Living and Working with Serious Mental Illness

Photo courtesy of Marjorie Baldwin, Ph.D.

Life has a funny way of testing one’s mettle.

Marjorie Baldwin, then professor at East Carolina University, never imagined her years of research in employment discrimination toward those with disabilities would turn personal.

Yet that’s exactly what happened fourteen years into her career when her son was diagnosed with schizophrenia. Baldwin’s work as a health economist expanded to include discrimination against workers with mental illness.

Today, as a professor at Arizona State University in the W. P. Carey School of Business, her research in employment discrimination, especially those with mental health disorders, has garnered international attention and a grant from the National Institute of Mental Health (NIMH).

Back in 1999 when her son’s strange behavior led to a mental health crisis, hospitalization, and a diagnosis of schizophrenia, Baldwin was completely blindsided. Like so many other families, she knew little about mental illness.

“Everyone is clued into knowing drugs are dangerous, but not to signs and symptoms of mental illness,” she said.

Baldwin found herself donning two hats. One as a mother with a son afflicted with a serious mental illness (SMI) and another as a researcher looking to understand the ramifications of SMI, and what it might mean for her son’s future.

“I grieved for the son I had lost,” she said, then delved into the subject matter as a researcher. She discovered that mental illness stereotypes remained formidable within the workplace, educational institutions, and even the healthcare sector.

Through her research and lived experience with a son who had schizophrenia, three key societal stereotypes emerged toward those with SMI: 1) dangerous to others; 2) responsible for their illness; and 3) incompetent in the workplace.

Dangerous to Others

The first stereotype reared when Baldwin and her husband arrived at the hospital after their son’s initial psychotic break. The parents were greeted by two administrators. The first administrator wanted to make sure her son, David, was covered by insurance. The second had papers for the parents to sign that would immediately withdraw David from school.

“At the time, I thought, ‘How nice of them to have all the paperwork put together,’” she said, referring to the withdrawal documents. “But what I didn’t understand at the time was it would be not so nice and not so easy to get my son readmitted.”

David withdrew from school in the spring, went home, and responded well to medication. He stabilized enough for his doctor to approve David’s return to school on a part-time basis. The dean of students saw it differently and demanded David go before a hearing of faculty that lasted two-to-three hours. Her son was permitted to have others testify on his behalf, including his doctor and case manager. His parents also were present.

When it was Baldwin’s turn to speak, she said, “If you’d like, we can talk about my son’s rights under federal laws for education and employment for people with disabilities under the Americans with Disabilities Act. I have done my research on the subject.”

Then she spread out all her articles on the table in front of the faculty and said, “But I’d rather not talk about his rights. I’d rather talk about why he deserves to be back in school.”

After the hearing, Baldwin returned to her son’s apartment. Thirty minutes later the school called to confirm his reinstatement with one caveat—he could not live on campus.

Baldwin accepted the terms feeling hurt and angry because she knew why. The school believed David was a danger to others.

Her research said otherwise. It said that those in remission or on medication were not likely to be dangerous to others. In fact:

The vast majority of violent crimes (95-99%) were not committed by individuals with SMI.

Males between 15 and 24 were more likely to commit acts of violence than those with SMI (17% versus 12%).

Individuals with SMI were more likely to be victims of violent crimes, and for those with schizophrenia the number was 12 times the norm.

Most people with SMI are more dangerous to themselves.

After reviewing these statistics, Baldwin commented, “So maybe what colleges should be concerned about are the males on their campuses.”

Responsible for Their Illness

As David made plans to return, Baldwin reached out to disability services on campus for assistance. That’s when stereotype number two came out from behind the curtain—responsible for one’s illness.

When Baldwin explained the situation, the disability counselor said, “If he is not ready to return to school fulltime, he shouldn’t return.” To which Baldwin responded her son had approval from the school to do so on a part-time basis.

The counselor replied, “Well, when your son got in trouble.”

Baldwin shot back, “My son did not get in trouble, he got sick,” and with that she never spoke to the department again.

Baldwin was appalled that someone in disability services behaved in such a manner. This person had bought into the myth that mental illness was something a person should be blamed for. That it was David’s fault, she said.

She discovered that the stereotype of blame was so deep, even those afflicted with SMI believed they were responsible for their illness.

“Imagine thinking that way about physical illness,” Baldwin said. “I am embarrassed because I have pneumonia. I am disappointed in myself for getting pneumonia. That doesn’t make sense.”

The truth is SMI is a biological brain disorder. Researchers who have done scans on individuals with SMI can see a difference in the brain. The brain chemistry is not the same. Research has proven it is no one’s fault.

These encounters and her son’s efforts to recover gave Baldwin a different lens on homelessness. She no longer saw the people in the street as beggars or lazy. Baldwin saw within these destitute souls the same behavior she witnessed in her son. She understood this could be her son, and she took to heart the plight of those around her.

Incompetence

David graduated from college in 2001, and Baldwin’s research emphasizes that finishing college or any level of higher education is especially meaningful for those with mental health disabilities. This accomplishment can lead to a greater sense of self-worth, competitive pay, and competitive employment. At the time David graduated, he was stable, taking his medications, and living on his own. He had a job and his life looked hopeful.

So much so that his parents moved to Arizona and Baldwin took a position at Arizona State University. Then David went off his meds, ran up his credit cards, lost his job, and had an altercation with a roommate that landed him in jail. Baldwin found a disabilities lawyer to help her son and posted bail. It gave Baldwin the necessary leverage to move David to Arizona to live with them and help him recover.

The road back wasn’t easy. Even as David stabilized, the rest of his life was a mess. Exhaustion and uncertainty took hold of Baldwin as well. She didn’t know if she had the strength to help David rebuild his life. Together they went to see his case manager and that’s when the third stereotype factored in. This one happened to be right in Baldwin’s wheelhouse— incompetent to hold a competitive job.

Mother and son met with an elderly counselor to discuss employment. She offered David a job collecting coins from a vending machine. The woman saw a mentally ill person and decided this was the only job David could do.

“My research showed this was wrong,” Baldwin said.

In her NIMH research, she surveyed 800-plus workers with SMI and found they were in competitive jobs earning greater than $20 per hour for three-plus years. These were individuals from all walks of life—lawyers, nurses, bakers, analysts.

David’s mother knew the truth behind the research and hoped her son would find his future. The road was difficult. The lows were deep. Both questioned if he would have a future.

All the while, David held on to one sentence his doctor had said, “You can recover from this.” Those words gave him hope.

David overcame all three stereotypes. He recovered, married, has three children, and has a successful career as a handyman.

Baldwin acknowledges that her son is fortunate. That outcomes vary for those with serious mental illness. Yet she emphasizes no one should give up, and to not let these stereotypes and discrimination prevent anyone from finding gainful employment. There are those with serious mental illness who have succeeded.

As for David, when making arrangements for his wedding, he asked his mother what music she’d like for the mother-son dance.

Baldwin knew right away, “To Dream the Impossible Dream.”

Marjorie Baldwin is the author of Beyond Schizophrenia: Living and Working with a Serious Mental Illness.