Mental Illness and Employment.

Comments on an article by Sturm and Lipton, and the article they are commenting on, by Rothaus, Cleveland and Johnson (see record 1964-02889-001). Sturm and Lipton criticize the study by Rothaus, Hanson, Cleveland and Johnson (the current authors) on the grounds that employment of psychiatrically discharged patients is controlled by personnel directors and not by employment interviewers. In our study we had found it advantageous for the psychiatric patient seeking employment to describe his recent hospitalization as a learning experience designed to aid him in coping with the problems of living rather than alluding to his hospitalization as treatment or a cure for illness. Using the former approach, ex-psychiatric-patients were judged by employment interviewers of the Texas Employment Commission as being more readily employable than patients using the mental-illness approach. But Sturm and Lipton complain that we were working with the wrong people since only personnel directors and employers do the direct hiring. In Texas at least, this is not necessarily so. The authors also comment on other criticisms of Sturm and Lipton. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized controlled trial comparing two vocational models for persons with severe mental illness.

The authors compared 2 approaches to vocational rehabilitation for individuals with severe mental illness: the individual placement and support (IPS) model of supported employment and the diversified placement approach (DPA), which emphasizes work readiness and offers a range of vocational options, including agency-run businesses and agency-contracted placements with community employers. In all, 187 unemployed participants with severe mental illness were randomly assigned to IPS or DPA. Over 2 years, IPS had significantly better competitive employment outcomes than DPA. Competitive employment rates over the 2-year follow-up were 75.0% for IPS and 33.7% for DPA. However, IPS and DPA did not differ on paid employment outcomes. The authors conclude that IPS is more effective than DPA in achieving competitive employment, but not paid employment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preparedness for progress.

The extensive problems of mental illness are reviewed. "Either we must develop new kinds of mental health personnel or we must develop new skills in the personnel we already have. This is no longer a pious statement; it is an absolute necessity in the imminence of approaching events." Problems involved in training specialists are considered. Efforts must be made "to identify those areas in which our skills… can be useful." Efforts should be made "to find answers to social needs where our contribution can be effective" and we must "accept responsibility for handling the wide range of truly psychiatric problems, whether or not they fit our individual preferences." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On pseudoscience in science, logic in remission, and psychiatric diagnosis: A critique of Rosenhan's "On being sane in insane places".

Argues that D. L. Rosenhan's (see record 1973-21600-001) report on normal persons who posed as psychiatric patients is pseudoscience presented as science. Just as his pseudopatients were diagnosed at discharge as "schizophrenia in remission," so a careful examination of this study's methods, results, and conclusion leads to a diagnosis of "logic in remission." Rosenhan's study proves that pseudopatients are not detected by psychiatrists as having simulated signs of mental illness. This rather unremarkable finding is not relevant to the real problems of the reliability and validity of psychiatric diagnosis and only serves to obscure them. A correct interpretation of these data contradicts the conclusions that were drawn. In the setting of a psychiatric hospital, psychiatrists seem remarkably able to distinguish the "sane" from the "insane." (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

More on pseudoscience in science and the case for psychiatric diagnosis. A critique of D.L. Rosenhan's "On Being Sane in Insane Places" and "The Contestual Nature of Psychiatric Diagnosis"

Rosenhan's 1973 article, "On Being Sane in Insane Places," was pseudoscience presented as science. Just as his pseudopatients were diagnosed at discharge as having "schizophrenia in remission", so a careful examination of this study's methods, results, and conclusions leads to a diagnosis of "logic in remission." Rosenhan's study proves that pseudopatients are not detected by psychiatrists as having simulated signs of mental illness and that the implementation of certain invalid research designs can make psychiatrists appear foolish. These rather unremarkable findings are irrelevant to the real problems of the reliability and validity of psychiatric diagnosis and only serve to obscure them. A correct interpretation of his own data contradicts his conclusions. There are purposes to psychiatric diagnosis that Rosenhan's article ignores. His more recent suggestion that certain requirements be met prior to the adoption of a new psychiatric classification system is unrealistic.     

Rejoinder to Robert F. Morgan's review of psychobattery.

