In the past, people with severe mental health problems were often seen as incapable of working. Today, the importance of having opportunities to participate in meaningful work and earn a living is more widely recognised than in the past. This is acknowledged in the Victorian Mental Health Act 2014, which has as one of its guiding principles that people be provided with mental health services “with the aim of bringing about the best possible therapeutic outcomes and promoting recovery and full participation in community life” (section 11(1)(b)).
Many of the people we spoke to were in paid employment or worked as (unpaid) volunteers. Others were studying, in caring roles, or retired. A few people had more than one role, such as working and parenting, while some were not currently working or studying. Of those people who were working, most were employed in the mental health sector, though a few worked in retail, law, manufacturing, or other parts of the community sector. Part-time employment was common. When discussing their experiences, people talked about what helped them find and maintain work as well as the barriers they faced. They also reflected on what it was like working in the mental health sector.
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Supports
Barriers
Working in the mental health sector
Supports
People described several factors that had helped them find or maintain work, including contacts and referrals to people who helped them find employment, flexible working hours, and supportive supervisors (when they disclosed their mental health problems to them).
A few people said they secured employment through contacts they made in mental health services. Cindy emphasised the importance of ‘who you know’, explaining that she found her job in a mental health organisation after starting as a volunteer.
Nicky described how she got her job as a ‘consumer consultant’ through ‘networking’ in mental health service organisations.
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Look it’s been a journey, and it’s been a long journey, and so since I was unwell in 2007, early 2007, I’ve been doing a lot of things, like personal development, like working as a volunteer, doing jobs, doing community visiting for the [government office], Intellectual Disability. And so I’d go around with another community visitor and assess the premises, assess the treatment given and things like that. And also volunteering for mental health organisations, like [mental health organisation], and [mental health organisation].
And making connections and networks with people from [mental health organisation] and [mental health organisation], and that’s really how I got my job at the first public health, mental health hospital through networking. And so now I work as a consumer consultant in adult mental health in the hospital just not far from me. So it’s really good, yeah.
Most employed people we spoke to worked part-time. Some emphasised the importance of having flexible working hours, while others talked about the need to balance hours worked with the income they earned. Having recently lost one of her two part-time jobs, Jenny needed to find another one, while Cindy felt she had too many hours, but said she was ‘not going to complain’ because she valued her workplace for other reasons.
Allen described how working part-time had ‘multiple benefits’ for him. He felt supported by his manager.
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I also have delayed sleep phase syndrome which is a sort of a syndrome of sleeping where you tend to go to bed quite late and get later as a result and it can be quite difficult to get to work, you know, at the usual time. If it’s say nine o’clock or eight thirty I find that very challenging. I get to work at 10 o’clock and that’s accepted by my employer and it sort of suits us both.
If you can step in proactively to manage your mood and mental state then you still might need time off or you still might need a quiet morning. But to be quite honest, a lot of the time I’ve had a bad night, all I really need is to get to work at 12 o’clock and that’s all I ask.
I can manage my medication as I wish. If I cannot feel under stress to get to work before 12 then, you know, that’s all I need. I might lose two hours of work that I could’ve done but, you know, that wouldn’t have mattered anyway most likely and the difference to me is substantial.
And in that respect obviously you spoken about the value of having employers that are going to be able to be flexible and support you in that.
Yeah, I mean, I currently haven’t really got a great relationship with my employer in terms of mental health personal needs, but I think it would be there and in terms of flexibility of hours. Otherwise my manager’s been pretty good with me hasn’t always been for reasons of mental health. I mean because I only work part-time, a lot of your mental ill health time is not going to occur on days that you’re at work anyway. And if they are then you’ve always got a day before it and a day after to recover. So you can see that working part-time has multiple benefits.
Some people commented that people with severe mental health problems could be better supported to participate in work. Those who spoke about having understanding, flexible employers were appreciative of them. Being able to take sick leave was important but not always easy to negotiate (see also Discrimination and social responses to mental health problems). Others such as Brendan discussed the difficulty of obtaining flexibility and understanding from an employer without disclosing mental health problems.
Barriers
Barriers to finding or maintaining employment included concern about disclosing a mental health problem, diagnosis or hospital admission, self-doubt, disincentives built into the design of social security benefits, and lack of support from mental health professionals.
A few people thought self-doubt was a barrier to maintaining a particular career or job. Alice described how before she became ‘unwell’, she never had ‘professional self-doubt’ about her ability to work well in her corporate role. However a mental health practitioner who suggested that her job made her ‘stressed’ planted ‘a seed of doubt’ in her mind. Alice went on to resign, then began working in the community sector.
Brendan described how his ‘doubts’ about his ability to do his job influenced his decision to resign.
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So the counselling didn’t happen, also it was a bit of a, having supervision wasn’t very regular, I only had supervision three times in the eight months or so that I worked. So I had a lot of doubts, you know, about how it was going, whether I was doing things right, whether I was managing things.
