Integration of people with mental disturbances and psychiatric illnesses in the labour market M a ris Taube, Raisa Andrezina, Agnese Uzkalna

Latvian situation description 450 million people around the world have psychiatric and neurological problems Each year people commit suicide About Latvians have psychiatric and behavior disturbances The number of regular psychiatry service users are % from persons, who use psychiatry services, have schizophrenia, 24% organic mental disorders (dementia etc.), 23% intellectual disabilities 25% of service users are under the treatment longer than one year

Target auditory of the project Patients from mental hospitals or patients who regularly use ambulatory services, Patients who don’t have job, never had a job, had lost the job or were disabled, Patients who have psychiatric illnesses (for example, schizophrenia) or who have other type of mental disturbances (intellectual disabilities, organic mental disorders)

Target auditory of the project I Totally 243 patients were working at the project, from them: 178 with psychical illness, mostly schizophrenia, 65 with mental disturbances, mostly intellectual disabilities.

Ventspils Liepāja Talsi Kuldīga Saldus Tukums DobeleJelgavaBauska Aizkraukle Jēkabpils Preiļi Krāslava Rēzekne Ludza Madona Gulbene Balvi Alūksne Cēsis Valmiera Limbaži Sigulda Valka Ogre Daugavpils Jūrmala JELGAVA DAUGAVPILS RIGA STRENCI AINAZI VECPIEBALGA AKNISTE Latvian project partners

Patients were doing following jobs Auxiliary worker in gardening, Auxiliary worker in cleaning up the territory, Janitor, Courier, Iodine-sticks planer in specialized workroom, Cutter in workshop of cardboard articles, Kitchen worker, Dressmaker, Auxiliary worker in inventory warehouse, Repair- locksmith, Patients’ newspaper editor.

Targets of the Project Recommendations for System of employment of mental health users in Latvia, Role of Mental health facilities in Latvian employment system

The aim of research To evaluate important s of employment for persons with mental problems

The participants of research 58 persons from Riga, Vecpiebalga, Ainaži, Strenči, Jelgava, Daugavpils and Aknīste

Methods Demographic questionnaire – structured questionnaire about marital status, lifestyle, living place, education etc. Life Satisfaction Questionnaire - assessment of satisfaction of person with his life, life factors, free time, work, financial situation, family situation, relation with friends, health situation etc. Modified Role checklist (Ocenley F., Kielhofner G., Burris R., 1985) – consist of 10 Roles – student, volunteer, family member, householder, friend etc. Modification means that person choose role in past (till 7 days), present (today) and in future (from today).

Methods I Daily activities Questionnaire for working days and holidays – assessment of regular activities during one typical day every half hour (self care, productivity, free time, sleep). This instrument helps to compare balance of person’s activities in working days and holidays. Modified Occupational Case Analyze Interview & Rating Scale OCAIRS (Kaplan & Kielhofner 1989) – consist of 14 questions about will, habit etc. The instrument was modified make little easier and also was included questions about work situation, previous work experience.

Results 58 workers participate in research – 37 (64%) of them men 21 (36%) women. From all participants 6 was marred, 25 single, 12 diverse, 3 widower, 12 have friends.

Results 28 workers current living is hospital, 19 – in own flat, 7 – in own house, 4 – in social flat. Education level is different – 8 persons (14%) are without any education, 20 persons (34%) with basic education, 15 (26%) professional education, 12 persons (21%) secondary education.

Role checklist Most important role ’s: w orker - 52 times family member 31 times, friend – 22 times, h ousehold housekeeper – 11 time, student – 8 time.

Life satisfaction 91% of project participants were satisfied and much satisfied with their life. Partly satisfied were 9% of participants. Important, that persons who work longer hours, was most satisfied with their life.

Non satisfaction aspects

Satisfaction with financial situation „Wen was changing life (independent Latvia) is problematic to fit in new life, world, money, nowadays all problems concentric to money” „..I’m looking for greater salary; I will go to market not one time, but more.”

Satisfaction with health „..If you are sic, you looking also for relaxation, and if you use medicines, you must relax, because there have side effects, sleepiness etc.”

Satisfaction with free time „There is lack of possibilities to do something; there work is all, after work I’m going to sleep and relax.”

Satisfaction with family Social workers/job consultants indicate, that situation in families is very important and give serious impact to workers feeling and relationship in collective and also to quality and quantity of job

Satisfaction with work

„I’m happy to do this work, I’m able to work and I will be here until its will be possible” „If I’m going in to real life, for me will be many difficulties; in work, education, will be problems, because my thinking process is slow, I have problems with memory, sometime is problem with concentration. But if someone helps me, support me – I will work.” „I’m not tire d, because we now our responsibilities, we have work, we not thinking about our fantasies, delusion...” „In work I’m worriless. I forget for all, all my attention is to work. That’s much easier.” „I like that’s at work not very strong time-limit. I try to stimulate self for more q uigley work.”

Satisfaction with work „..I like that’s work is not difficult, the collective is good, and also money is very necessary for me. You feel needful, able to do something necessary for others.” „..It’s sometime difficult, but after that I’m to screw oneself up to do something.” „What is good? I like... How can I say – I’m accuped, I’m working, not to rove, like others.” „It’s not enough stability. Hospital is bad place, you think – if you will not able to stand up one day...and work, today we are in this project, but whats happened after project...”

Activities „..It’s very important, if it’s strong agenda, that’s help for sleep, also help for organization of daily activities.” „It’s easy to concentrated, because you have job.” „No sleeplessness – after work I’m ready for sleep.”

Social environment I don’t like work alone, I fear, I’m alone also in life, I don’t have relatives, all is gone.” „You feel there safely, you understand, you are supported.” “If people have similar problems, it’s easy to understand, because if you are not health problems, you are very difficult to understand mentally ill person’s problems. Will be very difficult work together with healthy persons...” „I will work together with people who understand me. With young people will be problems, better with older or middle age people.”

Social environment Most respondents not will work together with persons without mental health problems, because there life experience show, that this persons are not able to understand mentally ill persons situation and there attitude is negative, some time merciless. „There is, of course, better, because healthy people are assuming, I don’t like contact with them.” „Some time relatives misunderstanding, some time I do something wrong because I’m sick, but other people not understand me.”

Results Employment is very important in the life of persons with mental problems, because that’s give some structure for life, financial support, development physical and cognitive function, support integration into society, support positively self-esteem of persons Results of current research in area of employment give basic knowloges for decision makers.

Results I Most of persons working in project are happy for these possibilities. Some persons will try to work after project in society, but most of workers much better will work in shelter work system. Most important problem is small salary, unsafely future and not clear future after projects end. EQUAL project “Integration of people with mental disturbances and psychiatric illnesses in the labor market” was important for development mental health system user’s employment possibilities.

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