The present author applauds Robert F. Morgan's stated efforts in his review (see record 2007-04428-001) of the author's book, Psychobattery, (1981) to form "an ombudsman group to improve professional practice and protect the consumer." However, the present author does not approve of Morgan's inability to interpret straightforward statements in Psychobattery. He first seems to have completely missed the point that the book is about serious mental illness; essentially schizophrenia and bipolar and unipolar affective diseases. If Morgan were more interested in reviewing Psychobattery, instead of ventilating his prejudices in favour of unproved treatments by unqualified personnel, perhaps he would have mentioned the chapter of "The Biological Basis of Mental Illness." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comment on Kiesler's "Public and Professional Myths…"

Contends that C. A. Kiesler (see record 1983-24077-001) has drawn too many inferences based on incomplete and inaccurate analyses in his article on public and professional myths about mental hospitalization. Specifically, the present authors differ with Kiesler's contention that mental hospitalization is increasing, his implicit assumption that episodes of mental disorder in general hospitals without psychiatric units are equivalent to those in general hospitals with such units, and his comparison of effects of hospitalization for mental illness vs alternate modes of care. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relation between speaking times and decision in the employment interview.

Is a job applicant more likely to be hired if the personnel interviewer does the most talking? "A sample of 115 employment interviews conducted by six Army personnel officers was examined. The applicant was accepted by the interviewer in 70 cases and rejected in 45 cases. From a recording of each interview measures were taken of the time the applicant spoke, the time the interviewer spoke, and the total time. The time vacant of speech was determined by subtracting the speaking times from the total time of the interview… . The interviewer influences both the amount the applicant talks and the amount of the time free of speech that accumulates during the interview. The amount the interviewer talks appears to be directly related to his decision to accept an applicant." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Orthodoxy at the employment table.

Comments on the article by Mark A. Stewart about the employment practices of psychiatrists (Amer. J. Psychiat., 1960, 117, 85). Thinking that the evil he finds in the employment practices of psychiatrists is a local matter, Stewart comments: "We would surely be amused, or horrified, if biology teachers were required to be 'evolutionists,' or if psychologists had to be 'behavioristically oriented'." Whether or not psychiatrists will be amused or horrified to find that their predicament is shared by psychologists, so far the reaction of psychologists to the policy of buying orthodoxy at the employment table has been blank. The question is raised by Stewart whether or not "requiring applicants to subscribe to a particular theory may be an unfair employment practice, and as such could be challenged in the courts." Regardless of the legal niceties, I believe that a loyalty oath to the theory of psychoanalysis has about as much relevance as inquiry into whether or not the candidate has submitted himself to ritual circumcision, tattooing, or an appendectomy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Hartford Study of Supported Employment for Persons With Severe Mental Illness.

The authors compared 3 approaches to vocational rehabilitation for severe mental illness (SMI): the individual placement and support (IPS) model of supported employment, a psychosocial rehabilitation (PSR) program, and standard services. Two hundred four unemployed clients (46% African American, 30% Latino) with SMI were randomly assigned to IPS, PSR, or standard services and followed for 2 years. Clients in IPS had significantly better employment outcomes than clients in PSR and standard services, including more competitive work (73.9% vs. 18.2% vs. 27.5%, respectively) and any paid work (73.9% vs. 34.8% vs. 53.6%, respectively). There were few differences in nonvocational outcomes between programs. IPS is a more effective model than PSR or standard brokered vocational services for improving employment outcomes in clients with SMI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Heterogeneity in Youth Symptom Trajectories Following Psychiatric Crisis: Predictors and Placement Outcome.

The authors examined heterogeneity in symptom trajectories among youths following psychiatric crises as well as the psychosocial correlates and placement outcomes associated with identified trajectories. Using semiparametric mixture modeling with 156 youths approved for psychiatric hospitalization, the authors identified 5 trajectories based on symptoms over the 16 months following crisis: high improved, high unimproved, borderline improved, borderline unimproved, and subclinical. Membership in unimproved symptom groups was associated with less suicidality, younger age, more youth hopelessness, and more caregiver empowerment. Improved symptom group membership predicted long-term decreases in days in out-of-home placements. More important, and in contrast with general impressions from the existing literature, findings suggest that a substantive proportion of youths with serious emotional disturbance sustain high levels of symptomatology following intensive mental health services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Beliefs about mental illness as a functon of psychiatric status and psychiatric hospitalization.

Beliefs about mental illness were assessed among psychiatric inpatients at a VA hospital, the mental health staff responsible for their treatment, and a group of medical and surgical (control) patients. Results indicated that: (a) Psychiatric and nonpsychiatric patients generally hold similar opinions regarding mental illness. Severely disturbed psychiatric patients, however, view mental illness in more moralistic terms than do "normals." (b) Psychiatric hospitalization is generally accompanied by a change in the patient's beliefs concerning mental illness, toward those held by the staff. (c) Psychiatric patients whose beliefs about mental illness are most strikingly influenced by the staff tend to respond most favorably to treatment, as measured by length of hospital stay and gains in self-esteem during the 1st month of treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental illness stigma and the fundamental components of supported employment.

