Results of a Multisite Randomized Trial of Supported Employment Interventions for Individuals With Severe Mental Illness

Cook, Judith Α.; Leff, H. Stephen; Blyler, Crystal R.; Gold, Paul B.; Goldberg, Richard W.; Mueser, Kim T.; Toprac, Marcia G.; McFarlane, William R.; Shafer, Michael S.; Blankertz, Laura; Dudek, Ken; Razzano, Lisa A.; Grey, Dennis D.; Burke-Miller, Jane K.

doi:10.1001/archpsyc.62.5.505

Cited by 246 publications

(194 citation statements)

References 31 publications

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“…As a secondary outcome, we assessed the wages earned from competitive employment. The data for competitive employment corresponded to outcomes derived from integrated paid work with at least minimum wage, and not reserved for people with disabilities [21]. The data for any employment corresponded to outcomes derived from any paid work, including sheltered workshops or transitional employment with wages.…”

Section: Outcomes Measuresmentioning

confidence: 99%

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Employment outcomes for people with schizophrenia spectrum disorder: A meta-analysis of randomized controlled trials

Carmona

Gómez-Benito

Huedo‐Medina

et al. 2017

Int J Occup Med Environ Health

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Access to employment plays a critical role in the recovery and functioning of people with schizophrenia. We have investigated the effectiveness of treatments to enhance employment outcomes for people with schizophrenia and evaluated the potential moderators of these outcomes. A literature search was conducted in CINAHL, Cochrane Databases, MED-LINE, ProQuest XML, PsycINFO, Scopus, and Web of Science. Grey literature databases, references lists of the retrieved articles and specialized journals in the field were also inspected. Job placement, job tenure and wages earned were tested. Risk ratios were extracted for job placement and standardized mean differences were calculated for job tenure and wages earned. Twenty-five randomized controlled trials published between 1986 and December 2015 were analyzed. Engaging in a vocational intervention increases the likelihood of obtaining a competitive job (risk ratio (RR) = 2.31, 95% confidence interval (CI): 1.85-2.88) and has a positive impact on hours worked in any job (standardized mean difference (SMD) = 0.42, 95% CI: 0.16-0.68). There was no evidence of intervention efficacy with regard to wages earned from competitive employment. Participation in rehabilitative vocational treatment is not sufficient to ensure work participation for people with schizophrenia. Comprehensive treatments are necessary to address functional deficits that hinder labor stability and job performance for people with schizophrenia. Int J Occup Med Environ Health 2017;30(3):345-366

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Section: Outcomes Measuresmentioning

confidence: 99%

“…of competitive employment [21]. When we could not establish which type of employment outcome was obtained, we used a conservative approach and coded the outcome as any job.…”

Section: Inclusion Criteriamentioning

confidence: 99%

Employment outcomes for people with schizophrenia spectrum disorder: A meta-analysis of randomized controlled trials

Carmona

Gómez-Benito

Huedo‐Medina

et al. 2017

Int J Occup Med Environ Health

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“…The IPS model of SE [12][13][14][15][16] emphasizes rapid job placement, competitive jobs, ongoing support without a time limit, client choice of jobs, integration of vocational support and clinical care, and openness to all who want to work [17]. Clinical trials have shown IPS to be associated with higher CE rates, shorter time to entering CE, greater numbers of hours worked per week, and more weeks worked per year among individuals diagnosed with SMI [13,[16][17][18][19][20][21][22][23][24][25][26] and, most recently, among veterans with posttraumatic stress disorder (PTSD) [27].…”

Section: Supported Employmentmentioning

confidence: 99%

Health and well-being of homeless veterans participating in transitional and supported employment: Six-month outcomes

Leddy¹,

Stefanovics²,

Rosenheck

2014

J Rehabil Res Dev

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Abstract-Supported employment, specifically individual placement and support (IPS), improves competitive employment (CE) rates for individuals with serious mental illness, but has not shown greater improvement in non-vocational outcomes than other rehabilitation approaches. The Department of Veterans Affairs offers two types of vocational services, IPS and transitional work experience (TWE), but no study has compared the effectiveness of these approaches. This secondary analysis of data from a study of homeless veterans compared 6 mo improvement in diverse outcomes for five employment patterns: never worked, worked only in TWE, worked in TWE followed by CE, worked in CE without IPS, and worked in CE with IPS referral. Veterans referred to IPS were more likely to be competitively employed. Those who worked in CE (whether following TWE or with or without IPS referral) showed the greatest increase in days worked, employment income, and total income and the greatest decrease in public support income when compared with those who worked only in TWE or not at all. Veterans in TWE showed the greatest increase in residential treatment days, but there were no other differences in nonvocational outcomes between groups. There are multiple paths to CE, but few differences in non-vocational outcomes across employment experiences.

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“…Analysis of data from a national household survey revealed that more than three-quarters (77%) of the general working-age population are employed in a given year, while less than one-fifth (17%) of those with severe mental health conditions are working [1]. Supported employment, an evidence-based practice (EBP) for enhancing employment outcomes among people with severe mental illness, is available [2][3]. However, many outpatients have co-occurring physical illnesses, chronic medical conditions, and disabilities that also impair vocational performance and may affect their ability to benefit from supported employment services.…”

Section: Introductionmentioning

confidence: 99%

Effects of co-occurring disorders on employment outcomes in a multisite randomized study of supported employment for people with severe mental illness

Cook

Razzano

Burke-Miller

et al. 2007

JRRD

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Abstract-Effects of co-occurring disorders on work outcomes were explored among individuals with severe mental illness who were participating in a multisite randomized study of supported employment. At seven sites, 1,273 people were randomly assigned to an experimental supported employment program or a control condition and followed for 2 years. Multivariate regression analysis examined work outcomes including earnings, hours worked, and competitive employment, as well as whether psychiatric disability was disclosed to coworkers and supervisors. Individuals with any comorbidity had lower earnings and were less likely to work competitively. Those with physical comorbidities had lower earnings, worked fewer hours, and were less likely to work competitively. Disclosure was more likely among those with both cognitive and physical comorbidities, as well as those with learning disabilities. Competitive employment was less likely among those with intellectual disability, visual impairment, and human immunodeficiency virus/acquired immunodeficiency syndrome. The experimental condition was positively related to all outcomes except disclosure. The results suggest that, with some exceptions, comorbidities affect employment outcomes, requiring tailored services and supports to promote vocational success.

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Results of a Multisite Randomized Trial of Supported Employment Interventions for Individuals With Severe Mental Illness

Abstract: The SE models tailored by integrating clinical and vocational services were more effective than services as usual or unenhanced services.

Cited by 246 publications

References 31 publications

Employment outcomes for people with schizophrenia spectrum disorder: A meta-analysis of randomized controlled trials

Employment outcomes for people with schizophrenia spectrum disorder: A meta-analysis of randomized controlled trials

Health and well-being of homeless veterans participating in transitional and supported employment: Six-month outcomes

Effects of co-occurring disorders on employment outcomes in a multisite randomized study of supported employment for people with severe mental illness

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