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BACKGROUND: Severe mental illnesses lead to deterioration in the life skills of the patient, resulting in socio-occupational dysfunction and low rates of employment. The purpose of this study was to explore attitudes, knowledge, and barriers to employment as experienced by patients and their caregivers in India. METHOD: Patients with schizophrenia or bipolar affective disorder, aged between 18 and 60 and undergoing inpatient treatment and their caregivers, were approached for written informed consent and recruited for focus group discussions. A total of eight focus groups were conducted until saturation of themes was seen to have been achieved. The data were transcribed, coded, synthesized, and organized into major findings and implications for practice. RESULTS: Role expectations based on gender were seen to influence the decision to work. The possible recurrence of illness due to excess stress and unsupportive working environments was cited as the most common problem that could arise related to employment. Stigma and faulty attributions related to the illness were the most cited barriers to employment. Most participants felt that psychosocial rehabilitation and family and community support were essential for facilitating work. Most participants did not consider mental illness as a disability and were unaware of government schemes for the mentally ill. CONCLUSION: Considering gender-based role expectations, avenues for self/family employment and improving the awareness of benefits for mental illness both among consumers and health care professionals are essential to enhance economic productivity in people with severe mental illness.
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