Şizofreni Tanısı Almış Bireylerin İstihdamı

Öz

İstihdama katılım, çoğu zaman şizofreni tanısı konulan bireylerin psikososyal iyilik hali üzerinde olumlu bir etkiye sahiptir. Şizofreni tanısı konulan bireylere yönelik farklı ülkelerin istihdam modelleri incelendiğinde, her bir ülkenin birbiri ile benzeşen ve farklılaşan uygulamalara sahip olduğu ifade edilebilir. Bu uygulamalardan korumalı istihdam ve kota, Türkiye’de şizofreni tanısı konulan bireylerin istihdamında en yaygın olarak uygulanan yöntemlerdir. Ancak ilgili alanyazın, bu bireylerin istihdama katılımları önünde bireysel (eğitim düzeyi, hastalık seyri, ilaç kötüye kullanımı), toplumsal (ayrımcılık, damgalanma, sosyal dışlanma) ve yasal engellerin (spesifik politika düzenlemelerinin olmaması) olduğunu göstermektedir. Bu çalışmada şizofreni tanısı konulan bireylerin bu alanda yaşadıkları sorunları ortaya koymak, istihdama katılımlarını artırmaya ve istihdamda sürekliliklerini sağlamaya yönelik çeşitli öneriler sunmak amaçlanmaktadır.

Anahtar Kelimeler

• şizofreni
• istihdama katılım
• istihdam modelleri,

Employment of Individuals Diagnosed with Schizophrenia

Abstract

Employment participation often has a positive effect on the psychosocial well-being of individuals diagnosed with schizophrenia. When the employment models of different countries for individuals diagnosed with schizophrenia are examined, it can be stated that each country has similar and different practices. Quota and sheltered employment are the most common methods which are used in the employment of individuals diagnosed with schizophrenia in Turkey. However, based on the literature, it is seen that there are individual (education level, disease prognosis, drug abuse), social (discrimination, stigmatization, social exclusion) and legal obstacles (lack of specific policy arrangements) to these individuals’ participation in employment. This study aims to reveal the problems experienced by individuals diagnosed with schizophrenia in this area. Besides, another aim of this study is to offer various suggestions for increasing their participation in employment and ensuring their continuity in employment.

Keywords

• employment
• schizophrenia
• employment models

Kaynakça

1. 65 Yaşını doldurmuş muhtaç, güçsüz ve kimsesiz Türk vatandaşlarına aylık bağlanması hakkında kanun (1976) https://www.mevzuat.gov.tr/MevzuatMetin/1.5.2022.pdf (30 Mart 2020'de ulaşıldı).
2. Aile, Çalışma ve Sosyal Hizmetler Bakanlığı (2020) Engelli ve Yaşlı İstatistik Bülteni. https://ailevecalisma.gov.tr/media/42250/istatistik-bulteni-2020-mart.pdf (20 Nisan 2020’de ulaşıldı).
3. Bejerholm U, Björkman T (2010) Empowerment in supported employment research and practice: Is it relevant?. Int J Soc Psychiatry, 57(6):588-595.
4. Bevan S, Gulliford J, Steadman K, Thomas TT, Moise A (2013) Working with Schizophrenia: Pathways to Employment, Recovery & Inclusion. The Work Foundation.
5. Bond G, Drake R, Becker D (2008) An update on randomized controlled trials of evidence-based supported employment. Psychiatr Rehabil J, 31(4):280-290.
6. Can Öz Y, Ünsal Barlas G (2017a) Şizofrenili bireylerde istihdamın önemi. JAREN, 3:46-50.
7. Can Öz Y, Ünsal Barlas G (2017b) Şizofreni hastalığı olan bireylerin işe yerleştirme ile ilgili görüşleri ve beklentileri: niteliksel bir çalışma. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi, 3(3):28-32.
8. Can Öz Y. (2016) Şizofreni hastalığı olan bireyleri işe yerleştirme ile ilgili görüşler ve beklentiler: hasta, ailesi ve işverenler (Doktora tezi). İstanbul, Marmara Üniversitesi.

