Employment, education and youth with psychosis

In a group of youth with early psychosis, we found that for many patients, not having completed high school was indicative of psychosocial disability that began before the onset of psychosis and coincided with other mental health and/or substance use problems. Vocationally disengaged youths had greater difficulty accessing specialized early intervention services for psychosis, so they made more attempts to seek help but still had longer delays before getting help. Once in such services, they were eight times likelier to drop out if the service did not help them reintegrate into education or work. Unfortunately, our work has also shown that up to one-third of youth were unemployed/not in school even after five years of receiving specialized early intervention. This means we need specific interventions to support young people in pursuing and maintaining work and study goals.

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Our qualitative interviews highlighted the value of self-determination for youths with psychosis in returning to or continuing school or work, and the need for services to foster autonomy, relatedness and competence to facilitate returning and sticking to work and study.

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We believe that it is important to understand and question why we focus on what we do in the field of mental health. So, we are conducting a critical discourse analysis of pertinent documents on this topic (e.g., treatment guidelines, policy statements).  Critical discourse analysis involves ways to critically analyze texts to really unpack what is being told, why is it being told in that way, and what may be missing in these narratives. So, how do we as a field talk about why its important to focus on young people’s education and employment outcomes? Are our discourses about productivity or about purpose? This work has implications for practice and policy, particularly around ensuring that a focus on young people’s work and study is grounded in dignity and social justice.