People with mental illness can become productive members of society, according to experts from three rehabilitation programs in Chicago, Philadelphia, and Boston. Each of these programs runs a federally funded Research, Rehabiliation and Training Center (RRTC) for adults with psychiatric illness.

Judith Cook, Ph.D., oversees the Mental Health Services Research Program in the department of psychiatry at the University of Illinois at Chicago. This program operates two research centers and several large-scale research projects studying mental health rehabilitation. Cook coordinates a five-year, $22 million study funded by the federal Center for Mental Health Services. The study, called the Employment Intervention Demonstration Program (EIDP) Coordinating Center, collects data on different vocational models taking place at eight sites throughout the U.S.

Although data collection ends for the study in March 2000, preliminary findings show that 58 percent of the more than 900 study participants worked at some point during the program. They earned more than $4.2 million, logging more than 793,000 hours, said Cook. She noted that these figures are particularly impressive considering that "national studies conducted from 1994 to 1998 indicate that at any point in time 58 percent to 65 percent of people with severe mental illness were either unemployed or not looking for work."

Matrix Research Institute and the University of Pennsylvania’s department of psychiatry operate the Rehabilitation and Research Training Center on Vocational Rehabilitation Services for Persons With Mental Illness. It focuses solely on mental illness and employment, explained Barbara Granger, Ph.D., Matrix’s director of training and dissemination division. The center, which is participating in the EIDP study, offers year-round training and sells numerous publications.

"Most—70 percent to 85 percent—of people with mental illness indicate they want to work. And if given employment opportunity, support, and encouragement, can do so," said Granger. However, they are thwarted by numerous barriers, she said.

Granger cited three such barriers based on Matrix’s research and current literature:

1. Many psychiatrists tell their patients they won’t have to work or can’t work because of their illness. To remedy this situation, the center published the curriculum "Training Psychiatric Residents to Recognize the Importance of Work for People With Serious Mental Illness," available on its Web site at <www.matrixresearch.org> under "Publications" and then "Vocational Rehabilitation."

2. Consumers are afraid of losing health care benefits provided by the government, particularly pharmaceutical coverage. Unfortunately, this is true even with the recent passage of the Work Incentive Improvement Act. The law will extend Medicare for an additional 4.5 years but doesn’t solve the problem of Medicare’s inadequate coverage of prescription drugs. There is a provision in the law that will provide modest funding to encourage states to provide more comprehensive Medicaid coverage to more people; however this is up to the discretion of the states so there is no guarantee the states will choose to enhance their existing prescription programs.

3. Many consumers have difficulty communicating with their employers. Specifically, they don’t know whether they should tell their employer about their mental illness, and if they decide to do so, they often don’t know how. To help them, Matrix has written a series of 15 brochures titled "Mental Illness and Work" and a handbook with the Bazelon Center for Mental Health Law, Mental Health Consumers in the Workplace: How the Americans With Disabilities Act Protects You Against Employment Discrimination. The handbook is scheduled for publication next month and information on receiving a copy will be featured on their homepage.

Boston University’s Center for Psychiatric Rehabilitation offers patients many services, including a one-year computer training program and one-on-one vocational rehabilitation. Furthermore, its new Recovery Center offers numerous courses, including "Personal Fitness Training" and "Job Seeking Seminar."

One of the Center for Psychiatric Rehabiliation’s projects is the Web site "Handling Your Psychiatric Disability in Work and School" at <www.bu.edu/SARPSYCH/jobschool/main.html>. The site states that "it is the only one designed exclusively to provide information about the Americans With Disabilities Act and other employment and education issues for people with psychiatric disabilities." Besides offering information on such topics as "What Laws Protect Someone With a Psychiatric Disability" and "Disclosing Your Disability to an Employer," the site has a list serve on handling mental illness at work or school.