Can schizophrenics be given jobs?

Union minister Maneka Gandhi’s recent statement doubting the ability of schizophrenia patients to work has attracted a lot of criticism. Social media was flooded with posts by those suffering from schizophrenia and those working closely with them, about how they have been successfully holding jobs for years. We speak to psychiatrists and find out if a schizophrenic patient is fit to work and decode more about the mental disorder.

‘Not all schizophrenic patients can work’

“Schizophrenia patients believe something that is  not real. There are two stages — remission and relapse. Relapse is the acute stage where all symptoms are present and remission is a period where they are asymptomatic. So the psychiatrist tries to maintain the remission stage by giving medicines. If the patient is in chronic stage, you cannot expect them to work,” says Dr Preethi Swaroop, a consultant psychiatrist and secretary of Hyderabad Psychiatric Society.

He adds, “When a person is stressed, it triggers excessive production of dopamine, which in turn triggers hallucination. A schizophrenic will hear voices that are non existent… voices discussing, voices arguing and he reacts to them as well by communicating back. So a person with schizophrenia should never take up a stressful job. They do get the job but they are unable to sustain the pressure.”

Dr Prabhakar Korada, professor of psychiatry, TRR Institute of Medical Science, agrees and adds, “I have patients who suffer from schizophrenia. Not that they don’t get jobs, they do. But they come back and say that they are not able to adjust, that their colleagues are plotting against them.  

“They can take up routine jobs which are not sensitive, definitely not something in the defense or firearms field. They could think that people are attacking him and he could in turn start attacking and hurt others.”

Mental stigma

“There is still a mental stigma attached to it. If you tell your colleagues that you are suffering from schizophrenia but you are under medication and are stable, he is probably not going to talk to you again,” says Dr K. Prashant, consultant psychologist, Yashoda Hospitals, Somajiguda.

He adds that there are many examples of people suffering with schizophrenia who have made it big in their respective careers, taking John Nash, a Nobel laureate in Economics, as an example.

Says Dr Prashant, “I have many patients who suffer with schizophrenia and have been doing good in their respective lives. One of my patients is an MD of a company. When he first came to me, he was very depressed. He started psychotherapy and he is doing wonderful now. What the person himself does to deal with the symptoms also helps a lot. I also have another gentleman who is a surgeon and is doing very well.” Dr Preethi Swaroop adds that not many schizophrenics report to doctors because of the mental stigma.

“Because of the stigma attached to it, the cases we see in India are just the tip of the iceberg. I conduct regular camps at the Kowkur dargah in the city and Kondagattu temple in Karimnagar. I find many schizophrenics there. They think that there is a bad omen and that’s why they have to go to a religious place to get cured and so they don’t approach psychiatrists.”

‘It’s a good idea to give them job’

Adds Dr Prashant, “Giving them a job is a very good idea. But remember that they cannot take stress. There should be someone supervising them who is gentle and kind. I have people in the IT field who have schizophrenia. I don’t know how long they are able to last because it is one of the worst places to be for a schizophrenic. They need a place where they would meet people who are not rude or mean to them. You can’t predict their thoughts and feelings at that time. We mostly give schizophrenics antipsychotics and one of the side effects of this is that you don’t see any emotion. They look very dull. The reason is because it stops all thoughts and because of that they don’t have emotions as well. We can’t stop just the negative thoughts, so we try to stop all thoughts.”

He continues, “The work they do must be therapeutic. It must be something that helps them feel better about themselves, gives them strength and a sense of identity. The problem with that is when they share their thoughts, people at work are going to react. They need to be in a place where people around are cared for, understood and supportive.”

“You don’t have to mention about your illness unless you are specifically asked. If so, you can disclose that you are suffering from schizophrenia but stable to work. They may ask you to get a certificate from a doctor stating that you are fit to work. Unless you are asked, it is your right to withhold the information. Unless doing the job is going to be dangerous to others’ lives,” adds Dr Prabhakar.