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Pettinger C, Hunt L, Gardiner H, Garg P, Howard L, Wagstaff C. Engaging with 'less affluent' communities for food system transformation: a community food researcher model (FoodSEqual project). Proc Nutr Soc 2023:1-15. [PMID: 38099419 DOI: 10.1017/s0029665123004913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
The UK food system is distorted by inequalities in access, failing the people most in need, yet it should provide access to safe, nutritious affordable food for all citizens. Dietary patterns are associated with socio-demographic characteristics, with high levels of diet-related disease mortality attributed to poor dietary habits. Disadvantaged UK communities face urgent public health challenges, yet are often treated as powerless recipients of dietary and health initiatives. The need for food system transformation has been illustrated within recent UK government policy drivers and research funding. The Food Systems Equality project is a research consortium that aims to 'co-produce healthy and sustainable food systems for disadvantaged communities'. The project focusses on innovating food products, supply chains and policies, placing communities at the centre of the change. Tackling the above issues requires new ways of working. Creative approaches in food research are known to empower a wider range of individuals to share their 'lived food experience' narratives, building relationships and corroborating co-production philosophies, thus promoting social justice, and challenging more traditional positivist/reductionist 'biomedical' approaches for nutrition and food studies. This review paper critiques the use of community-centric approaches for food system transformation, focusing on one, a community food researcher model() as an exemplar, to highlight their utility in advocating with rather than for less affluent communities. The potential for creative methods to lead to more equitable and lasting solutions for food system transformation is appraised, consolidating the need for community-driven systemic change to foster more progressive and inclusive approaches to strengthen social capital. The paper closes with practice insights and critical considerations offering recommendations for readers, researchers, and practitioners, enabling them to better understand and apply similar approaches.
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Affiliation(s)
- Clare Pettinger
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Louise Hunt
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Hannah Gardiner
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Paridhi Garg
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Lisa Howard
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, UK
- Food Plymouth CIC The local Sustainable Food Places Food Partnership, Plymouth, UK
| | - Carol Wagstaff
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, UK
- Department of Food and Nutritional Sciences, University of Reading, Reading, UK
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Martinelli A, Bonetto C, Bonora F, Cristofalo D, Killaspy H, Ruggeri M. Supported employment for people with severe mental illness: a pilot study of an Italian social enterprise with a special ingredient. BMC Psychiatry 2022; 22:296. [PMID: 35473634 PMCID: PMC9040313 DOI: 10.1186/s12888-022-03881-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 02/03/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND People with mental disorders are far more likely to be unemployed than the general population. Two internationally recognized, evidence-based models of interventions for employment for people with severe mental health problems are Individual Placement Support and the Clubhouse. In Italy, a common model is the 'social enterprise' (SE), which is a programme run by non-profit organisations that help individuals with disabilities to be employed. Despite SEs spread and relevance in Italy, there are no studies about Italian samples. This paper reports on a pilot evaluation of psychosocial and work outcomes of a SE based in Verona, Italy. The study aims to investigate if people with SMI involved in SE job placements may achieve personal recovery and better outcomes over time, and in comparison with a comparable group of users. METHODS This is a pilot descriptive study with three components. A longitudinal design that comprised a functioning description of 33 SE members with a psychiatric disability in two time-points (when they joined the SE-on average 5 years before the study recruitment, and at the study recruitment-year 2018); and a repeated collection of job details of the 33 members in three time points: 2 years before the recruitment,-year 2016; 1 year before the recruitment - year 2017; and at the recruitment-year 2018. An assessment at the recruitment time-year 2018, of SE users' satisfaction with the job placement, symptoms, functioning, and quality of life (QoL). A cross-sectional study that compared the 33 SE members at the recruitment time-year 2018, with a matched group of people with the following criteria: living in local supported accommodations, being unemployed and not SE members. The two groups were compared on ratings of psychopathology, functioning, and QoL. Descriptive analyses were done. RESULTS At the recruitment time - year 2018, all SE participants showed a significant better functioning (p < 0.001) than when they joined the SE-when they had been employed for an average of 5 years. In comparison to the matched group, SE members had significantly better functioning (p = 0.001), psychopathology (p = 0.007), and QoL (p = 0.034). According to their SE membership status, participants comprised trainees (21.2%) and employee members (78.8%). Trainees compared to employees had lower autonomies, functioning, QoL and more severe psychopathology. Over the two years prior to study recruitment, trainees showed stable poor autonomies, while employee members showed a variation from average autonomies in the 2 years before the recruitment time - year 2016, to good ones at the recruitment time - year 2018. Over the two years, all SE members set increasing numbers of objectives in all three domains. All SE participants reported high levels of satisfaction with all aspects of the job placement. CONCLUSIONS SE that provides tailored support to assist people to gain employment skills may be an effective component in helping recovery from SMI.
