Labor inclusion and medicalization: neuroleptics as actants in the experiences of workers diagnosed with schizophrenia in Chile

Resumen

People diagnosed with schizophrenia exhibit low rates of labor market participation, a phenomenon that has been predominantly addressed from biomedical approaches that associate work inclusion with pharmacological stabilization. However, there is limited research examining how the everyday use of neuroleptics shapes the work experiences of those employed with this diagnosis. The aim of this study was to understand the role of neuroleptics — conceived as actants — in the experiences of workers diagnosed with schizophrenia in Chile and their implications for labor inclusion. A qualitative ethnographic study was conducted between 2022 and 2024 in the Metropolitan Region of Chile, including participant observation across diverse everyday and workplace settings, as well as 86 interviews (53 with workers diagnosed with schizophrenia and 33 with individuals from their close environment). Drawing on actor-network theory and the notion of enactment, the analysis identified that the diagnosis and the neuroleptic become assembled as a lifelong practice, configuring an experience marked by tensions. Although medications are valued for alleviating distress, their assemblage with diagnosis and their side effects — sedation, motor disturbances, salivation, weight gain, and affective flattening — mediate the body, the psyche, and social life, hindering work performance and exposing individuals to stigma and discrimination.