Work and recovery from schizophrenia in India: a mixed methods study in Kerala

ABSTRACT Background According to the WHO, people diagnosed with schizophrenia in developing countries recover more fully than people with the same diagnosis in developed countries. At a time when international organizations are attempting to scale up biomedical psychiatric interventions in India and other low-income countries, it is important to understand why a place like India is doing better in recovery from serious psychosis. Method Interviews of 20 people diagnosed with schizophrenia in Kerala, India were conducted to determine level of functioning and quality of worklife. Quantitative assessments of the relations between these factors were undertaken along with qualitative, ethnographic analysis of narratives of interviewees. Results Analysis of interviews shows that quality of worklife is correlated with higher functioning among this group, and service user narratives claim that work enabled their recovery. Comparisons to other research further indicates that people in India with this diagnosis are more often employed than people with the same diagnosis in the United States and Europe. Discussion Employment and the quality of worklife appear to be positively related to recovery in terms of increasing functionality among people diagnosed with schizophrenia in this part of India. Certain employment programs and sociocultural factors likely contribute to differences in outcome.