But because I never, you know, would ask or speak out or, you know, look to engage on those types of things, I guess they sort of stayed fairly blank, you know. As I said, I got some good feedback but I think I still had a lot of doubts about my ability to do it, and we’d spoken about that, you know, my boss, I think was quite, couldn’t believe that I would have doubts about my own ability because I was doing the job so well.
But, you know, that was still my reality that I always had these doubts about, that I was doing it. And I think towards the time where just recently, where I got unwell and had to resign, I was starting to sort of slip a bit in that some of the participants who I was helping, some of their stories were fairly similar, some of the stuff that I was going through, and I sort of, I don’t think I was dealing too well with that. I’d get a little bit distracted at times, nothing major but sort of just finding that I wasn’t perhaps listening as well as I should’ve been, and that was a worry.
Some people described worrying about disclosing their mental health problems to employers. Allen said he had not told anyone at work about his ‘diagnosis’ because he was concerned about the possibility that his colleagues might ‘see someone as a diagnosis rather than as they present themselves’.
Alice confided to her boss that she had had a compulsory admission. Later, a situation arose in which she felt ‘judged’ by her boss because of her disclosure.
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The little bit that I guess I did disclose in my current work environment, I did at times feel that I was judged, not necessarily when I was in the vulnerable moment of disclosing, but later on. I disclosed that I’d had an admission, again it wasn’t in the writing, so it wasn’t in the upfront documentation. But I felt that I’d developed enough rapport with the person to disclose that.
And then how did that later on come to be something that you felt you were being held up against?
So it kind of came about by you know, I mean I’m the type of person that has lots of balls juggling all the time anyway. And you know depending on what happens with those balls, or putting to one side or one dropping or whatever. You know, I’d like to think I’m quite dynamic but you know, yeah. But look there was a significant shift in that I’d decided to stop taking my medication. So to me I felt a lot more centred with who I was before all this happened, since that has happened. So there’s been several months now.
And again I’m managing that tightly in terms of who I’m telling. So I kind of had felt, look I probably jumped the gun a little bit to advise that at the time. But I kind of felt that my changes in the workplace, in terms of my behaviour, probably as a result of that, were being seen negatively when I felt that they were more positive. Because to me I was becoming more you know assertive, not that I wasn’t assertive before. But definitely compared to how I was prior to any of this happening, I definitely was a lot more, not toeing of the line, but a lot more, held back a lot more you know.
So I was kind of like asserting myself, expressing my opinion, showing my initiative, getting things done. And was kind of almost in a zone again with work, which I hadn’t felt in a long time. And yeah so I kind of ended up being pulled up on that a little bit, which I found quite bizarre. Because you know I ended up managing that process by saying that I felt that the change was nothing but positive. And if anyone felt otherwise then come talk to me. You know, yes there was a change and that’s fine.
But I guess working in a smaller environment of not you know thousands of people that it’s probably easier to pick up those changes in people. But life I think in our modern day world has become so busy, that you know people will, I don’t know. I guess I don’t look for consistencies in people’s behaviours. So, do you know what I mean? Like I don’t, I just feel that we need to be dynamic to get stuff done in the modern world. We can’t, yeah I can’t be doing something on a real monotone element.
A few people described different factors that either hindered them from seeking additional paid work or left them ill-equipped to return to work after a period of being ‘unwell’. While Vanessa described facing a disincentive to seek paid work by the fact that Centrelink would then ‘cut’ her income support, Alice said that when she was discharged from a mental health unit, returning to her corporate job was very difficult because she ‘was not prepped with any story to tell anybody in the organisation’. As a result, she left after her first day back. Mental health practitioners were not always supportive of people’s attempts to find more or better work.
When
Jenny was unhappy in her job, she said her psychiatrist did not support her attempt to find another job.
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This psychiatrist who prescribed the medication, he was shocking. He was really, a sort of military man. I don’t know whether he’d been in the military. But he said things to me like, ‘Olanzapine didn’t make you put on weight’, which was a blatant lie, because olanzapine makes you put on a lot of weight. It’s one of the worst and, so he lied about that.
He told me that I would never get another job. I worked in accounts, in that same position that I’d got from the voluntary work, I stayed there. For a number of years actually, I worked there. But my boss was, she wasn’t Australian and she wasn’t a good communicator. She and I were probably a good pair, because I was still not a, still didn’t know how to communicate and I still had these voices in my head. But at least I was going to work and I was committing, I was going regularly. I could get to work on time and I could be there on time and I could, you know, go when I was required to go and all that sort of. I could meet commitments.
But I hated it after a while. I hated that job and I was trying to get another job and this psychiatrist said to me, and I was telling him about my attempts. I had 10 interviews and didn’t get any of the jobs and, you know, it was very frustrating. And he said to me, “You’ll never get another job. Just stick with what you’ve got”. You know, so he just wasn’t… Talking about, you know, positives and negatives, this was the most negative experience I’ve really had.
