Recovery From Schizophrenia: Psychiatry And Political Economy

HEALTH, ILLNESS AND THE ECONOMY 49Figure 2.4 Age-specific suicide rates per 100,000 population for white, American Indianand other non-white groups in the USA, 1969 and 1971 averageSource: National Institute of Mental Health, Suicide, Homicide and Alcoholism among AmericanIndians, Washington, DC, Department of Health, Education and Welfare, 1973committed suicide versus those who did not: both studies found an associationbetween unemployment and suicide for men. 131 In many cases it is clear thatunemployment and job instability is a result of poor physical or mental health; 132but we should not expect a simple one-way relationship. Impaired performanceor loss of work role may well damage self-esteem and increase hopelessness anddepression. The central role of the workplace in this relationship for those whoare employed is revealed by the repeated finding that suicide (like sudden cardiacdeath) is most common on Mondays, declining in frequency as the weekprogresses. 133It is clear that the job market and the economy have a direct and decisiveimpact on our patterns of living, our view of ourselves and our emotions. Sincethis is so, we might reasonably expect the economy to influence the onset ofserious mental illness and to affect the rate of admission to psychiatric hospital.MENTAL HOSPITAL ADMISSIONSThe first comprehensive attempt to estimate the effect of the economy on mentalhospital admissions was Harvey Brenner’s Mental Illness and the Economy, publishedin 1973. 134 Earlier researchers had studied the variations in hospital admissions