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June 24, 2014

Social Disadvantages of Mentally ill People

People who are affected by some kind of mental illness are the most dejected and marginalized members of the community, both socially and economically. Employment and job is the primary source of earning among the people of the society. The people having any kind of mental illness face the high rates of unemployment and lower labor force participation rates. This joblessness lead them towards social problems such as poverty, crimes, social exclusion, poor mental and physical health and homelessness (Moskos,2007). Studies show that people with mental illnesses want to work but despite this willingness they are unable to secure any competitive employment opportunities or sustain it in the long run (Waghorn & Lloyd, 2005).
Unfortunately, mentally ill people face multiple barriers in securing employment which include stigma of community and workplace, personal barriers such as problems with health, substance abuse issues, homelessness, lack of family support, and social isolation (Mental Illness Fellowship of Australia Inc.,2010).
During the past few years, the social problems among the people having mental illnesses such as crime, unemployment, and homelessness, has received increasing attention by the media and in the field of psychiatric research. But when the situation is analyzed at deeper level, it will be surprise for the social service providers and other advocates that mental or psychiatric illness is not the only explanatory factor which results in these problems. The mentally ill persons are more frequently a victim of such social problems not only because they are mentally ill but also because of the fact that they reside in the world in which such social problems are indigenous. Thus, these social problems are over simplified by labeling as social problems just to formulate simpler interventions and policies to deal with such complex phenomenon.
In most of the past researches done on the subjects, it has been inferred that crimes, homelessness and joblessness are extensive among the people suffering from some mental illnesses. They explain that the mental illness is the prime explanatory factor for all such social problems among the population of individuals suffering from any kind of mental illness. But most of the studies done on the subject fail to provide comparisons between the individuals who has serious mental illness with that of the individual facing similar socio-economic circumstances but no mental illness. Few of the studies which has been done on the subject show little relationship between the mental illness and the resulting social problems ( Draine, Salzer, et al., 2002).
If the situation is analyzed deeply poverty and unemployment plays an important role in creating a relationship between serious mental illness and the social problems. There are three major social problems that arise as a result of this relationship; crime, joblessness and homelessness.
·                     Crime
In U.S. there has been huge prevalence of mental disorders among the jail population. So much so that jails of Los Angeles, Chicago and New York are referred to as ‘Largest Mental Hospitals’ in media ( Blumstein & Beck, 1999).
There has been a drastic increase in the number of prison inmates in United States during the last two decades. The number of people incarcerated has almost doubled. Similar is the case with people on parole or probation (Blumstein & Beck,1999). This increase in the number of jail inmates has been attributed to the increase in the number of people with mental illness by the mental health advocates. But if a closer look is taken at the situation, the mentally sick people are more likely to become part of the social groups who bear high rates of being arrested such as people with the problems of substance abuse who are unemployed, less formal education and have low incomes, are at greater risk of incarceration. These other factors are independent of mental illness and the mentally ill people are more likely to be arrested by the legal justice system due to these prevalent factors.
One of the study conducted in Australia showed that the increase in the number of arrested people with schizophrenia who were incarcerated after deinstitutionalization, was the result of the overall general increase in the arrest rates of general population and not primarily due to their psychiatric status ( Mullen, Burgees, et al., 2000).
It has also been observed that the lifetime arrest rates among the individuals with mental illnesses ranges from 40 to 52 % (Draine & Solomon, 1992). This figure may seem remarkable at first place but similar increase has been observed in the arrest rates of the general population. Research has also shown that psychiatric status of an individual is not a strong predictor of criminal recidivism, in fact there are many other factors which are strongly associated with crime and criminal acts ( Bonta, Law & Hanson,1998).
The relationship between crime and mental illness is a complex phenomenon. There are many other risk factors such as substance abuse, problems of unemployment and homelessness which  are involved in the occurrence of criminal behavior (Benda,1991).
·                     Joblessness
Joblessness or unemployment is another important social disadvantage among the mentally sick people. The labor force participation rate of people with mental illness has been found to be quite low i.e. 1.5 percent in 1985 to 27.2 percent in 1994 ( Trupin, Sebesta & Yelin, 1997).
Limited amount of research has been done on the work experiences of mentally ill persons during their lifetime. One of the study, which involved almost 300 people diagnosed with various mental problems, found that all the almost all the people has been competitively employed during their life time (McCrohan, Mowbray & Bybee,1994). Another study conducted on 100 young adults diagnosed with schizophrenia, showed that almost 85 % of the schizophrenics were able to maintain competitive job for more than 3 months during their lifetime (Test, Knoedler et al., 1994).
But if the situation is considered in the wider context of other socio demographic variables such as educational level of the mentally ill a complicated picture emerges. For example, data of one of the comorbidity study showed that if there is an early onset of mental illness, it adversely effects the educational achievements of an individual ( Kessler, Foster, et al., 1995).
Thus, this shows that there is a strong relationship between the mental illness and employment. If the symptoms of mental illness increase over a period of time it effects the educational attainment of an individual which in turn leads towards unemployment. In addition to this, race, sex, age, presence of any disability and the residence in the metropolitan city are some of the other factors that contribute towards the status of employment. These factors are independent of mental illness.


·                     Homelessness
The problem of homelessness among the mentally ill people was raised by media and researchers during 1980s (Bassuk, Rubin & Lauriat, 1984). Many of the carefully conducted studies which compared the housed and homeless people reported that mental illness is not one of the evident risk factor in becoming homeless. Multivariate studies conducted in Chicago, New York City, Worcester, Massachusetts and Buffalo on families and single adults showed no effect of mental illness or substance abuse on becoming homeless ( Bassuk, Buckner, et al.,1997; Toro,Bellavia et al.,1995).
This shows that homelessness is a more evident and pressing problem than mental illness. The people who are homeless are much more vulnerable to mental disorders including severe mental disorders than the population in general. When the problem of poverty becomes severe, homelessness occurs and it effects whole of the population in general and is not specific to the people suffering from any kind of mental illness.
Conclusion
Keeping in view all the studies and research, it becomes evident that mental illness in itself is not the cause of social disadvantages like crime, joblessness and homelessness. In fact, these problems arise due to poverty and the people who are already mentally ill are adversely affected by such problems. Social problems places adverse effects on whole of the population in general and are not only unique to the mentally ill population. Mentally ill people are just more adversely affected by such social problems and are over represented in the research literature and studies related to this topic.

References
Bassuk, E.L., Buckner, J.C., Weinreb, L.F., et al. (1997). Homelessness in female-headed families:childhood and adult risk and protective factors. American Journal of Public Health87:241–248.
Bassuk, E.L., Rubin, L. & Lauriat, A. (1984). Is homelessness a mental health problem? American Journal of Psychiatry 141:1546–1550.
Bonta, J., Law, M. & Hanson, K. (1998). The prediction of criminal and violent recidivism among mentally disordered offenders: a metaanalysis. Psychology Bulletin 123:123–142.

Benda, B.B. (1991). Undomiciled: a study of drifters, other homeless persons, their problems, and service utilization. Psychoso -cial Rehabilitation Journal 14:40–67.

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