On Finding a Job
Lewis Mantus
The world can be a very hostile place for a person with a history of mental illness who is trying to re-establish himself with a job and a place in the community. A man who has made a successful new start draws on his own experience of the problems involved and suggests ways of improving the situation.
In 1958 when I was 17j years old and had just returned from attending an advertising conference in Harrogate as a junior delegate, I became very depressed and morose and eventually ended up in an Epsom mental hospital where I was to stay for 11 months. At first when I came out I tried to study by correspondence course, which was disastrously unsuccessful in the circumstances.
Lack of guidance
Until recently I have never known what career to follow (certainly a vagueness partially due to a stillprevalent lack of vocational guidance in schools); this was probably part-cause of my first illness and, certainly, of my second series of illnesses.
I had been married a year when my firm was closed down by its parent company. After that I made a poor choice for my next job and a chaotic period continued for over a year?including two sackings. Eventually, my depression and frustration became manic depression, which led to a rush of fantastic, but (for me at the time) logical, ideas for making money.
This phase of my life started in August 1967, and has continued ever since, covering six stays in three hospitals, totalling years as an in-patient out of the last five years. Since my last discharge from hospital in March 1971, I have managed, by learning to recognise my symptoms, and with help from truly marvellous people at Horton Hospital, to treat myself at home, with minimum time off work (two weeks out of the past year which I have spent working for a very helpful company).
Having outlined my ‘credentials’ as a consumer of both the mental health and employment services, I can now go on to express some opinions.
In a well-run hospital there is usually a high-calibre psychiatric social worker part of whose job involves helping the patient’s family to understand his illness, finding accommodation after hospital discharge, liaising with employers to keep a patient’s job open, and providing a link with the Disablement Rehabilitation Officer (DRO) at the Employment Exchange. But constructive help in vocational guidance is not part of a social worker’s job despite the fact that the prospect of having to find work without help or direction is terrifyingly awesome for most ex-patients.
Since leaving hospital I have never been contacted by a local authority social worker. Could not vocational guidance be included in the training of social workers who are going to be attached to psychiatric hospitals and could not more effort be made to communicate and involve employers on a much wider scale?
Re-training courses
At present sending a report to the DRO is the most the social worker does in the case of an ex-patient deemed to be capable of working in the community again straightaway. A DRO will most probably offer a re-training course. I took one of these when I was 19 and found it helpful mainly because it provided time ‘? Getting any kind of job?whether manual or white-collar clerical ?can pose great, and sometimes unexpected, problems for a person coming out of a psychiatric hospital.
10 for recovery and readjustment. But, at the end of the course, I was left to my own devices to find work. These courses are not designed for mental rehabilitation, i.e. for someone who has spent time ‘out of society’, and who needs the most elementary instruction to be suitable for employment.
Again more government money is urgently needed for proper training programmes for DROs and staff and for the setting up of such rehabilitation centres. On a wider scale, Employment Exchanges would get better vacancies on their books if they made a charge to employers, well undercutting the private agencies, then people needing work would not give them up as ‘useless’ when looking for a ‘good’ job.
My recent experience of private agencies can be summed up as ‘When they are good they are very good, but when they are bad they are unprintable’. Their slogan should be ‘Placing grass-hopping secretaries?a speciality’. In the main, agency staff are not trained to find the right person for the right job, but to be salesmen. They have no skill to deal with the ‘difficult’ applicant, like an ex-patient, who is forced to rely on private agencies after frustratingly impotent government ‘help’.
Remotely suitable
A usual agency fault is sending the nearest person to a job, even if they seem just remotely suitable. The Agencies Association, with official enforcement, should require agencies to register with them and follow a conduct and training code, encouraging staff to take the Association’s exam. The training course should include the study of work-connected social problems: mental, physical, racial, etc.
Help is also needed to develop the possibilities of temporary work, which can provide a less demanding way of working in the community, while still fulfilling the essential need and satisfaction of earning money. Usually physical work, wherever possible, is the best, e.g. gardening, labouring, restaurant work. Being able to type has provided me with a useful earning capacity for short periods while looking for a permanent position.
Going for an interview can be a nightmare. When confronted with an application form, fill in everything except the ‘previous job’ details. It is then up to the individual to attempt, based on experience and personal qualities, to show his capabilities for the job. The subject of your mental illness must be explained with candour and, if possible, with confidence. A question to be expected is, ‘Will it re-occur’? It is important not to give assurances that it will not reoccur, but to convey that, with the possibility of permanent employment, the chances of a re-occurrence would be greatly reduced.
