Predictors of Employment for People With Mental Illness: Results of a Multicenter Randomized Trial on the Effectiveness of Placement Budgets for Supported Employment

Rössler, Wulf; Ujeyl, M.; Kawohl, Wolfram; Nordt, Carlos; Lasalvia, Antonio; Haker, Helene; Hengartner, Michael Pascal

doi:10.3389/fpsyt.2019.00518

Cited by 9 publications

(9 citation statements)

References 22 publications

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“…Our results further indicated that psychosocial functioning and chronic physical illness could have an influence on the working status. The influence of psychosocial functioning and mental illness on work is in line with other studies [ 28 – 30 ]. In a 5-year prospective, longitudinal study based on a sample of 529 individuals with SMI who met criteria for sustained competitive employment at study entry, more than half of the participants experienced work interruptions during the follow-up period.…”

Section: Discussionsupporting

confidence: 90%

Predictors of competitive employment in individuals with severe mental illness: results from an observational, cross-sectional study in Germany

Gühne

Pabst

Kösters

et al. 2022

J Occup Med Toxicol

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Background Employment is of great importance as it is associated with various positive effects. Individuals with severe mental illness (SMI) are often excluded from competitive employment. Current data on employment of individuals with mental illness are rare, and influencing factors are under-researched. The present study examines possible predictors of competitive employment among individuals with SMI. Methods This was a cross-sectional and multicentered study of 300 individuals with SMI aged 18 to 65 years. The following inclusion criteria were used: (I) diagnosis of schizophrenia, schizotypal and delusional disorders (ICD-10 F2x), or affective disorders (ICD-10 F3x), (II) duration of psychiatric illness ≥ 2 years, and (III) substantial impact of illness on social functioning. Participants were interviewed by trained staff using standardised instruments. The relationship between potential predictors (age, sex, education, marital status, living situation, migration background, psychosocial functioning, age at first mental problem, physical illness, work ability) and employment was analysed using a hierarchic binary logistic regression model. Results Only one-third (34%) of participants were competitively employed. Almost one-third were unemployed (30%), and 28% reported early retirement due to mental illness. Psychosocial functioning was positively associated with competitive employment (OR = 1.09, 95% CI: 1.05 – 1.13, p < 0.001); concurrent chronic physical illness was negatively associated with competitive employment (OR = 0.38, 95% CI: 0.21 – 0.71, p = 0.002). Conclusions Findings confirm a high risk of exclusion from competitive employment among individuals with SMI. Nonetheless, a substantial proportion of individuals are employed. Findings call for efforts to maintain or enhance workforce participation among individuals with SMI. A special focus should be placed on improving physical health and strengthening psychosocial functioning. Trial registration The study was registered in the German Clinical Trials Register (DRKS) under the registration number DRKS00015801 before the start of recruitment (Registration date: 21.02.2019).

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Section: Discussionsupporting

confidence: 90%

Predictors of competitive employment in individuals with severe mental illness: results from an observational, cross-sectional study in Germany

Gühne

Pabst

Kösters

et al. 2022

J Occup Med Toxicol

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“…Interestingly, in our cohort, despite a range of variables being considered, the only variable associated with discharge NEET status in the multivariable analysis was NEET status at service entry; supporting previous findings that baseline functioning is often the best predictor of employment outcomes (Rössler et al, 2019). We also re‐ran the model without entry NEET status, and found that SUD during treatment predicted discharge NEET status.…”

Section: Discussionsupporting

confidence: 87%

Not in education, employment and training status in the early stages of bipolar I disorder with psychotic features

Cotton

Filia

Lambert

et al. 2021

Early Intervention Psych

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Objective There is a lack of existing research regarding young people with bipolar I disorder (BD‐I) and psychotic features, who are not in education, employment, and training (NEET). Thus, the aims of the study were to: (a) establish rates of NEET at service entry to a specialist early intervention service; (b) delineate premorbid and current variables associated with NEET status at service entry and (c) examine correlates of NEET status at discharge. Method Medical file audit methodology was utilized to collect information on 118 patients with first episode psychotic mania treated at the Early Psychosis Prevention and Intervention Centre (EPPIC), Melbourne, Australia. NEET status was determined using the modified vocation status index (MVCI). Bivariate and multivariable logistic variables were used to examine relationships between premorbid, service entry and treatment variables, and NEET status at service entry and discharge. Results The NEET rate was 33.9% at service entry, and 39.2% at discharge. Variables associated with NEET status at service entry were premorbid functioning and polysubstance use. NEET status at service entry was the only significant correlate of NEET status at discharge. When service entry NEET was taken out of the model, substance use during treatment was predictive of NEET status at discharge. Conclusions NEET status at service entry was related to a history of premorbid decline, and risk factors such as substance use and forensic issues. NEET status can decline during treatment, and utility of vocational intervention programs specifically for BD, in addition to specialist early intervention, needs to be examined.

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“…Some of the findings are considered contradictory. In addition to functioning, sociodemographic factors and work history [ 5 , 30 , 42 , 43 ], for example, a connection between stigma and discrimination in the workplace and employment [ 44 ] and between the type of vocational rehabilitation measure and work [ 45 ] is also described. The low values of the explained variance in our models suggest that further predictors would have an influence on the desire to work.…”

Section: Discussionmentioning

confidence: 99%

Employment status and desire for work in severe mental illness: results from an observational, cross-sectional study

Gühne

Pabst

Löbner

et al. 2021

Soc Psychiatry Psychiatr Epidemiol

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Purpose People with a severe mental illness (SMI) are at particular risk of occupational exclusion. Among the approaches to occupational rehabilitation, supported employment (SE) has been proven to be the most effective. A requirement to enter SE-programs is that individuals must want to seek competitive employment. The aim of this work is to investigate the relationship between serious mental illness and the desire to work including potential predictors. Methods This is a cross-sectional observational study of patients with SMI aged 18–65 years (n = 397). Patients were interviewed by trained staff using standardised instruments. The relationship between potential predictors and a strong preference for employment were analysed using a hierarchic binary logistic regression model. Results Only about one-quarter (27.9%) of SMI patients is in competitive employment. Another quarter is unemployed (25.9%). Results show that the desire for competitive employment is strong among more than half of the SMI patients. Among the unemployed, two-thirds express a strong desire for work. These individuals are an ideal target group for SE interventions. Comorbid chronic physical illness, diagnosis, and the subjectively judged ability to work are associated with the desire for work. Conclusion Our data confirm a substantial exclusion of individuals with SMI from the workforce. In general, care needs for workplace interventions are not being met and leave much room for improvement. In addition to employment status, the desire for work should be routinely assessed. Study registration The study was registered in the German Clinical Trials Register (DRKS) (https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00015801) and under the WHO-Platform “International Clinical Trials Registry Platform” (ICTRP) (https://apps.who.int/trialsearch/Trial2.aspx?TrialID=DRKS00015801) under the registration number DRKS00015801 before the start of recruitment (Registration date: 21.02.2019).

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Predictors of Employment for People With Mental Illness: Results of a Multicenter Randomized Trial on the Effectiveness of Placement Budgets for Supported Employment

Cited by 9 publications

References 22 publications

Predictors of competitive employment in individuals with severe mental illness: results from an observational, cross-sectional study in Germany

Predictors of competitive employment in individuals with severe mental illness: results from an observational, cross-sectional study in Germany

Not in education, employment and training status in the early stages of bipolar I disorder with psychotic features

Employment status and desire for work in severe mental illness: results from an observational, cross-sectional study

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