Working in the mental health sector
Many of the people we spoke to who were employed were working in the mental health sector, either as consumer consultants or in other roles. They described varying experiences, ranging from feeling ’empowered’ to expressing uncertainty about the possibly limiting impact of working in mental health on their sense of self. Some talked about the benefits they personally derived from feeling well supported by the mental health organisations which employed them. Others emphasised the opportunity that working in the mental health sector gave them to ‘help’ others going through similar experiences to themselves.
Cindy felt ’empowered’ by her work for a mental health organisation.
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Well it makes me empowered again because I’ve got some responsibility. I find the office work to be rather hard though because concentrating and you’ve really got to concentrate especially doing your timesheet. Oh, so many times I got it wrong because they’ve changed the system on how you do it and no one told me. So I was filling them in wrong and getting them in late but still somehow being paid on time.
But yeah, no the job, it keeps me very busy because I’ve got to work split shifts. Like this morning, I finished at nine and tonight I’m starting at eight at night and I’m working right through until the morning, 9:30. And then I’ve got another shift after that so I’m actually working until 12:30 straight through but it’s an eight hour sleep, I’m not active which is good for me.
I can’t do active. I told them, and they said, “Yes we want you well so we understand” and they’re really good like that see, bosses and everything. They’re really nice so I’m lucky, very lucky. I count my lucky stars. I don’t think I could have been this well without it, which is weird because like I said other jobs have made me sick before especially their attitude towards you. So I’m really lucky now.
They had me taking people out for movies at first, running a community kitchen which I was already doing anyway and taking people out to dinner and I was getting paid to do this. So they sort of got me into it a little bit at a time and built me up to being able to do what I do now. So the company really know how to treat people with mental illness, I think. They know how to treat people in general but you know they’re very understanding towards what we need as people to do a good job and be productive.
Some people described both advantages and possible drawbacks of working in the mental health sector. While Allen said he appreciated that his job gave him ‘a wage, an occupation and something to do’, he reflected that working in mental health can perhaps prevent people from ‘getting their minds off’ their mental health issues.
Lisa said she felt in ‘two minds’ about her role which identified her as a person with ‘lived experience’ of mental health problems.
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I don’t particularly like that, my role actually in my role description, it said like, I guess one of the main requirements of being in a role like mine is that you have a lived experience of a mental illness. I sort of have an issue with it being a requirement of the job in a way. I think it goes back to what I was saying about being surrounded by other sick people. You know, for lack of a better term – sick people – but being constantly surrounded by, I guess, other mentally ill people sort of kept me ill for a longer period than I expected.
And, I socialised with a lot of those girls after I was released and it felt like the most bizarre thing. You know, you talk to these so called friends but what do you talk about? You talk about your medications and your illness and you talk about like the fun times we had in hospital and I’m like what fun times? You know, I mean, I think there’s one woman now that I’m still very good friends with. But that’s not the only thing we talk about, you know. So, yeah, this whole idea of like surrounding yourself with people who are also ill, kind of helped me shape my identity as some…
Like, I very strongly identified as someone who is mentally ill and that was like who I am at that stage in my life. If you identify as being ill then it keeps you ill in a way. And so I refuse, not refused to but I don’t talk about that part of my life or those experiences very often. And I’ve found that when I do it’s met with a range of different things. Sometimes it’s quite patronising where it’s like, “Oh, you’ve done very well for yourself in spite of that” and like well, “Yeah, why wouldn’t I?” So yeah, like it’s a strange thing.
And, you know, if I tell someone that I have bipolar disorder they’re like, “Oh, but you don’t seem crazy”. So I feel some conflict with working for a mental health organisation because I don’t know if my opinions or my experiences is valued or if it is at all and sometimes there’s, I think, the idea of my role and the requirements surrounding it make me feel a bit funny about how I view myself and my identity as someone who has experienced a mental illness or is continuing to do so. Like I’m sort of in two minds about that.
Others reported enjoying their work in the mental health sector. Cindy said the organisation she worked for ‘really know[s] how to treat people with mental illness’. She felt ‘lucky’ because she did not think she could have been ‘this well’ without her current role. Brendan talked about a role he had supporting people with mental health problems to find work, which involved ‘helping people’ to navigate challenges he himself had experienced.
For
Nicky, getting a job in the mental health sector after not being ‘part of the workforce’ for a while made her feel more a ‘part of society’
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So as far as quality of life goes, it’s very important for me to be part of the workforce because when I wasn’t working, I just felt very let down and I felt very useless, worthless and not part of society really. So I think for someone’s quality of life, they have to feel valued and a part of the community, and to do that, it could be undertaking meaningful activity. Like I don’t know, voluntary work or doing short courses, or it could be applying for work on a part time basis that is not so, that is quite light work and is not so demanding on the person.
And it makes you feel like you’re capable of achieving things as well, when you’re working with other people and you’re trying to connect and network and make some progress. And make some progress in society, not just for yourself, but for others as well, I think.