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Affiliation(s)
- Alessandra Martinelli
- grid.5611.30000 0004 1763 1124Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy ,grid.419422.8Unit of Clinical Psychiatry, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni, 4, 25125 Brescia, BS Italy
| | - Chiara Bonetto
- grid.5611.30000 0004 1763 1124Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Federica Bonora
- grid.5611.30000 0004 1763 1124Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Doriana Cristofalo
- grid.5611.30000 0004 1763 1124Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Helen Killaspy
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, London, UK
| | - Mirella Ruggeri
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy. .,Section of Psychiatry, Verona Hospital Trust, AOUI, Verona, Italy.
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Sultan-Taïeb H, Villotti P, Berbiche D, Dewa CS, Desjardins É, Fraccaroli F, Zaniboni S, Mazaniello-Chézol M, Lecomte T, Durand MJ, Corbière M. Can social firms contribute to alleviating the economic burden of psychiatric disabilities for the public healthcare system? HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:1311-1320. [PMID: 31149764 DOI: 10.1111/hsc.12775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 02/19/2019] [Accepted: 04/16/2019] [Indexed: 06/09/2023]
Abstract
In a number of countries, unemployment rates for people with psychiatric disabilities are much higher than in the general population. On the one hand, the expenses for mental health reach 3.5% of the total public health and social services budget in Québec. On the other hand, social firms (SFs) receive government subsidies. The objective was to compare public healthcare expenses for people with psychiatric disabilities who work in SFs with those associated with people with a similar condition who are looking for a job in the competitive labour market. This study followed a retrospective comparative design and considered two groups, namely: 122 employees working in SFs and 64 individuals participating in a supported employment program as job-seekers. Two complementary datasets were used: a self-report questionnaire and public healthcare databases. The cost analysis was performed from the perspective of the public healthcare system and included outpatient visit fees to physicians, outpatient visits to health professionals other than physicians in public healthcare centres, inpatient expenses due to hospitalisations, emergency room visits and amounts reimbursed to patients for medication. Regression analyses using generalised linear models with a gamma distribution and log link were used. Our results revealed that when controlling for sociodemographic variables (gender, age, marital status, education, physical disability), global health (EuroQol EQ-5D-5L), the severity of psychiatric symptoms (18-item Brief Symptom Inventory) and self-declared primary mental health diagnosis, annual healthcare costs paid by the public insurance system were between $1,924 and $3,912 lower for people working in SFs than for the comparison group. An explanatory hypothesis is that working in SFs could act as a substitute for medical treatments such as outpatient visits and medication use. There might be a form of compensation between supporting SFs and financing the public healthcare system, which provides valuable insights for public decision-making.
