Mental illness and employment discrimination.
OBJECTIVE
Work is a major determinant of mental health and a socially integrating force. To be excluded from the workforce creates material deprivation, erodes self-confidence, creates a sense of isolation and marginalization and is a key risk factor for mental disability. This review summarizes recent evidence pertaining to employment-related stigma and discrimination experienced by people with mental disabilities. A broad understanding of the stigmatization process is adopted, which includes cognitive, attitudinal, behavioural and structural disadvantages.


RESULTS
Stigma is both a proximate and a distal cause of employment inequity for people with a mental disability who experience direct discrimination because of prejudicial attitudes from employers and workmates and indirect discrimination owing to historical patterns of disadvantage, structural disincentives against competitive employment and generalized policy neglect. Against this background, modern mental health rehabilitation models and legislative philosophies, which focus on citizenship rights and full social participation, are to be welcomed. Yet, recent findings demonstrate that the legislation remains vulnerable to the very prejudicial attitudes they are intended to abate.


CONCLUSIONS
Research conducted during the past year continues to highlight multiple attitudinal and structural barriers that prevent people with mental disabilities from becoming active participants in the competitive labour market.
Stuart
Heather
H
Department of Community Health and Epidemiology, Queen's University, Kingston, Ontario, Canada. hh11@post.queensu.ca
D004651:Employment / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology*; D011287:Prejudice; D013240:Stereotyping; D014481:United States / Q000453:epidemiology