Recovery From Schizophrenia: Psychiatry And Political Economy

258 WORKthe consumption of psychiatric treatment is more than ten times as great. Ifconsumers could participate in providing these services, the potential forimproving their financial and work situation would be considerable. Aninnovative program that trains mental health consumers with long-term mentalillness to work as service providers within the mental health system will bedescribed in the next chapter.Another large area of consumption by the mentally ill is accommodation. Ifconsumers were cooperative property owners instead of tenants, this could be animportant form of economic advancement. The possibility of developing housingcooperatives for the mentally ill will also be addressed in the next chapter.ECONOMIC DISINCENTIVES TO WORKThe interviews with the mentally ill people in Boulder, Colorado, made itapparent that there are serious financial disincentives to work. For example, theincome and benefits of mentally ill people in Boulder who work part-time add upto little more than for those who are unemployed. Part-time workers earn morethan the unemployed, but receive less from Social Security, food stamps andbenefits. This amounts to what economists term an “implicit tax”—and in oursurvey, for part-time workers, it amounted to 64 per cent of earned income.Thus, someone working part-time for minimum wage (at that time $4.25 anhour), would actually have kept, in real terms, $1.57 an hour. 42 This person’s caseillustrates the situation:Jennifer, a 28-year-old single woman with schizoaffective disorder, wasreceiving a Supplemental Security Income (SSI) pension of $409 (£255) amonth. She took a 25-hour-a-week job as a teacher’s aide for developmentallydisabled children, earning $6.63 an hour. In so doing, her SSIdropped by $315 a month, she lost $17 a month in food stamps, and herrent subsidy went down by $143. Now that she was working, she could nolonger stop at her parents’ house and eat lunch every day, and she was oftentoo tired to go there to eat at night: as a result, the cost of her food andmeals went up by $110 a month. Overall, she found herself ahead by nomore than $73 a month. The decision to continue in the job became based,therefore, not on economic gains, which were insignificant, but on theopposing factors of stress and self-esteem. Initially, because the disabledpupil to whom she was assigned was so difficult, she decided she wouldquit; when she was given an easier child to work with, however, sheresolved to continue in the job. Without an analysis of her economicsituation, her ambivalence about working would not have appeared asrational as, in fact, it was, and might have been blamed on schizophrenicapathy, deficits in functioning or just plain laziness. 43