RT Journal
A1 Lehman AF, Goldberg R, Dixon LB, et al
T1 IMproving employment outcomes for persons with severe mental illnesses
JF Archives of General Psychiatry
JO Archives of General Psychiatry
YR 2002
FD February 1
VO 59
IS 2
SP 165
OP 172
DO 10.1001/archpsyc.59.2.165
UL http://dx.doi.org/10.1001/archpsyc.59.2.165
AB Background 
    Unemployment remains a major consequence of schizophrenia and other severe mental illnesses. This study assesses the effectiveness of the Individual Placement and Support model of supportive employment relative to usual psychosocial rehabilitation services for improving employment among inner-city patients with these disorders.Methods 
    Two hundred nineteen outpatients with severe mental illnesses, 75% with chronic psychoses, from an inner-city catchment area were randomly assigned to either the Individual Placement and Support program or a comparison psychosocial rehabilitation program. Participants completed a battery of assessments at study enrollment and every 6 months for 2 years. Employment data, including details about each job, were collected weekly.Results 
    Individual Placement and Support program participants were more likely than the comparison patients to work (42% vs 11%; P<.001; odds ratio, 5.58) and to be employed competitively (27% vs 7%; P<.001; odds ratio, 5.58). Employment effects were associated with significant differences in cumulative hours worked (t211 = −5.0, P = .00000003) and wages earned (t = −5.5, P= .00000003). Among those who achieved employment, however, there were no group differences in time to first job or in number or length of jobs held. Also, both groups experienced difficulties with job retention.Conclusions 
    As hypothesized, the Individual Placement and Support program was more effective than the psychosocial rehabilitation program in helping patients achieve employment goals. Achieving job retention remains a challenge with both interventions.