Unemployment, Mental Health and Substance Use

Unemployment rates among people living with mental health problems are incredibly high—even among people who want to work. Seventy to 90% of people living with serious mental illnesses in Canada are unemployed. Unemployment rates among people living with depression or anxiety can be over 30%. Research tells us that most people living with a serious mental illness want to work, but few do find work—and, often, the work doesn’t meet their goals or abilities. Even people with former substance use problems may have a hard time finding or keeping work because of stigma or discrimination.

On this page:

• The bigger picture
• What else do we know about employment and mental health?
• Why are some people with mental illnesses and former substance use problems unemployed?
• Is employment the only goal?
• What can I do about it?
• Where do I go from here?

The bigger picture

Unemployment is one of many factors that influence health. Other factors like housing, income and a lack of social support also have a huge impact on overall well-being. It’s also easy to see how these factors are related. Unemployment can lead to a low income, which can lead to poor housing, which can change social networks, which can limit access to social supports, and so on. All of these social factors are related to mental health and substance use. But this also means that positive changes—like meaningful employment—can help add to a livable income, decent housing and good social support. These can help promote health and well-being, help people recover from mental health problems, and help people avoid substance-related harms. Finding meaningful employment won’t solve all problems, but it’s a very important part of the bigger picture for many people.

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What else do we know about employment and mental health?

There is a lot of research that shows working can be an important part of well-being. Some of the benefits of work include:

• Income and financial stability, which are important parts of quality of life
• Daily routines and a sense of structure
• Social activities and social supports
• Personal achievement
• A sense of purpose
• A sense of status and identity

For people living with a mental illness, employment may bring a lot of well-being and may even help promote recovery. And studies show that people living with a substance use problem are more likely to seek help when they’re employed.

But we also know that not all jobs are good jobs—and not all jobs or workplaces are good for our well-being. The quality of work is very important. People living with mental illnesses are often left with minimum-wage jobs that offer fewer benefits and little job security, and may only have part-time, temporary or contract work. These types of jobs offer fewer opportunities to advance and are at particularly high risk as the economy changes.

Individual costs of unemployment

Unemployment also has a big impact on well-being. Studies found that unemployed people who received the same amount of income assistance as they earned when they worked still experienced a loss of well-being.  Here are some ways that unemployment, especially when you didn’t plan it, affects your well-being:

• Higher stress
• Lower self-esteem
• Fear about the future
• Social isolation
• Stigma
• Increased risk of problematic substance use
• Increased risk of a mental illness
• Worsening symptoms of a mental illness

Community costs of unemployment

Unemployment costs communities because people aren’t contributing to the economy. It costs the Canadian economy billions of dollars. But the cost of unemployment to a community is about more than money—it affects the well-being of the entire community. Some of these costs include:

• Lower life satisfaction across the entire community—as unemployment rates rise, people across an entire community feel less satisfied with their own quality of life, even those with jobs
• Rising health problems—a Canadian study found that a 10% rise in unemployment would increase number of people dying from heart disease by almost 2%. Suicide rates would go up by just under 1%, and just over 4% more people would be admitted to psychiatric hospitals

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Why are some people with mental illnesses and former substance use problems unemployed?

There are many reasons for high unemployment rates among people living with a mental illness. The symptoms of these health problems can make it difficult to work. Side effects of treatments and time spent on recovery may also affect work. And people with former substance problems may experience job loss or have problems when they look for work if they reveal that they’ve been in treatment. But there are bigger factors that affect unemployment. Lack of education or training, system-wide issues like laws, and discrimination also play a big part.

Lack of education or training

Mental illnesses and substance use problems may start to affect older youth and young adults, right around the time they finish high school or start post-secondary education like university. Some people may not finish their education or complete the skills training they need. In a study of people living with schizophrenia, finishing high school was the biggest predictor of future employment.

System-wide issues

The move from government assistance to paid work can be complicated. Rules around assistance like disability benefits can make it harder to do paid work than to continue receiving assistance. Finding a job may take away some of your assistance and it can affect added benefits like access to low-cost health care or low-cost public transit. Some people lose income by working and may feel “punished” for finding a job. And people who want to move to paid work may be pressured to accept any job—even if it’s a poor job—instead of a job that fits their needs.

