in: Mental Health Europe Newsletter, No. 18 (autumn 1997), p. 10. This article first appeared in newsletter No.6 (Spring 1997) of the European Network of (ex-) Users and Survivors of Psychiatry. French translation


Mary Nettle
Employment Needs of People with Mental Health Problems

The current rate of unemployment for people with mental health problems is 70-80%. This, I feel, is not because people do not want to work, but that current work structures are not flexible enough to accommodate the up and down nature of peoples' emotional lives.

Prejudice (stigma) and ignorance means employers reject people with a history of mental illness. This causes people to lie about their medical history and therefore have no support if they need time off work often leading to them being dismissed from their job.

Particularly in Northern Europe the Social Security system provides a minimum income for people unable to work, but the rigid, inflexible way in which the rules are enforced can lead to what in the UK is called the Benefit Trap. This means that if you are able to get a job you have to give up all your benefit, which may be worth more than the job pays, and, if you find the job is too stressful and have to give it up, you spend a lot of time waiting, often with no money at all, to be able to get the level of benefit you had before.

In Canada people with mental health problems can be eligible for a disability pension, which is paid regardless of whether they are working or not. I feel that such a pension, guaranteed for life, would be a great help in reducing the stress levels associated with returning to work. It would not be a 'scroungers charter', as the pension would only be awarded to people who have been in the mental health system for some time.

In the UK we have a Disability Discrimination Act, which specifically includes people with a history of mental health problems. The equivalent act in the USA includes people with psychiatric disabilities. The criteria used to define disability varies according to individual experience. The way this experience is described varies from country to country. There is a debate within the mental health user movement as to whether we should consider ourselves to be disabled. Within the European Network of (ex-) Users and Survivors of Psychiatry, the definition of service user is left to the individual. This can be the same for a definition of disability. My view is that you are disabled if society treats you differently and there is no doubt this happens to us because of our mental illness label.

The European User Network established four principles in 1995.

  1. People experiencing psychosocial disabilities should enjoy equal opportunity and treatment in respect of access to, retention and advancement in paid employment which corresponds with their own informed choice and takes account of existing skills. In this principle, the rights of men and women experiencing psychosocial disabilities should be respected.
  2. Equality of opportunity for persons experiencing psychosocial disabilities shall extend to all levels of work organisation and management. This calls for respect for confidentiality of personal information.
  3. Every workplace should conform to standards established by the social partners ensuring a healthy and empowering work place.
  4. Special positive measures, such as wage subsidiaries and supported employment schemes, shall not be regarded as stigmatising nor discriminatory against other workers

The European Network of (ex-) Users and Survivors of Psychiatry is aiming to get these principles adopted in all countries and would welcome ideas.


(1) Mary Nettle is a self-employed mental health user consultant. She is on the editorial board of 'a life in the day' a journal about work and daytime opportunities for people who use mental health services. She is current chair of MINDLINK, the service user voice within 'Mind' Britain's largest mental health charity. Contact