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Affiliation(s)
- Hélène Sultan-Taïeb
- Human Resources Department, School of Management, Université du Québec à Montréal (UQAM), Montréal, QC, Canada
| | - Patrizia Villotti
- Department of Education, Career Counselling, Université du Québec à Montréal (UQAM), Montréal, QC, Canada
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| | - Djamal Berbiche
- Département des Sciences de la Santé Communautaire, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Longueuil, QC, Canada
| | - Carolyn S Dewa
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, California, USA
| | - Émilie Desjardins
- Faculté des sciences humaines, Université du Québec à Montréal (UQAM), Montréal, QC, Canada
| | - Franco Fraccaroli
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Sara Zaniboni
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Maud Mazaniello-Chézol
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| | - Tania Lecomte
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
- Département de Psychologie, Université de Montréal, Montréal, QC, Canada
| | - Marie-José Durand
- École de réadaptation, Université de Sherbrooke, Longueuil, QC, Canada
| | - Marc Corbière
- Department of Education, Career Counselling, Université du Québec à Montréal (UQAM), Montréal, QC, Canada
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
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Corbière M, Zaniboni S, Dewa CS, Villotti P, Lecomte T, Sultan-Taïeb H, Hupé J, Fraccaroli F. Work productivity of people with a psychiatric disability working in social firms. Work 2019; 62:151-160. [PMID: 30689598 DOI: 10.3233/wor-182850] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Several factors impact work productivity in employees with a psychiatric condition. OBJECTIVE In the context of social firms (SFs) the goal of this study is to test a theoretical model to predict work productivity across time, while considering worker and workplace factors. METHODS 222 people with a psychiatric disability employed in SFs were enrolled in a longitudinal study (6 month follow up) and completed the baseline battery of questionnaires on health (severity of symptoms), individual (self-esteem as a worker) and organizational factors (organizational constraints and supervisory support), and their work productivity (also measured at follow-up). Path analysis was used to test the hypothetical model, assessing individual and organizational factors in the context of social firms that could facilitate or hamper work productivity in the immediate term (T1), as well as the stability of work productivity in the middle/long term (T2 or 6 month follow up). RESULTS Work productivity of people with a psychiatric disability was affected negatively by severity of the symptoms, organizational constraints, and positively by self- esteem as a worker at T1. The stability of work productivity was significant across time (T2). Supervisor support was only related to work productivity at 6 month follow-up. CONCLUSIONS The results highlight the importance of the supportive workplaces for people with mental disorders that SFs provide, and the stability of work productivity across time. Supervisor support seems to have a delayed impact on work productivity. In future studies, researchers could determine how individual and organizational variables influence job tenure of employees with a psychiatric disability.
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Affiliation(s)
- Marc Corbière
- Department of Education, Career Counselling, Université du Québec à Montréal, Canada.,Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Canada
| | - Sara Zaniboni
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Carolyn S Dewa
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
| | - Patrizia Villotti
- Department of Education, Career Counselling, Université du Québec à Montréal, Canada.,Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Canada
| | - Tania Lecomte
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Canada.,Department de Psychologie, Université de Montréal, Canada, Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Canada
| | - Hélène Sultan-Taïeb
- Department of Organisation and Human Resources, School of Management, Université du Québec à Montréal, Montréal, Canada
| | - Julie Hupé
- Department of Education, Career Counselling, Université du Québec à Montréal, Canada.,Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Canada
| | - Franco Fraccaroli
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
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Vornholt K, Villotti P, Muschalla B, Bauer J, Colella A, Zijlstra F, Van Ruitenbeek G, Uitdewilligen S, Corbière M. Disability and employment – overview and highlights. EUROPEAN JOURNAL OF WORK AND ORGANIZATIONAL PSYCHOLOGY 2017. [DOI: 10.1080/1359432x.2017.1387536] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Katharina Vornholt
- Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Patrizia Villotti
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal (CRIUSMM), Department of Education, Career Counselling, Université du Québec à Montréal, Montréal, Canada
| | - Beate Muschalla
- Research Group Psychosomatic Rehabilitation (FPR), Charité Berlin, Hindenburgdamm, Berlin, Germany
