Moving Beyond the Illness: Factors Contributing to Gaining and Maintaining Employment (original) (raw)
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Clinical Factors Associated With Employment Among People With Severe Mental Illness
The Journal of Nervous and Mental Disease, 2005
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.
The future of supported employment for people with severe mental illness
Psychiatric Rehabilitation Journal, 2008
This paper reviews current research on innovative attempts to improve the dissemination and effectiveness of supported employment. The domains of active investigation include: (1) organization and financing of services, (2) disability policies, (3) program implementation and quality, (4) motivation, (5) job development, (6) illness-related barriers, (7) job supports, (8) career development, and (9) new populations. Work in each of these areas offers the promise of improving services and outcomes in the near future.
Interventions to Improve Employment Outcomes for Workers Who Experience Mental Illness
The Canadian Journal of Psychiatry, 2007
Objective: To review employment interventions for individuals who experience mental illness. Method: I reviewed employment interventions described in the mental health, disability, and rehabilitation literature for the period 1990 to 2005 and organized these interventions into a framework. Results: The framework develops 7 distinct individual-level employment interventions as well as interventions directed at the employer and at workplace organization. It also considers factors that will affect access to these interventions. Although there is a sense of optimism about the potential of these interventions, research in the area is limited. Conclusion: Physicians who are knowledgeable about the nature and scope of employment interventions for individuals with mental illness are in a good position to effect positive change in the work lives of the individuals they serve.
The New Hampshire study of supported employment for people with severe mental illness
Journal of Consulting and Clinical Psychology, 1996
This study compared supported employment services in 2 contrasting programs: (a) Group Skills Training, a professional rehabilitation agency outside of the mental health center that provided preemployment skills training and support in obtaining and maintaining jobs, or (b) the Individual Placement and Support (IPS) model, which integrated clinical and vocational services within the mental health center. People with severe mental disorders who expressed interest in competitive employ ment(A r = 143) were randomly assigned to 1 of these 2 programs. Results showed that clients in the IPS program were more likely to be competitively employed throughout most of the 18-month follow-up. Among those who obtained jobs, there were few group differences, although workers in the IPS program did work more total hours and earn more total wages during the 18-month followup. There were no group differences on nonvocational outcomes. Competitive employment is a primary goal for a large majority of people with severe mental disorders (SMD). Approximately three fourths of these individuals, including more than two thirds of those without jobs, desire paid employment (Rogers, Walsh, Masotta, & Danley, 1991). Vocational agencies (Hursh, Rogers, & Anthony, 1988), mental health providers (Bond & McDonel, 1991), families of people with mental illness (Kasper, Steinwachs, & Skinner, 1992), and mental health services researchers (Attkisson et al., 1992) also advocate vocational opportunities. Employment is considered important, not only because of the direct improvements in activity, social contacts, and remuneration but also because work may promote gains in related areas such as self-esteem, illness self-manage
Social Psychiatry and Psychiatric Epidemiology, 2021
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 h...
An update on supported employment for people with severe mental illness
Current Opinion in Psychiatry, 2014
This review examines the effectiveness of supported employment for people with severe mental illness. Method s: A comprehensive search was made for quantitative studies, primarily in the published literature. Results: Seven descriptive studies, three surveys, one quasi-experimental study, and six experimental studies were found. All studies suggested significant gains in obtaining employment for persons enrolled in supported employment programs. In experimental studies, a mean of 58 percent of clients in supported employment programs achieved competitive employment, compared with 21 percent for control subjects, who typically received traditional vocational services. Employment outcomes relating to time employed and employment earnings also favored clients in supported employment over control subjects. No evidence was found that supported employment led to stress levels precipitating higher rehospitalization rates. Two features of many supported employment programs have the most empirical support: integration of mental health and vocational services within a single service team and the avoidance ofpreplacement training. Two other widely held principles-ongoing support and attention to client preferences-have not been systematically evaluated. Conclusions: Supported employment appears to be a promising approach for people with severe mental illness, but more studies are needed, with close atand long-term follow-up.
Psychosocial rehabilitation journal, 1990
He is a nationally recognized authority on providing services to families of people with disabilities. Baruch F. Gould is Director of Resource Development at the Connecticut State Department of Mental Health. In his former position as Director of Psychosocial Services, he was instrumental in the development of supported employment activities for persons with severe and prolonged mental illness. This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
Culture, medicine and psychiatry, 2015
Employment has been highlighted as a determinant of health and as an essential milestone in the recovery process of people with serious mental illness. Different types of programs and public services have been designed to improve the employability of this population. However, there has not been much interest in the meanings attributed to these experiences and the negative aspects of work experience. In this research, we explored the meanings that participants attributed to their work experience and the impact of work on their recovery process. Research participants lived in Andalusia (Spain), a region in southern Europe with a high unemployment rate. Two versions of a semi-structured interview were designed: one for people who were working, and one for unemployed people. Participants' narratives were categorized according to grounded theory and the analyses were validated in group sessions. Apart from several positive effects for recovery, the analysis of the narratives about wo...