Schizophrenia the myths ... and the workplace

What do you need to know about employing a person with schizophrenia? The question can be a very real one for employers because it is estimated that schizophrenia affects one in every 100 people. As many as 35,000 people in Ireland will have schizophrenia at some point in their lives, as will 250,000 people in Britain.

It affects men and women, rich and poor, educated and uneducated; and people of all races, cultures and religions. It has no bearing on IQ - people with PhDs suffer from it, as do doctors and other professionals.

Schizophrenia usually first strikes between the ages of 16 and 25 - although it can start earlier or later than this. Stress caused by the workplace, exams, relationship difficulties or a bereavement can bring on the illness.

Usually, sufferers have an excess of the natural chemical dopamine in the brain, but medication can counteract the effects of this overload. It can take two or more months before medication takes effect. The positive consequences of medication can continue for some months after treatment has discontinued, leading some people with schizophrenia to believe they no longer need their medication, when in fact they do.

Employers and potential employers should know that people with schizophrenia have wrongly been tarred with the brush of having a propensity to violence. In fact, some studies have shown precisely the opposite.

Ms Orla O'Neill, director of Schizophrenia Ireland, says there is hard evidence to show that there is no greater risk of people with schizophrenia being violent than other people.

W.D. Boyd, director of the Confidential Inquiry into Homicides and Suicides by Men- tally Ill People, published in Psychiatric Bulletin in 1995, found that: "It is much safer to associate with someone who is psychiatrically ill than with a member of the general public." A study carried out at St John of God's Hospital in Stillorgan and published in the Journal of Psycho- logical Medicine in 1990 found that "the overall rate of violence among schizophrenic patients is relatively low and that such acts are generally of a minor nature".

Despite the prejudice of some sections of the media, people with schizophrenia manifest, at worst, the same levels of crime as the rest of the population. Mr Simon Wessely, in a paper published in the British Journal of Psychiatry last year, said: "Despite what the popular press would have us believe, the rate of increase of crime among schizophrenics is no faster than in the rest of the population." Another myth that should be debunked is that schizophrenia is a "split or dual personality". It isn't. Instead, people with schizophrenia, when they are ill, can lose touch with reality. Their thoughts, perceptions, feelings and motivation can become disturbed, so they can find it hard to think straight or communicate with others.

Lots of illnesses, including a bad dose of the flu, can induce a similar delirium. Any high fever can cause disordered thinking, incoherent speech, delusions and hallucinations.

But, with medication, most people with schizophrenia can lead a normal or near-normal life. Sometimes the hardest thing is not so much the disease itself, but the stigma grounded on fear and misunderstanding that can accompany it.

Schizophrenia Ireland runs a supported employment-training programme which aims to enable people with schizophrenia and other mental illnesses to enter, or re-enter, the open labour market. Currently, the programme operates in Dublin and Donegal.

The programme is based on a model originally developed in the US, where people go into the open marketplace rather than into sheltered employment, says Ms O'Neill.

Programme participants identify their strengths and interests, which are then matched with a job in the open labour market. Participants enjoy training to build confidence, enhance their communication skills and develop stress management techniques.

Then they proceed to employer-based training, where they learn the skills of their chosen area of work. Each person has a job coach, who supports both the participant and the employer. The job coach continues to offer support after completion of the programme. Funded by the European Social Fund, the placement lasts a year and it is free of charge to the employer - who doesn't have to pay wages or PRSI. By the year's end, the employer will have a trained person for the job. Ms O'Neill says: "It is hoped it will turn into a job at the end of the programme." Employers interested in the employment-training programme can contact Ms Orla O'Neill at 01 860 1620.