Ask the employer to contact your doctor before coming to any decision. Most important, do not look for sympathy or you will find the interview ceases very quickly. If the interview is more informal and you are able to gain the employer’s confidence during the course of it, then let the fact of illness come to light gradually, stressing that you are under supervision, and make it obvious to the interviewer that you could be a valuable member of the staff. The cardinal rule in either interview situation is do not lie, the employer has almost certainly come across mental illness within his day-to-day life, and should have some understanding of it.
Lobby government
Another potential help in finding work is the NAMH. In my experience the Association has not yet equipped itself to help to find work for ex-patients. Once on coming out of hospital, I turned to them for help to be told that, ‘We used to have a service but now we refer people to the DRO’. I will be interested to see if the Association will continue active involvement in this field after this year’s MIND Week. They should lobby government much more urgently and militantly to set up aid in this field, and not relent until it is forthcoming.
Until government help is forthcoming it seems to me that the Association must make itself a household name, well-known to employers and the general public alike. It should try to support Arthur Carr in the running of his voluntary agency since he is the only person at present trying to fill the desperate need of the ‘hard to place’; but basically, the Association should spearhead the campaign for proper government-financed facilities.
Employers need immediate education about the re-employment of ex-psychiatric patients. Personnel selection needs drastic re-thinking, there is too much reliance placed on qualifications and not enough consideration given to experience, capabilities, and so on for all people with a ‘slightly less than acceptable’ work record to be given the chance of a constructive future.
Humanising application procedures would be a good beginning; no person should be rejected on the evidence of a piece of paper. Employers still work on the assumption that someone who has been mentally ill cannot possibly be able to do an efficient job. An employer must realise that if someone who has been mentally ill is suitable for a position by virtue of experience, it takes no longer for him to acquire the skills of a new job than it does for any ‘normal’ person and, if it works out, the employer has a reponsible employee, well on the road to complete health.
If a relapse does occur, it is essential for employers to realise that it is of paramount importance that a job should be kept open, giving the ill staff member the strongest incentive to fight his illness. Usually there is a nurse and/or doctor on the staff of a reasonably sized company, who should be able to keep in contact with an employee with any kind of health problem. In other companies people who are responsible for firstaid, should at least be versed in recognising signs of mental illness, so that referral or treatment can get under way as early as possible.
The government has yet to realise that setting up proper rehabilitation facilities and providing help to find jobs for ex-patients will cost them nothing in the long term. The millions of pounds it will cost to set up such services save hundreds of millions in the long run. The Department of Employment still has no effective way of catering for the mentally ill?’perhaps they don’t exist’ ? There has never been a comprehensive study of the effect of mental illness on the economy, past, present and future. Money to improve re-employment prospects is needed now while such a study (which will take years) is carried out! Costefficiency arguments alone would justify setting up a ‘Mental Health Rehabilitation Council’ now. But a better state of general mental health cannot be achieved, even if government provides the best rehabilitation services in the world, without the full education of the general public. As long as ignorance and apathy exists the cause of mental health cannot advance with any meaning?mental illness is not something which will be eradicated by some ‘Salk Vaccine’.
The Health Education Council seems reluctant to undertake a programme of mental health education. The MIND Campaign is better qualified to do the job, but nobody, public or private, can contemplate such a programme on the massive scale which is necessary without substantial government funds.
Does the government not feel that it is responsible for the education of the public? Education is the single, most important factor in the improvement of mental health. Whatever extra funds are to be allocated to mental illness in the re-organisation of the NHS, there really has to be an immediate provision for rehabilitation services and public education.
From my own experience, as an ex-patient, the Establishment, which includes most voluntary organisations, is a much more daunting prospect to face than is the mental hospital. The return to living a full life in the community needs to be made a lot less difficult than at present. Better variety of work prospects, better educational facilities?more emphasis on vocation guidance in particular? would keep a lot of people out of hospital.
Mobilise ex-patients
It would be marvellous if a lobby of ex-patients, nurses, and social workers, could be mobilised to voice the opinions of the people who ‘really know’ how much better re-employment facilities need to be. Luckily, I am a self-motivated person, and I am sure that there are many more like me who would speak for themselves, given the incentive; this same group of people could also help with the job of fighting for the basic human right of having a job to do. But there are many more thousands who are unable (or unwilling for fear of unknown consequences) to speak for themselves, although this is exactly what is happening to them: these are people whose lives need not be wasted, and it is they who need the help of us all; it is they who stand in urgent need of an energetic champion.
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