RESEARCH WEEKLY: Impact of the COVID-19 Pandemic on Employment and Educational Outcomes of Individuals in a First-Episode Psychosis Clinic
By Morré Taylor
The COVID-19 pandemic has resulted in significant indirect outcomes, such as limiting employment and educational opportunities. These negative side effects of the pandemic have unique consequences for people experiencing first-episode psychosis (FEP), according to a recent research study published in Psychiatric Services.
The initial period after a psychotic episode is critical for early intervention and requires treatment that helps patients restore functional capacity, which can be accomplished, in part, through setting and achieving employment and educational goals. These recovery-oriented employment and educational goals, however, have been disrupted as a result of the pandemic and its impact on the economy. The millions of job losses and furloughs that have occurred because of the pandemic place a disproportionate burden on people with FEP who are at a high risk for unemployment due to the recency of their job tenures and stigma against people with severe mental illness in the workforce. The pandemic has also made it more difficult for people experiencing FEP to pursue their educational goals.
Study details
The authors of this study examined the potential effects of the COVID-19 pandemic on people experiencing FEP by examining the electronic health records of patients receiving care at McLean OnTrack, a first-episode psychosis clinic in Massachusetts. These researchers collected information on patients’ employment and educational statuses before the pandemic (from January 1 to September 21, 2019) and during the pandemic (from January 1 to September 21, 2020). Changes in employment and education were also observed relative to state emergency policy implementation dates. The researchers observed patients’ employment statuses before and after the implementation of the stay-at-home order on March 24, 2020 and changes in educational statuses were observed before and after March 16, 2020. These changes were then compared with the average changes in employment and educational engagement during the same week in 2019.
Results
The findings of the study show that the in the week of March 7, 2020, 41% of the patients at McLean were unemployed and that their unemployment status reached its peak of 71% in the week of May 17, 2020. Comparatively, the maximum unemployment rate in the entire state of Massachusetts during the week of May 17, 2020 was 22%. The researchers also found that in 2020, the average employment rate after the stay-at-home order was 33% lower than it was before the implementation of the order, compared to changes in employment during the same week before the pandemic in 2019.
The proportion of patients actively engaged in formal education also dropped during the early stages of the COVID-19 pandemic. The findings indicate that in 2020, patients’ average educational engagement after the stay-at-home order was an 29% lower than it was before the implementation of the order, compared to changes in educational engagement during the same week in 2019. Educational engagement, however, managed to recover in the fall of 2020 as indicated by the average proportion of patients engaged in an educational program in the week of September 21, 2020 (34%), which differs very little compared to the proportion of educational engagement during the same week in 2019 (37%).
Implications
Among this group of patients experiencing FEP, the researchers observed major job loss and disruptions in educational pursuits during the early stages of the COVID-19 pandemic. These findings are consistent with studies that demonstrate that disasters have a greater effect on populations who were considered vulnerable before the disaster occurred. Although this sample may not be representative of the national population of people experiencing first-episode psychosis, these findings should motivate FEP-based programs to offer employment and educational supports that are adaptable to the climate created by the pandemic so that, in the future, patients experiencing first-episode psychosis are able to successfully transition to remote working and learning.
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