CREST.BD Work & Bipolar Disorder Slides

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CREST.BDBipolar Wellness Center Webinars
Connect. Learn. Engage.

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Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
Work

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Connect. Learn. Engage.CREST.BDCREST.BD
Featuring: Dr. Raymond Lam
CREST.BD Member,
Professor and
Associate Head of Research,
Department of Psychiatry,
University of British Columbia,
Director of the Mood Disorders
Centre of Excellence,
UBC Hospital
@DrRaymondLam Work

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Defining work
Why work is important to your QoL
Work and BD
How you can take action
Webinar focus

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Defining work
Focus of webinar: relationship between paid work and QoL
Having a job is an important part of life for many people,
however, not everyone needs or wants one
Meaningful volunteer work, or other life roles (e.g.,
caregiving, parenting) can be equally important
Activities considered more important or less stressful may
be focused on
No one-size-fits-all prescription

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Why is work important to QoL?
Work can provide:
purpose and identity
feeling of competence
social support and networking
financial security and money for other important life
areas (e.g., leisure)
routine and structure

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Work and BD
Unemployment rates are
higher in people with BD than
in general population
Rates in BD may be inflated
BD associated with ‘workplace
under-performance’1
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Marwaha, S., Durrani, A. & Singh, S. (2013). Employment outcomes in people with BD: a systematic review. Acta
Psychiatrica Scandinavica, 128: 179-193.
40-60%
of people
with BD are
unemployed1

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Tse, S., Chan, S., Ng, K. L., & Yatham, L. N. (2014). Meta-analysis of predictors of favorable employment outcomes
among individuals with BD. Bipolar Disorders, 16(3): 217-229.
Work and BD: factors for success
good cognition
higher education
lower illness severity (e.g., being
hospitalized less frequently)
absence of comorbid conditions
(e.g., personality disorder)
ability to cope with
workplace stigma
good relationships at work

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good fit between the person with BD, the job and support
system
being in recovery from the mood episode2
Work and BD: factors for success
Successful re-entry into work after a mood episode linked to:
Factors related to success in the workplace broadly for people with
mental health conditions include:
regular assessment of mental health
actively working to maintain and improve mental health
striving to feel connected to others at work3
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Tse, S. & Yeats, M. (2002). What helps people with BD succeed in employment: a grounded theory approach. Work
(Reading, Mass.), 19: 47-62.
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Michalak, E. E., Yatham, L. N., Maxwell, V., Hale, S., & Lam, R. W. (2007). The impact of BD upon work functioning: A
qualitative analysis. Bipolar Disorders, 9(1): 126-143.

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Optimise BD treatments
Pharmacology a bedrock of treatment for many with BD
Pharmacology alone may be insufficient to flourish at work
Consider:
adjunct psychosocial treatments
occupational therapists offer a valuable resource

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Consider interventions designed to support people with mental
health challenges in the workplace:
‘supported employment’4, 5, 6
e.g., Individual Placement and Support (IPS) - “a direct, individualized
search for competitive employment that eschews prolonged preemployment
preparation, counseling, and training”
employee assistance programs
nonprofit organizations
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Campbell, K., Bond, G. R. & Drake, R. E. (2011). Who Benefits From Supported Employment: A Meta-analytic Study.
Schizophrenia Bulletin, 37: 370-380.
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Howard, L. M. et al. (2010). Supported employment: randomised controlled trial. British Journal of Psychiatry, 196:
404-411.
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Tse, S. (2002). Practice guidelines: therapeutic interventions aimed at assisting people with BD achieve their
vocational goals. Work (Reading, Mass.), 19: 167-179.

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Disclosure considerations
Disclosure of BD is a difficult decision, given reasonable concern that
employers will discriminate, and the possibility of negative attitudes from
co-workers
Supervisors and coworkers can be excellent sources of support when
workplace culture itself is supportive7,8
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Cross, W. & Walsh, K. (2012). BD - A Portrait of a Complex Mood Disorder (ed Dr. Jarrett Barnhill).
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Corrigan, P. W., Kosyluk, K. A. & Ruesch, N. (2013). Reducing Self-Stigma by Coming Out Proud. American Journal of
Public Health, 103: 794-800.
Employer responsibilities
People dealing health conditions have certain rights in the workplace
Disability and anti-discrimination laws protect the work rights of people
with BD

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Tools and Resources

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Resources
Web MD: Tips for Managing
Bipolar Disorder at Work
This site hosted by WebMD offers
a range of tips for managing BD at
work and practical suggestions on
topics such as: job performance,
disclosure, work schedules, leaves
of absence and the law.
http://www.webmd.com/bipolar-
disorder/guide/managing-bipolar-
disorder-at-work-job-performance-
tips

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Disclosure in the
workplace
Resources
Conceal or Reveal: A guide to telling employers about a mental
health condition
http://www.kcl.ac.uk/ioppn/depts/hspr/research/ciemh/cmh/CMH-Stigma-
Measures/CORAL-DA-Oct13-final.pdf

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Information for Employers
Employers’ guide to bipolar disorder and employment (UK)
http://www.bipolaruk.org.uk/assets/uploads/documents/information_leaflets/bipolar_uk_
employers_guide_to_bipolar.pdf
Accommodation and Compliance Series: Employees with BD (US)
http://askjan.org/media/Bipolar.html
Resources

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Resources
Mood FX
Monitor your mood on
your phone or PC
http://moodfx.ca/

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For more information and resources,
visit our Bipolar Wellness Center at:
http://www.bdwellness.com/
To assess your quality of life,
visit our QoL tool at:
http://www.bdqol.com/

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Acknowledgments

CREST.BD Work & Bipolar Disorder Slides

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