Purpose/Objective: The success of supported employment programs will partly depend on the endorsement of stigma in communities in which the programs operate. In this article, the authors examine 2 models of stigma--responsibility attribution and dangerousness--and their relationships to components of supported employment-help getting a job and help keeping a job. Research Method/Design: A stratified and randomly recruited sample (N=815) completed responses to a vignette about "Chris," a person alternately described with mental illness, with drug addiction, or in a wheelchair. Research participants completed items that represented responsibility and dangerousness models. They also completed items representing 2 fundamental aspects of supported employment: help getting a job or help keeping a job. Results: When participants viewed Chris as responsible for his condition (e.g., mental illness), they reacted to him in an angry manner, which in turn led to lesser endorsement of the 2 aspects of supported employment. In addition, people who viewed Chris as dangerous feared him and wanted to stay away from him, even in settings where people with mental illness might work. Conclusions/ Implications: Implications for understanding supported employment are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Theory and problems of adolescent development.

Reviews "Theory and problems of adolescent development," by David P. Ausubel (see record 1955-00581-000). Unlike most other books in this area, this book offers a systematic presentation of psychological knowledge woven around a dynamic point of view. It is a scholarly book written in language that makes for easy and interesting reading. The author opens his book with an organized set of arguments designed to convince his readers that there is justification for a book on the "Psychology of Adolescent Development." His major premise states that "adolescence is treated as a separate developmental period not because it covers a decade but because it spans an interval in which distinctive changes occur in a biosocial status of the human organism. The author has marshaled his psychological knowledge and psychiatric experience into a well-organized book. Dr. Ausubel quotes freely from other authors and from his own writings and research. There are extensive references contained in the bibliography at the end of each chapter. Although the author states that "this book is primarily intended as an advanced textbook in adolescent psychology for graduate students in psychology and education," it would appear that this book is written with sufficient clarity and nontechnical language to be used in any college course dealing with adolescent behavior. It would be especially desirable in clinically-oriented courses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Employment psychology: The interview.

Reviews the book "Employment psychology: The interview" by Roger M. Bellows and M. Frances Estep (see record 1955-01632-000). This text was "written for professional interviewers and for students of applied psychology who desire to become acquainted with the uses and limitations of the interview in selection of personnel." At the outset, the authors list requirements of self-training aimed at helping the interviewer to become more proficient. The emphasis then throughout the text is that the selection interview using the so-called talking methods alone lacks validity and utility. More objective selection material must be used in conjunction with the interview if selection is the goal. The reviewer would have liked to see discussed such related topics as occupational information and attitudes, age differences in job values, and pertinent information from the counseling field pertaining to the degree of leads various interviewers use. The presentation would have been more stimulating and complete, but it is well worth reading regardless. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A criticism of Rosenzweig's Babel.

Comments on the article "Operation Babel: A survey of the effectiveness of the foreign language requirements for the PhD degree in psychology" by S. Rosenzweig et al (Amer. Psychologist, 1962, 17, 237-243; see record 1963-04105-001). While interesting and stimulating to the amphitheater spectator, the aforementioned article was not a complete success. The current authors believe that the data collected by Rosenzweig do not lead to his conclusions. If his data are to support his philosophy, then another exploratory operation is deemed advisable. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A replication and extension of "Physical attractiveness and mental illness."

A. Farina et al (see record 1978-23202-001) investigated the relation between mental illness and physical attractiveness and found that female psychiatric inpatients were less attractive than normal controls. The current study extended this investigation in 2 ways. First, 28 psychiatric inpatients were compared to 3 separate control groups of 53 low, middle, and high socioeconomic status Ss. Mental patients were judged significantly less attractive than either middle- or high-income controls but were not significantly different from low-income controls. Second, to examine physical attractiveness prior to hospitalization, attractiveness ratings of the patients' high school yearbook pictures were compared with ratings of the adjacent same-sex photographs. Patients' photographs were judged significantly less attractive than their peers' even in high school. Findings suggest that being physically unattractive may predispose an individual to a number of negative social outcomes, one of which is mental illness. (5 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How employment helps female victims of intimate partner violence: A qualitative study.

This exploratory, qualitative study documents ways in which being employed is helpful to victims of intimate partner violence (IPV). The authors conducted in-depth interviews with 21 women employed by a large health care organization in a major U.S. city. Through content analysis, the authors identified six ways in which employment was helpful to participants: by (1) improving their finances, (2) promoting physical safety, (3) increasing self-esteem, (4) improving social connectedness, (5) providing mental respite, and (6) providing motivation or a "purpose in life." Findings suggest that employment can play a critically important, positive role in the lives of IPV victims. The importance of flexible leave-time policies and employer assistance to IPV victims is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)