9. Çakır H (t.y.). Engellilere Yönelik İstihdam Politikaları. https://www.akademikkaynak.com/engellilere-yonelik-istihdam-politikalari.html (2 Nisan 2020’de ulaşıldı.)
10. Drake RE (2018) Employment and schizophrenia: three innovative research approaches. Schizophr Bull, 44(1):20-21.
11. Drake RE, Bond GR (2014) Introduction to the special issue on individual placement and support. Psychiatr Rehabil J, 37(2):76-78.
12. Drake RE, Bond GR, Goldman HH, Hogan MF, Karakus M (2016) Individual placement and support services boost employment for people with serious mental illnesses, but funding is lacking. Health Aff, 35(6): 1098-1105.
13. Engelliler hakkında kanun (2005) https://www.mevzuat.gov.tr/MevzuatMetin/1.5.5378.pdf (30 Mart 2020'de ulaşıldı).
14. Evans, J, Repper, J (2000) Employment, social inclusion and mental health. J Psychiatr Ment Health Nurs, 7:15-24.
15. Evans J, Wilton R (2019) Well enough to work? Social enterprise employment and the geographies of mental health recovery. Ann Am Assoc Geogr, 109(1):87-103.
16. Evensen S, Wisløff T, Lystad J, Bull H, Ueland T, Falkum E (2015) Prevalence, employment rate, and cost of schizophrenia in a high-ıncome welfare society: A population-based study using comprehensive health and welfare registers. Schizophr Bull, 42(2):476-483. doi: 10.1093/schbul/sbv141
17. Greve J, Nielsen LH (2013) Useful beautiful minds - an analysis of the relationship between schizophrenia and employment. J Health Econ, 32:1066-1076.
18. Harrison J, Gill A (2010) The experience and consequences of people with mental health problems, the impact of stigma upon people with schizophrenia: a way forward. J Psychiatr Ment Health Nurs, 17: 242-250.
19. Haro JM, Novick D, Bertsch J, Karagianis J, Dossenbach M, Jones PB (2011) Cross-national clinical and functional remission rates: worldwide schizophrenia outpatient health outcomes study. The Br J Psychiatry, 199:194-201.
20. Hooley J (2010) Social factors in schizophrenia. Curr Dir Psychol Sci, 19(4): 238-242.
21. Işık I, Savaş G, Kılıç N (2019) Şizofreni hastalığına sahip bireylerin çalışma hayatı konusunda yaşadıkları güçlükler. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 10(3): 399-408.
22. İş Kanunu (2003) https://www.mevzuat.gov.tr/MevzuatMetin/1.5.4857.pdf (30 Mart 2020'de ulaşıldı).
23. Johnson‑Kwochka A, Bond GR, Becker DR, Drake RE, Greene MA (2017). Prevalence and quality of individual placement and support. Supported Employment in the United States. Adm Policy Ment Health, 44:311-319.
24. Krupa T (2004) Employment, recovery, and schizophrenia: integrating health and disorder at work. Psychiatr Rehabil J, 28(1):8-15.
25. Kurt E (2008) Türkiye’de psikiyatrik rehabilitasyonla ilgili yasal düzenlemeler. Anadolu Psikiyatri Dergisi, 9(1):51-57.
26. Leufstadius C, Eklund M, Erlandsson L (2020) Meaningfulness in work – Experiences among employed individuals with persistent mental illness. Work, 34:21-32.
27. Lord J, Hutchison P (1993) The process of empowerment: implications for theory and practice. Can J Commun Ment Health, 12(1):5-22.
28. Macia C, DeCarlo LT, Wang Q, Frey J, Barreira P (2001) Work interest as a predictor of competitive employment: policy implications for psychiatric rehabilitation. Adm Policy Ment Health, 28(4):279-297.
29. Marshall M, Lewis S, Lockwood A, Drake R, Jones P, Croudace T (2005) Association between duration of untreated psychosis and outcome in cohorts of first-episode patients: a systematic review. Arch Gen Psychiatry, 62: 975-983.
30. Marwaha S, Johnson S. (2004) Schizophrenia and employment: a review. Soc Psychiatry Psychiatr Epidemiol, 39:337-349.
31. Marwaha S, Johnson S, Bebbington P, Stafford M, Angermeyer MC, Brugha T et al. (2007) Rates and Correlates of Employment in People with Schizophrenia in the UK, France and Germany. Br J Psychiatry, 191:30-37.
32. McGurk SR, Mueser KT (2006) Cognitive and clinical predictors of work outcomes in clients with schizophrenia receiving supported employment services: 4-year follow-up. Adm Policy Ment Health & Ment Health Serv Res, 33:598-606.
