Suffering from mental illness doesn’t preclude holding a high-level, demanding job, according to a recent study by Boston University’s Zlatka Russinova, Ph.D., and Marsha Langer Ellison, Ph.D.

The researchers surveyed a nonrepresentative sample of 501 people with mental illness who worked as lawyers, managers, engineers, physicians, nurses, and other high-level professionals. The participants included top executives such as Robert Boorstin, a former health policy advisor to President Bill Clinton and most recently a senior advisor to the Secretary of the Treasury. Almost all the participants were Americans; 21 were from other countries.

Russinova and Ellison are senior research associates at the Center for Psychiatric Rehabilitation, which is affiliated with the Department of Rehabilitation Counseling at Boston University’s Sargent College of Health and Rehabilitation Sciences. The study was presented at the Annual Conference of the International Association of Psychosocial Rehabiliation Services last spring in Minneapolis.

Of the 501 participants, over 20 percent earned $50,000 a year, 36 percent earned over $40,000; 73 percent were employed full time. Eighty-eight percent were on psychotropic medications, and 78 percent had been hospitalized for psychiatric illness, 25 percent in the last three years.

"We’re not saying that everyone will recover [from mental illness]; however, our findings suggest that psychiatrists should communicate that recovery is possible and that working at a high-level job is possible," said Russinova. "Our findings also suggest that mental health professionals should reexamine the predominant belief that people with severe mental illness are best suited for low-wage, menial jobs."

She pointed out that many subjects reported being told by psychiatrists at their initial diagnosis or in later sessions that they had a very serious mental condition and most likely wouldn’t be able to work.

Almost half—43.5 percent—of the 456 participants who reported their illness had bipolar illness. Of the remainder, 29 percent had major depression, 11.5 percent schizophrenia/schizoaffective disorder, 10 percent PTSD or dissociative identity disorder, and 6 percent anxiety or other disorders.

Yet they were successful in a wide range of fields: Half of the unrepresentative sample (50.3 percent) worked in the mental health field (including positions in self-help and advocacy organizations), ranging from psychology to peer counseling. The other half (49.7 percent) worked in "nonhelping professions," such as engineering and accounting (33.5 percent), and in helping professions other than mental health, such as medicine and nursing (16.2 percent).

Russinova pointed out, "Perhaps mental health professionals should expand substantially their efforts to rehabilitate consumers to work beyond the mental health field because these findings show that consumers can work successfully in other occupations as well."

Participants attributed their job tenure to their job-related skills and performance (56 percent), their own drive and willpower (53 percent), and their ability to manage their condition so it did not affect work (50 percent).

To cope with on-the-job stress, they took breaks, relied on medication, and received support from their spouse or partner and/or psychiatrist or therapist. In addition, many found it helpful to modify their daily duties (49 percent) and their schedule (33 percent). Often this flexibility came with the job itself and did not have to be requested.

Most (86 percent) had revealed their mental illness at their workplace, and in doing so they negotiated for the following accommodations: flexibility in work hours (19 percent), modified work schedule (18 percent), number of hours worked (15 percent), and extra feedback or supervision (15 percent).

Finally, of this 86 percent, 63 percent had few or no regrets in revealing their illness.

"Our findings suggest that consumers should be directed to those professions and jobs that offer flexibility in duties and scheduling in terms of hours, days at work, and working at home. Jobs that don’t offer flexibility make it much more difficult for consumers to cope with the challenges that their psychiatric condition presents," said Russinova.

The study was funded by a grant from the National Institute on Disability and Rehabilitation Research and the Center for Mental Health Services.