Article

First episode psychosis and employment: A review

South West London and St George's Mental Health NHS Trust, London, UK.
International Review of Psychiatry (Impact Factor: 1.8). 01/2010; 22(2):148-62. DOI: 10.3109/09540261003661825
Source: PubMed

ABSTRACT

Despite considerable growth in treatments, interventions, services and research of young people with a first episode of psychosis, little attention has been given to the priorities of these young people, in particular, gaining employment. A literature review was undertaken with the aim of investigating: 1) whether young people with a first episode of psychosis want to work, 2) what challenges they experience regarding work, 3) what is understood about employment outcomes, 4) what the most effective interventions to enable them to gain employment may be, and 5) what the associated costs may be. The review found that these young people appear to want to work yet face a range of psychological and social challenges to achieving this. Typically by the time they first come into contact with mental health services a proportion are already falling out of education and employment, and this decline continues with contact with services. However, there are specific interventions that can support them to gain employment. The Individual Placement and Support approach, adapted to include support to fulfil educational goals, has demonstrated that a mean of 69% of young people with a first episode of psychosis can gain education and employment compared to 35% of controls.

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    • "Research has indicated that patients with first-episode psychosis show good recovery in symptoms; that is, however , not reflected in terms of their functioning (for instance, employment) (Dickerson et al., 2010). By the time they seek treatment, many have ceased academic pursuits and, since their schooling is affected, are unemployed and have decreased communication and decision-making skills, which are necessary to search successfully for employment or study (Rinaldi et al., 2010). Due to the impact of the illness, young people with psychosis commonly experience social exclusion, low self-esteem and decreased social and occupational functioning (Cotton et al., 2011). "
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    ABSTRACT: Introduction The purpose of this study was to examine the experiences and perceptions of young people in an early psychosis program towards participating in a 10-week photovoice and exhibition project and the themes that had emerged from their photographs. Method Photographs create meanings and participants are able to tell their stories in a meaningful way. Eleven clients who had gone through a prior 10-week photovoice project and exhibition consented to being interviewed for this study. Clients chose and brought to the interview photos of theirs that had been exhibited. Structured questions were asked to generate discussions. Findings Findings illustrated that participants were keen to educate the general public on mental health issues. They craved acceptance and were keen to make connections and build relationships. They were their own agents of change. Supportive networks create hope, which in turn helps people with mental health issues to reframe their outlook. Conclusion The results of this study are important and provide occupational therapists with another tool for intervention and advocacy. As both photovoice and occupational therapy focus on the process rather than the product, occupational therapists can utilize photography in groups creatively to generate more client- and peer-led discussions.
    No preview · Article · Jan 2016 · British Journal of Occupational Therapy
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    • "Having a job provides money to buy goods, provides structure to one's day and provides opportunities for meaningful social and interpersonal contacts (Nordt et al., 2007). Overall, it provides meaning to one's life (Rinaldi et al., 2010). Yet despite the importance that work has, it has been found that very high percentages of people with a mental illness do not sustain employment (Secker et al., 2001). "
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    ABSTRACT: Introduction This paper explores what happens to young people with psychosis who have competitive employment when they first engage in treatment.
    Full-text · Article · Jan 2016
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    • "There is also evidence that role functioning and depression symptoms are associated in EP ( Rinaldi et al . , 2010 ) . A recent study comparing employed and unemployed EP group found that depression was significantly elevated in the unemployed , but not currently employed , group ( Tandberg et al . , 2011 ) ."
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    ABSTRACT: Functional impairments are debilitating concomitants of psychotic disorders and are present early in the illness course and, commonly, prior to psychosis onset. The factors affecting social and role functioning in early psychosis (EP) following treatment are unclear. We evaluated whether six months of participation in the PREP(R), Boston, EP treatment program, part of a public-academic community mental health center, was related to improvements in social and role functioning and whether premorbid adjustment in adolescence, baseline neurocognition, and depression symptoms predicted functional improvement. The Global Functioning Social and Role scales, MATRICS neurocognitive battery, and Calgary Depression Scale were assessed at baseline and six months during naturalistic treatment, while premorbid adjustment was measured at baseline. All participants were psychotic disorder patients in PREP(R) (n = 46 with social functioning and 47 with role functioning measures at both time points). Large improvements were observed in role functioning (d = 0.84) and medium to large improvements were observed in social functioning (d = 0.70). Models consisting of adolescent premorbid adjustment and change in depression symptoms predicted social and role functioning change, whereas neuropsychological functioning did not. Substantial improvements in social and role functioning were observed among this sample participating in a recovery-based EP program. The impact of clinical factors on social and role functioning was highlighted. Further studies of premorbid adjustment in adolescence and the treatment of depression in EP programs in controlled treatment trials are needed to confirm these findings. © The Royal Australian and New Zealand College of Psychiatrists 2015.
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