33. Nordentoft M, Jeppesen P, Petersen L, Bertelsen M, Thorup A (2009) The rationale for early intervention in schizophrenia and related disorders. Early Interv Psychiatry, 3:53-57.
34. Nygren U, Markstrom U, Svensson B, Hansson L, Sandlund M (2011) Individual placement and support – a model to get employed for people with mental illness – the first Swedish report of outcomes. Scand J Caring Sci, 25: 591-598.
35. OECD. (t.y.). Good mental health throughout life. https://www.oecd.org/health/health-systems/Mental-health-Facts-and-Figures.pdf (16 Mart 2020’de ulaşıldı.)
36. Organisation for Economic Co-operation and Development (2013) Mental Health and Work: Sweden, Paris, OECD Publishing.
37. ÖSYM Web Sitesi (2020) EKPSS 2019 yerleştirme sonuçlarına ilişkin sayısal bilgiler. https://dokuman.osym.gov.tr/pdfdokuman/2019/EKPSS/TERCIH/sayisalbilgiler09012020.pdf (2 Nisan 2020’de ulaşıldı).
38. Rosenheck R, Leslie D, Keefe R, McEvoy J, Swartz M, Perkins D et al. (2006) Barriers to employment for people with schizophrenia. Am J Psychiatry, 163:411-417.
39. Schizophrenia Commmission (2012) The abandoned illness: a report by the schizophrenia commission. https://www.rethink.org/media/2303/tsc_main_report_14_nov.pdf (28 Ocak 2020'de ulaşıldı).
40. Steadman K (2015). Working with schizophrenia: Employment, recovery and inclusion in Germany. http://www.theworkfoundation.com/wpcontent/uploads/2016/11/384_Schizophrenia_Germany.pdf (20 Nisan 2020’de ulaşıldı).
41. Sosyal Sigortalar ve Genel Sağlık Sigortası Kanunu (2006) https://www.mevzuat.gov.tr/MevzuatMetin/1.5.5510.pdf (30 Mart 2020'de ulaşıldı).
42. Şen M (2018) Türkiye’de engellilere yönelik istihdam politikaları: sorunlar ve öneriler. Sosyal Güvenlik Dergisi, 8(2):129-152.
43. Thornicroft G (2014) Toplumun Reddettiği: Ruhsal Hastalığı Olan İnsanlara Karşı Ayrımcılık (Çeviri Ed. H. Soygür). Ankara, İmaj Yayınevi.
44. Tsang H, Pearson V (2001) Work-Related social skills training for people with schizophrenia in Hong Kong. Schizophr Bull, 27(1): 139-148.
45. Tsang H, Tam P, Chan F, Cheung W (2003) Stigmatizing attitudes towards individuals with mental illness in Hong Kong: Implications for their recovery. J Community Psychol, 31(4): 383-396.
46. TÜİK (2011) Özürlülerin Sorun ve Beklentileri Araştırması. Ankara, TÜİK.
47. Türkiye Cumhuriyeti Anayasası (1982) https://www.mevzuat.gov.tr/MevzuatMetin/1.5.2709.pdf (30 Mart 2020'de ulaşıldı).
48. Türkiye İş Kurumu Web Sitesi (2018) Yıllık istatistik bültenleri. https://www.iskur.gov.tr/kurumsal-bilgi/istatistikler/ (2 Nisan 2020’de ulaşıldı).
49. Twamley EW, Vella L, Burton CZ, Becker DR, Bell MD, Jeste DV (2012) The efficacy of supported employment for middle-aged and older people with schizophrenia. Schizophr Res, 135(1-3): 100-104.
50. Uşan MF (2003). Mesleki eğitim ve istihdam, devlet personel rejimi ve iş mevzuatı. http://acikerisim.ybu.edu.tr:8080/xmlui/handle/123456789/789 (18 Mart 2020'de ulaşıldı).
51. Üçok A, Gorwood P, Karadayı G (2012) Employment and its relationship with functionality and quality of life in patients with schizophrenia: EGOFORS Study. Eur Psychiatry, 27(6):422–425. doi:10.1016/j.eurpsy.2011.01.014
52. Waghorn G, Chant D, King R (2005) Work-related subjective experiences among community residents with schizophrenia or schizoaffective disorder. Aust NZJ Psychiatry, 39(4): 288-299. doi: 10.1080/j.1440-1614.2005.01567.x
53. Weinberg D, Shahar G, Davidson L, McGlashan TH, Fennig S (2015) Longitudinal associations between negative symptoms and social functioning in schizophrenia: the moderating role of employment status and setting. Psychiatry, 72(4): 370-381.
54. Whitley R, Drake RE (2010). Recovery: a dimensional approach. Psychiatr Services, 61:1248-1250.
55. Yıldız M, Kaytaz Yılmaz B, İncedere A, Abut F, Aydın A, Sarandöl A, et al. (2019) Rates and correlates of employment in patients with schizophrenia: A multicenter study in Turkey. Int J Soc Psychiatry, 65(3): 235-243. doi: 10.1177/0020764019839082
56. Zaprutko T, Kus K, Bilobryvka R, Rakhman L, Goder R, Michalak M et al. (2015). Schizophrenia and employment: evaluation from professionals point of view. Psychiatr Q, 86(4):569-79.