The Importance of a Hobby

A rock-bottom aspect of the self in American culture is being able to give a reply concerning a vocation to the ubiquitous social query, “What do you do?” 

In a psychiatric unit, one does nothing of one’s normal adult work. One’s only contribution there to the people (s)he loves is by giving the products made in art therapy…. (Of course, there can be the sizable contribution of learning from one’s past mistakes and thereby being kinder to one’s family and friends upon discharge....)

Furthermore, a day or even several hours spent doing nothing but being a passive onlooker at television or social media does not yield any sense of accomplishment.

Developing one or more skills, whether they involve creating (food, writing, artwork, handiwork, etc.) or learning (whether religious knowledge perhaps, or readiness for remunerative employment), results in higher valuation of you by others. And greater self-esteem.

Disclosing a Psychiatric Disability in the Context of Interviewing or a Job

While the Americans with Disabilities Act, and perhaps similar legislation in other nations, confers rights to be accommodated to people with invisible disabilities as well as those with visible, I do not suggest that you avail yourself of such rights. There is simply too much prejudice against people who are thought of as “mentally ill.”

The exception is in the governmental context, where in the United States it is the Rehabilitation Act of 1973 that gives the authorization. Governmental jobs, being more subject to bureaucracy, also yield less bias in the workforce. Finally, sometimes governmental agencies actually provide affirmative action preferences in hiring to those who self-disclose as having a disability. Such agencies have systems in place to follow through with reasonable accommodations, not according to the letter of the law but in the spirit of righteousness.

The Snowball of Vocational Inexperience

A person with few friends with whom to practice social interactions is at a disadvantage in the workplace. It is harder for him or her than for most people to get along with co-workers and to respond properly to supervisors.

This deficit in experience (and opportunities for learning skills) can lead to such a person’s being susceptible to being terminated—laid-off or even fired—from his or her first job.

Such a spotty employment history often snowballs into the person’s having misunderstandings in his or her next job (once secured,) due to:

·         A relative lack of knowledge of job skills needed in the industry or profession; and,

·         A relative lack of knowledge of the culture of the particular (new) employer’s. This is because the characteristics of a typical worksite are likely similar within an industry or profession.

So on his or her next job, it is even more likely (than on the prior job) that it will be difficult for the person to be promoted to a better position. And his or her being terminated from a subsequent job is likewise even more likely.

Some aspects of almost every job involve promotion (sales or marketing.) This activity is feasible only to the extent that the employee has “people skills.” And such are hard to learn for the first time on the job itself, without a firm foundation in earlier life.

The lack of many friends in adolescence and early adulthood, which can be the situation for many people diagnosed with serious mental illness, can snowball into later vocational inexperience.

People with Mental Health Symptoms ("Peers") Are Needed in Mental Health Work

One Mr DJ Jaffe, the self-styled Executive Director of Mental Illness Policy Org, “a non-partisan think-tank on serious mental illness funded by people with and families of the seriously mentally ill only,” had a startling opinion piece published online in Psychiatric Times on February 14, 2018.

Permit me to quote his final two paragraphs to show you his bias, ahem, there is no other word for his opinion.

The new Assistant Secretary [overseeing the Substance Abuse and Mental Health Services Administration of the US, known as SAMSHA] has spoken about requiring peer support specialists to work in concert with medical experts. She has also taken steps to eliminate non-evidence-based programs from SAMSHA and to focus it on evidence-based programs that help the seriously mentally ill. But the leadership of CMHS…is still putting out contracts that are burdened with the expensive requirement to hire peers without sufficient evidence they improve outcomes or do so better than non-peers.

Using scarce resources to support programs like paid peer support that lack evidence they help—while so many proven programs go unfunded—makes little sense.* Research should be conducted to determine if paid peer support improves meaningful metrics in people with serious mental illness and if provision of those services by paid peers is superior to provision of the same services by others. Paid peer support should not be expanded until that research is clear. If expanded, then steps should be taken to ensure that the peer support trade associations do not lobby to make treatment for the seriously mentally ill more difficult.

*Examples of programs proven to improve meaningful metrics in people with serious mental illness include appointments with psychiatrists, hospitalization, medications, electroconvulsive therapy, assisted outpatient treatment, clubhouses, assertive case management, intensive case management, supported housing, psycho-social rehabilitation, and others.

(I’ve even quoted his footnote to his conclusion to show that he has not heard of many contemporary treatments like transcranial magnetic stimulation (tCMS), and that his ideas about what works do not include meditation/prayer as second in line—but rather, hospitalization!) 

And notice how he is authoritarian enough to want “steps… [so] that the peer support trade associations do not lobby.” 

Why is he wrong? I can be briefer than he….

1. Peer employees of mental health agencies provide consumers/patients with self-esteem. They see that various forms of employment are possible for them.
2. Those who are peer employees themselves have jobs that bring them self-respect as well as income.
3.  “Patient-centered treatment” is required by the US Centers for Medicare & Medicaid Serrvices (known as CMS) under the rubric, “Partnerships for Patients.” 

Mr Jaffe is out in left field!

(C) Copyright Deborahmichelle Sanders 2018. All rights reserved.