Key tenets of the recovery model - optimism about recovery from schizophrenia, the importance of access to employment and the value of empowerment of user/consumers in the recovery process - are supported by the scientific research. Attempts to reduce the internalized stigma of mental illness should enhance the recovery process.

The results do not support the utility of a broad approach for an anti-stigma campaign, but rather suggest a more specific focus, such as perceived dangerousness.

Subjective and objective data are distinct types of information. Objective measures may be more suitable in detecting treatment effects. Subjective information is necessary to complete the QOL picture and to enhance the interpretation of objective data.

No abstract

People with serious mental illness no longer spend years of their lives in psychiatric institutions. In developed countries, there has been a major shift in the focus of care from hospitals into the community. However, whilst it means those with mental illness are not confined, it does not guarantee they will be fully integrated into their communities. The barriers to full citizenship are partly due to the disabilities produced by their illnesses and partly by stigmatising and discriminatory attitudes of the public. This book analyses the causes of these barriers and suggests ways of dismantling them. The book is constructed in two parts, the first relates to social inclusion and the second to occupational inclusion. Throughout, the text is annotated with quotes from consumers, to illustrate their experience of the issues discussed. The innovations outlined are described in sufficient detail for the reader to implement them in their own practice.

Substance use among a random sample of mentally ill, community-based patients was examined. Current use was found to have declined substantially from a high lifetime prevalence, and a family history of substance abuse was associated with moderate to heavy use. No association was found between heavy substance use and elevated psychopathology, hospitalization, or medication noncompliance. Hospital admissions and some symptoms were less prevalent among users preferring marijuana.

This study examines attitudes toward work, work incentives, and the impact of work on quality of life for people with schizophrenia, and investigates whether these findings differ among Western countries. We interviewed 24 randomly selected subjects with schizophrenia and schizoaffective disorder (12 employed and 12 unemployed) at each of three sites: Boulder, Colorado, United States; Berlin, Germany; and Berne, Switzerland. No significant differences were found in the subjects' attitudes toward work or subjective well-being, although Swiss patients had a higher cost-of-living-adjusted income. Unemployed subjects reported a lower subjective reservation (minimum financially worthwhile) wage than employed subjects in Berlin and Berne, whereas the reverse was true in Boulder. When subjects from all sites were combined, employed patients displayed less psychopathology and significant advantages in terms of objective and subjective measures of income and well-being: They were also more likely to stress the importance of work. The results suggest that work is associated with a markedly better quality of life for people with schizophrenia, but that disability pension programs in the United States might introduce work disincentives.

Labeling theory predicts that psychotic patients who accept the label of mental illness will function less well than those who reject their diagnosis. Accepted psychotherapeutic theory suggests the reverse. Two predictive models were tested. Results supported the central hypothesis of the psychotherapeutic model but not that of the labeling model, although some elements of the latter model were affirmed. Besides acceptance of diagnosis, an internal locus of control appears important for good outcome in psychosis.