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Labor Issues Affect Mental Healthcare Patients and Providers, Too

September 04, 2019

My impression is that most people like Labor Day the most for it being a day off to enjoy with family on a long weekend, right as we plow back into the stress of school and work after a more casual summertime. Often forgotten, or perhaps not even known, Labor Day celebrates the American labor movement specifically.

In recent times, organized labor has been decreasing in its presence and power in the United States. Only about 10% of workers are now in a union, according to a new Gallop poll, yet the over 60% approval by Americans of organized labor is at its highest. This suggests that the population values organized labor, but that businesses do not.

For those of us working in mental healthcare, the American labor movement may largely have seemed irrelevant. Psychiatry and many other mental healthcare disciplines could not —or would not—be part of any organized labor union. Perhaps that was not so important in the past, but it very well may be now. Why?

Medicine and mental healthcare have become big businesses in the last decade or two. Along the way, healthcare workers have had to follow new demands that seem to put business priorities, especially profits, over health ethics, compromising our ideal of helping patients to the limits of our ability. Moreover, clinicians are often not engaged in deciding what should be done in the systems they work in. The result? Epidemic rates of burnout in psychiatrists and other healthcare disciplines. Burnout seems to sap our souls and reduce quality of care.

Our patients have another sort of labor challenge. Due both to their illness and mental health stigma, finding appropriate work has been a major challenge. Probably the Fountain House “clubhouse” model does that best in guiding the more seriously ill to satisfying work. Indeed, recent research indicates that being involved as clubhouse members substantially reduces costs for their treatment services, thereby producing both business goals and improved healthcare outcomes.

Patients have also found some work as peer counsellors in our workplaces. They often serve as a support for other patients and a bridge to caregivers. When mental healthcare professionals also have their own publicly disclosed mental illness, they are called prosumers. However, there is still great reluctance to professionally self-disclose such information due to anticipated - and often real - adverse consequences in licensing and job security.

Thus, Labor Day may now actually have significant and unique meaning for our mental healthcare workplaces. Long ago, Freud stated that satisfying work and love were the bookends of life. As we return to work this week after the Labor Day holiday, let’s consider joining together in formal and informal mental health labor movements in order to make our labor more rewarding for our administrators, caregivers, and patients.

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