What do you know about schizophrenia?
If you’re like many, popular culture has greatly defined your understanding of this condition. You may think people with schizophrenia are violent, constantly having delusions, unable to accomplish anything meaningful, and best left alone.
But few movies or memes show what it’s really like to experience schizophrenia and how someone with the disorder can live a rich, full life.
Research shows that rates of violence for people with schizophrenia are actually lower than other mental health disorders. And risk factors for violence, including prior history of violence and substance abuse in individuals without mental health conditions, are the same for those with any type of mental health condition.
As a therapist, I’ve been working with people diagnosed with schizophrenia for over 15 years. An HR leader is an important gateway and key to the successful employment and retention of an individual with schizophrenia.
Here are some of the things I wish HR leaders knew.
What is schizophrenia?
Schizophrenia is a mental health disorder that is marked primarily by psychosis. While hallucinations—seeing, hearing, or feeling things that aren’t present—and delusions—fixed, false beliefs—are common, people with the condition can also experience reduced motivation, motor impairment, cognitive impairment, and difficulty with relationships.
Schizophrenia usually manifests early in life, between adolescence and early adulthood, although symptoms can start to develop in childhood. The condition may have a genetic component: people with family members who have a history of schizophrenia are six times more likely to be diagnosed with the disorder.
Living and working with schizophrenia
While schizophrenia is one of the top 15 leading causes of disability worldwide, with medication, social support, and other accommodations, people with the condition can and do work, raise families, and live relatively normal lives outside of episodes.
You may be surprised to learn that comedian Darrel Hammond, writer, artist, and 1920s fashion symbol Zelda Fitzgerald, and former pop star Aaron Carter were all diagnosed with schizophrenia, and were still able to build highly successful careers in the spotlight.
Top four myths about schizophrenia
Schizophrenia isn’t a common condition, which is one of the reasons it’s so misunderstood.
According to Johns Hopkins, 1% of the population worldwide has been diagnosed with schizophrenia. In comparison, 18% have panic disorder, 2.6% have bipolar disorder, and 9.5% have depression.
Because it’s relatively rare, there are many myths about schizophrenia that could make employers hesitant to hire affected individuals. Here are the top four.
False: People with schizophrenia are violent
Popular culture often portrays people with this disorder as violent. But multiple studies show that violence is not a defining marker in this population.
A study of 1,435 participants with schizophrenia found that every 19 out of 20 people had no incidence of violence during a two-year period. Risk factors for becoming violent are drug use and being a victim of recent violence.
However, people with schizophrenia do sometimes harm themselves. The lifetime suicide rate is approximately 10%.
False: Schizophrenic episodes always involve delusions
Schizophrenic episodes aren’t always dramatic events, and in truth, the disorder and symptoms manifest in a variety of different ways.
One person with the condition may go in and out of delusions. Another may have long episodes involving hallucinations. Someone else may experience catatonia or abnormal body movements.
False: People with schizophrenia can’t work
Schizophrenia can be a very disabling condition. However, depending on how the condition manifests, with appropriate support, people with schizophrenia can and do work. With the right accommodations, working can play a vital role in stabilizing symptoms.
In fact, individuals with schizophrenia want to work. They can succeed in the workplace if they’re matched with a job that reflects their interests, strengths, and what they’re naturally good at—and if they have the right workplace accommodations.
Examples of reasonable accommodations include working from home, allowing a flexible work schedule, regular breaks, a quiet space to work, and sick leave.
False: Medication is the only thing that is effective
People with schizophrenia require multiple pillars of support to manage the condition. While medication can be effective, significant social support, meaningful work and activities, and routines all help make the condition less disabling.
Schizophrenia in the workplace
Currently, about 10-15% of people with schizophrenia are in the workforce, but 70% would like to be working. Understandably, misperceptions of the disorder can make it very difficult to get (and sometimes keep) a job.
And yet, with the right role, people with schizophrenia can contribute greatly to an organization’s success, just like any other employee.
But there are a few important things that HR leaders need to know.
Hiring a person with schizophrenia
Schizophrenia is a protected condition under the Americans with Disability Act (ADA). Like with any candidate, HR and hiring managers need to decide if someone with schizophrenia has the right qualifications for the role and can do the job with reasonable accommodations.
Schizophrenia affects each person in a different way. To be fair to an individual presenting with this or any disorder, hiring personnel would need to give them a fair chance.
Generally, individuals with schizophrenia often have difficulty engaging in teamwork, and using the executive functioning skills of goal setting and focusing that are needed in most workplace settings. These factors can keep otherwise qualified individuals with the disorder from getting and keeping a job, and also result in credibility issues.
And yet, with reasonable accommodations (those that don’t impinge on workflow or require global changes), people with schizophrenia can be highly productive.
For example, consider a programmer who is really good at her job. But when she’s in a psychotic episode, she’s not functional.
In her case, reasonable accommodations could include working with her treatment provider to determine (and avoid) potential triggers in the workplace, providing a quiet place to work, or even allowing her to work in a room by herself, so she doesn’t have to constantly interact with other people.
How to talk about schizophrenia in the workplace
If you’ve hired someone with schizophrenia, that information must remain confidential. However, if the employee opts to share their diagnosis with others, you may want to provide additional education about the condition.
If employees feel scared or uncertain, consider sharing:
- Information about what schizophrenia really looks like and the many false beliefs about it
- Strategies and accommodations that are in place to ensure workflow isn’t disrupted
- How to recognize a schizophrenic episode and what to do. For example, the employee may sit and stare or freeze and his preference is that you leave him alone during this time.
- With permission, the employee’s history with schizophrenia. For example, “She’s had this condition since she was 16 and is not dangerous to herself or others. She was able to go to college and graduate and appreciates being left alone in her office to work.”
Consider, too, sharing these helpful resources about schizophrenia to build understanding and empathy:
Offering a mental health benefit
Mental health support from employers has become increasingly important for all employees, and this is especially true for people with schizophrenia. Fast access to therapy and medication management is critical to identify what triggers episodes and how to reduce and even stop them.
Offering a mental health benefit can also encourage conversations about disorders in the workplace, providing more information about what’s actually true, reducing stigma, and increasing compassion.
Read this blog next to learn how to see employees with bipolar disorder through a new lens.