Findings are consistent with previous studies indicating that many people diagnosed with severe mental illness spend considerable time involved in sleep and passive leisure (Eklund et al., 2009
). During weekends, participants spent almost half the day sleeping and another quarter involved in passive leisure. While we did not collect data on a comparison group of general population participants, recent findings from the ATUS indicate that average Americans spend 10% of their weekdays watching television and roughly 34% sleeping (BLS, 2009
), both lower than the proportions found in the current study (17% and 40%, respectively). However, it is important to consider that general population estimates vary considerably by employment status and the presence of children in the home; in the ATUS, unemployed adults without children in the home reported spending 18% of their weekdays watching television and 37% sleeping, estimates similar to what we found (BLS, 2009
The current study sheds some light on factors that are associated with productive activity. DT participants spent roughly 10% more of their weekdays in productive activity than ACT participants. While this finding was attributable to involvement in mental health treatment as a “productive activity,” it is interesting to note that these participants also spent more time in productive activity on weekends, when the difference was accounted by more time spent eating and travelling, and less time watching television. It is possible that more active involvement during the weekday led to a “spill-over” into weekends.
Regarding clinical and demographic variables, only negative symptoms negatively predicted involvement in productive activity including treatment, while African-American ethnicity positively predicted productive activity excluding treatment. A prior study found that African-Americans with severe mental illness were more involved in organizations such as churches and social clubs (Wong, Nath, & Solomon, 2007
), suggesting that African-Americans living in predominantly African-American communities may have greater opportunities for social participation.
Limitations of the current study include the small sample size and limited generalizability, since the participants were predominately middle-aged African-Americans and some participants may have self-selected out of the study, so that study participants may not be representative of other mental health consumers. Despite these limitations, the present study suggests that structural factors, rather than “illness” factors (such as symptoms and diagnosis), may determine time-use. The extent to which treatment programs and local community resources impact opportunities for productive time-use needs to be studied further so that rehabilitation interventions can be tailored to increase such opportunities.