Recovery and economy; salary and allowances: a 10-year follow-up of income for persons diagnosed with first-time psychosis

Alain Topor,Per Bülow,Claes-Göran Stefansson,Gunnel Andersson,Anne Denhov

doi:10.1007/s00127-019-01655-4

Abstract

PurposePersons with severe mental health problems (SMHP) point out financial strain as one of their main problems. De-institutionalisation in welfare countries has aimed at normalisation of their living conditions. The aim of the study was to follow the changes in income and source of income during a 10-year period for persons with a first-time psychosis diagnosis (FTPD).MethodsData were gathered from different registers. Data from persons with FTPD were compared to data on the general population. Two groups with different recovery paths were also compared: one group without contact with the mental health services during the last five consecutive years of the 10-year follow-up, and the other with contact with both 24/7 and community-based services during the same period.ResultsSMHP led to poverty, even if the financial effects of SMHP were attenuated by welfare interventions. Even a recovery path associated with work did not resolve the inequalities generated by SMHP.ConclusionsAttention should be paid to the risks of confusing the effects of poverty with symptoms of SMHP and thus pathologizing poverty and its impact on human beings. Adequate interventions should consider to improve the financial situation of persons with SMHP.

Highlights

The de-hospitalisation process in most Western countries was partly motivated by the miserable living conditions that the patients were subjected to in the “total institutions” [1]
The study population could be considered as a total population from the catchment area, as privately financed psychiatric services directed towards persons with a psychosis diagnosis are non-existent in Sweden
Sources of income according to recovery paths population in Stockholm, a difference appears from the start

Summary

Introduction

The de-hospitalisation process in most Western countries was partly motivated by the miserable living conditions that the patients were subjected to in the “total institutions” [1]. A core concept for the subsequent changes in the organisation of mental health care services was “normalisation”. The consequences of the downsizing of in-patient care institutions have been mostly described in terms of trans-institutionalisation from mental hospitals to prisons and boarding houses [3,4,5] and abandonment [6, 7]. The great majority of persons with severe mental health problems (SMHP) remained outside the labour market, and their economic status and living conditions sometimes worsened even if they managed to work [8]

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