When Work Doesn’t Work

Well Community member Nathan* used to work. He liked to work. He wants to work again. But the challenges of living with bipolar disorder make steady work impossible. Coping with mental illness often occupies a great deal of his focus and energy and keeps him from being able to concentrate on the job. “My mind won’t stop. Even though I’m treated [with medication], my mind still races a lot, and it’s to the point where it keeps me awake at nighttime.”

As a result, Nathan has struggled to multitask in jobs, and recalls how he often wasn’t able to keep up with production while working at a factory. “I can’t have a whole bunch [of directions] in my head because I get things mixed up. In the work environment, sometimes they would just pile things on top of me. It just becomes overwhelming.”

Nathan is not alone. In fact, NAMI (the National Alliance on Mental Illness) reports that fewer than one in five individuals served in public mental health systems are employed, even though the majority want to work.

A job provides far more than a paycheck. It contributes to a sense of self-worth and dignity. It helps an individual obtain stable housing, healthy food and countless other things that make pursuing stability easier. And it offers a sense of purpose and structure and, in most cases, facilitates regular interaction with others—all factors that bolster mental wellbeing.

But for those who are struggling the most with mental health challenges, these benefits can be difficult or impossible to access. Most Well members rely on public assistance, which is no more than $794 per month.

In addition to the challenges Nathan describes, numerous other factors contribute to the high unemployment rate among those living with serious mental health conditions. For example, lack of a permanent address or a reliable means of transportation can make it difficult to apply for open positions. In addition, many who deal with mental health struggles are at a significantly higher risk of numerous other physical conditions that can hinder their ability to work.

For many like Nathan, having the desire to work doesn’t equate to the ability to hold down a job. “It’s not because I don’t want to do it; it’s because I’m the kind of person that has to check things two or three times,” he says. “I couldn’t get it in my head to let it go.”

As Nathan explains, it’s simply not reasonable to expect someone dealing with a serious mental illness to perform at a high level on the job. For him, and many like him, satisfactorily completing a task requires a great deal of effort, and he wishes that others would have realistic ideas of what he can accomplish, despite his desire and best attempts to do his work well. “Just making the quota is actually an accomplishment for me—anything extra and you’re probably asking for too much.”

Myths about mental illness and the resulting stigma also stand as barriers to employment. False beliefs that mental health challenges are linked to low intelligence, lack of skill, proclivity to violence or unreliability can prevent employers from being open to hiring a person living with a mental illness and can hinder qualified candidates from applying.

Perhaps the most pressing factor that makes work hard for those living with severe mental health disorders, however, is that managing mental illness can be a consuming experience that leaves little mental, physical or emotional energy to devote to employment. Not only does maintaining stability require time dedicated to things like doctors’ appointments, therapy and trips to the pharmacy; by nature it crowds out the hours and personal capacity required to get and keep a job.

In some cases, accommodations from employers, part-time positions and roles with flexible schedules can help those living with serious mental illness be part of the workforce. But, for some, regular work—especially work that provides sufficient income to provide for basic needs—is out of reach.

For those who are unable to work due to mental health challenges, alternative forms of meaningful activity are especially important. However, some of the same barriers that prevent employment—like stigma—can also prevent those living with mental illnesses from serving as volunteers or getting involved in church or social groups. For them, The Well Community provides a lifeline of connection, acceptance and purpose.

“Just being around others who understand and accept you as you are is so important,” says Well Community member Melody. “I never could keep a job very long, but I have come to The Well for years. It makes me feel good about myself.”

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*Names have been changed.