Stigma and discrimination

Some employers may be reluctant to hire people living with a mental illness or people with a former substance use problem. But negative attitudes come from other places, too. Some mental health professionals don’t encourage people to work in order to avoid the stress of finding a job and working. Some people doubt their own abilities and believe that they can’t work or can’t handle the stress of work. These kinds of “low expectations” can add a lot of barriers to recovery and employment.

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Is employment the only goal?

Mainstream employment (permanent full-time work) may not be a goal for everyone. Some people find meaning from unpaid activities like volunteer work. Others find that part-time work is a good fit for them. And some people work during wellness but lessen their work responsibilities when they’re not feeling well. What’s important is choice.  Everyone’s end goal and journey to wellness is unique. But we do know that many people who want to work have a hard time finding meaningful work.

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What can I do about it?

Look at different employment programs

Many community organizations and agencies offer employment programs. Some offer unpaid work and focus on building skills and experience. Others offer paid positions and focus on securing permanent mainstream work. Here are a few examples that you might find in your community:

• Unpaid work experience or job trials—Short, unpaid job placements in an area that interests you. Job trials may help you gain current work experience and practice your skills. They may also be a good way to see if you’re ready to go back to work.
• Transitional employment—A series of different jobs that move from short-term, entry-level positions to a long-term job in a field that interests you. This may be a particularly good option for people that don’t have a lot of job experience or people who haven’t been in the workforce for a long time.
• Supported employment—A permanent, mainstream job with access to extra support if you need it. Supported employment believes that anyone can do meaningful work.

Volunteer

Many people who are unemployed for any reason find that volunteering is a good first step. These unpaid positions may be a good way to explore different kinds of work, refresh your job skills, build networks and boost your resume. They’re also a good way to rebuild self-esteem and ease into the workforce at your own pace. If you’re considering a volunteer position, it’s important to make sure you won’t be penalized for volunteer work by your assistance provider.

Learn to cope with unemployment

• Establish a daily schedule including a regular time for job search activities
• Set daily goals that you know you can accomplish. Go for a walk, go to the library or call a friend. Write your plan for the next day before you go to bed
• Keep busy and stay active outside your home. Isolating yourself at home will not get you a new job and can lead to additional stress
• Reward yourself on a regular basis for your efforts
• Pursue the hobby you always wanted to try
• Check into new career opportunities or the possibility of continuing your education
• Look into courses or other educational opportunities to keep your skills up-to-date

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Where do I go from here?

If you or someone you love is dealing with unemployment, it’s a good idea to talk to your doctor, mental health practitioner or mental health team. They may refer you to a program that fits your needs. Other places to find information include:

BC Partners for Mental Health and Addictions Information

Visit www.heretohelp.bc.ca for more info sheets and personal stories about working and unemployment and related issues like stigma and discrimination.

Open Door Group (formerly THEO BC)

Visit www.opendoorgroup.org or call 1-866-377-3670 for more information about training, education and job placement services for British Columbians living with disabilities.

Canadian Mental Health Association Employment Services Inventory

Visit www.cmha.bc.ca/how-we-can-help/adults/employment to access the Employment Services Database. The directory lists more than 4500 services from 540 agencies that can help you find employment supports in your community.

Ministry of Social Development, Employment and Assistance Programs

Visit www.gov.bc.ca/hsd for information on assistance programs, employment programs, help for people with disabilities, fact sheets and other publications.

Service Canada

Visit www.servicecanada.gc.ca for helpful information about income support, finding a job and upgrading your skills. You can also learn about your rights in the workplace.

Crisis lines aren’t only for people in crisis. You can call for information on local services or if you just need someone to talk to. If you are in distress, call 310-6789 (do not add 604, 778 or 250 before the number) 24 hours a day to connect to a BC crisis line, without a wait or busy signal. The crisis lines linked in through 310-6789 have received advanced training in mental health issues and services by members of the BC Partners for Mental Health and Addictions Information.

© 2014

This info sheet was prepared by CMHA BC Division on behalf of the BC Partners for Mental Health and Addictions Information and HeretoHelp. Funding was provided by BC Mental Health and Substance Use Services, an agency of the Provincial Health Services Authority. For more resources visit HeretoHelp.bc.ca