Supported employment models with high levels of integration of psychiatric and vocational services were more effective than models with low levels of service integration.

Research has shown that supported employment programs are effective in helping psychiatric outpatients achieve vocational outcomes, yet not all program participants are able to realize their employment goals. This study used 24 months of longitudinal data from a multisite study of supported employment interventions to examine the relationship of patient clinical factors to employment outcomes. Multivariate random regression analysis indicated that, even when controlling for an extensive series of demographic, study condition (experimental versus control), and work history covariates, clinical factors were associated with individuals' ability to achieve competitive jobs and to work 40 or more hours per month. Poor self-rated functioning, negative psychiatric symptoms, and recent hospitalizations were most consistently associated with failure to achieve these employment outcomes. These findings suggest ways that providers can tailor supported employment programs to achieve success with a diverse array of clinical subpopulations.

Context: Family members of adults with mental illness often experience emotional distress and strained relationships.Objective: To test the effectiveness of a family-led educational intervention, the Journey of Hope, in improving participants' psychological well-being and relationships with their ill relatives.Design and Setting: A randomized controlled trial using a waiting list design was conducted in the community in 3 southeastern Louisiana cities.Participants: A total of 462 family members of adults with mental illness participated in the study, with 231 randomly assigned to immediate receipt of the Journey of Hope course and 231 assigned to a 9-month course waiting list.Intervention: The Journey of Hope intervention consisted of 8 modules of education on the etiology and treatment of mental illness, problem-solving and communication skills training, and family support. Main Outcome Measures:Participants' psychological well-being and relationships with their ill relatives were assessed at study enrollment, 3 months after enrollment (at course termination), and 8 months after enrollment (6 months after course termination). Mixed-effects random regression analysis was used to predict the likelihood of decreased depressive symptoms, increased vitality, and overall mental health, and improved relationship ratings.Results: Intervention group participants reported fewer depressive symptoms, greater emotional role functioning and vitality, and fewer negative views of their relationships with their ill relatives compared with control group participants. These improved outcomes were maintained over time and were significant (PϽ.05 for all) even when controlling for participant demographic and relative clinical characteristics. Conclusion:Results show that family-led educational interventions are effective in improving participants' psychological well-being and views of their relationships with ill relatives.

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Participation in family-led education interventions, such as the Journey of Hope, may provide families with the information they need to better cope with their relative's mental illness.