience often didn’t feel able, or want, to return to their workplace. However, others, like Becky and Lucy, eventually returned to work when their psychosis passed.
Having a psychotic experience was a life changing moment for some people which led them to a career change. Luke’s first psychotic experience happened two weeks into his first job with a global professional services organisation and he hasn’t been able to return to full time employment. Although he used to think that type of job was “everything he wanted in life” he’s now changed his priorities and is “not too bothered about it”. A few people found that the experience had made them rethink their plans for the future, often in a positive way.
Finding new work, stigma and discrimination
Finding employment after, or in the context of ongoing psychotic experiences, could be challenging. Some people experienced a long and difficult processes applying for jobs. Joe put in fifty applications before he finally got his job as a care worker. Some people had been given help. Green Lettuce had support from his “advisor” when he was looking for a job in the IT sector. Although he has spent “loads of time looking” he says there isn’t much in his area and he has now decided to set himself up as self-employed web designer.
Some people spoke about stigma and discrimination that exists against people who experience difficulties due to mental health experiences.
Tariq feels that the Disability Discrimination Act is “ineffective” for people with mental health experiences. He says that being turned down for a job involving working with members of the public because of your mental health history is discrimination. Ruby applied to be a teaching assistant in a special needs school but when she missed the occupational health assessment because she was unwell she was told: ‘you are clearly not reliable so I am going to say that you are not fit for work’.
Talking about psychosis at work
When people found a job, there could be a difficult decision about whether and how to discuss their mental health with their new employer. Whether or not an employer knew about the person’s mental health experience and how they responded to it was critical in shaping people’s experiences of work.

Some people found it difficult to let others at work know just how unwell they felt because there were no obvious outward signs that they were unwell. Luke says mental health is “something that’s invisible” and Sameeha believes people think “you don’t look it, so how could you possibly be ill”. Luke thinks there is a general belief that if someone’s broken their leg and has to work from home for three weeks, it's fine. But if he can't get out of bed in the morning because he’s depressed, people don’t consider that to be a justifiable reason.
But those who had told their employer about their psychosis, found that they had been very understanding, which made it easier when they needed to take time off for therapy, treatment, or because they felt unwell.
Some mentioned that work colleagues were supportive in other ways, or shared their own experiences of psychosis. This could be positive. When Ruby had her first experience she was working during her gap year. Her manager who had a “major depressive disorder” herself gave her support and found her somewhere to live when she couldn’t live at home. But Lucy found it unhelpful when someone she worked with who had had mild depression tried to give her advice such as taking St John’s Wort “she couldn’t quite understand… our experience was so different”.
Volunteering
Many people had volunteered as peer support workers and mentors for charities and mental health service providers. Fran works in a centre where they train mental health staff and Tariq volunteers at his local hospital where he “befriends” people who are unwell. Andrew Z volunteers with the EIP team that supports him with his own mental health at the local hospital and is helping to set up a mentoring scheme. Barry said volunteering had many benefits: gaining new skills, getting a reference for future work, and it could provide opportunities to make new friends.

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