| | - Jana Bauer
- Lehrstuhl für Arbeit und Berufliche Rehabilitation, Universität zu Köln, Köln
| | - Adrienne Colella
- A.B. Freeman School of Business, Tulane University, New Orleans, LA, USA
| | - Fred Zijlstra
- Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Gemma Van Ruitenbeek
- Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Sjir Uitdewilligen
- Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Marc Corbière
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal (CRIUSMM), Department of Education, Career Counselling, Université du Québec à Montréal, Montréal, Canada
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Work Accommodations and Natural Supports for Employees with Severe Mental Illness in Social Businesses: An International Comparison. Community Ment Health J 2017; 53:864-870. [PMID: 27913895 DOI: 10.1007/s10597-016-0068-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 11/24/2016] [Indexed: 10/20/2022]
Abstract
Little is known about the types of work accommodations and natural supports that are useful for people experiencing severe mental illness working in social businesses. We conducted an exploratory, descriptive and cross-sectional investigation in Australia, Canada and Italy to study the nature of work accommodations and natural supports available in social businesses. Study findings are drawn from survey responses of a convenience sample of 90 employees with self-reported psychiatric disabilities. Results showed that, regardless of the country, social businesses provide many work accommodations and natural supports, especially those linked to schedule flexibility and support, while work accommodations related to training and schedule flexibility were linked to longer job tenure. Overall, this study advances our knowledge about the spectrum of work accommodations and natural supports that are available in social businesses for people with severe mental illness. Also, it highlights the type of work accommodations that are likely to support this population to sustain employment.
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Villotti P, Corbière M, Dewa CS, Fraccaroli F, Sultan-Taïeb H, Zaniboni S, Lecomte T. A serial mediation model of workplace social support on work productivity: the role of self-stigma and job tenure self-efficacy in people with severe mental disorders. Disabil Rehabil 2017; 40:3113-3119. [DOI: 10.1080/09638288.2017.1377294] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Patrizia Villotti
- Centre de Recherche de l’Hôpital Charles LeMoyne, Université de Sherbrooke, Longueuil, Canada
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, Canada
| | - Marc Corbière
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, Canada
- Department of Education – Career Counselling, Université du Québec à Montréal, Montréal, Canada
| | - Carolyn S. Dewa
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
| | - Franco Fraccaroli
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Hélène Sultan-Taïeb
- Département d'organisation et ressources humaines, École des Sciences de la Gestion, Université du Québec à Montréal, Montréal, Canada
| | - Sara Zaniboni
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Tania Lecomte
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, Canada
- Department de Psychologie, Université de Montréal, Montréal, Canada
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Suijkerbuijk YB, Schaafsma FG, van Mechelen JC, Ojajärvi A, Corbière M, Anema JR. Interventions for obtaining and maintaining employment in adults with severe mental illness, a network meta-analysis. Cochrane Database Syst Rev 2017; 9:CD011867. [PMID: 28898402 PMCID: PMC6483771 DOI: 10.1002/14651858.cd011867.pub2] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND People with severe mental illness show high rates of unemployment and work disability, however, they often have a desire to participate in employment. People with severe mental illness used to be placed in sheltered employment or were enrolled in prevocational training to facilitate transition to a competitive job. Now, there are also interventions focusing on rapid search for a competitive job, with ongoing support to keep the job, known as supported employment. Recently, there has been a growing interest in combining supported employment with other prevocational or psychiatric interventions. OBJECTIVES To assess the comparative effectiveness of various types of vocational rehabilitation interventions and to rank these interventions according to their effectiveness to facilitate competitive employment in adults with severe mental illness. SEARCH METHODS In November 2016 we searched CENTRAL, MEDLINE, Embase, PsychINFO, and CINAHL, and reference lists of articles for randomised controlled trials and systematic reviews. We identified systematic reviews from which to extract randomised controlled trials. SELECTION CRITERIA We included randomised controlled trials and cluster-randomised controlled trials evaluating the effect of interventions on obtaining competitive employment for adults with severe mental illness. We included trials with competitive employment outcomes. The main intervention groups were prevocational training programmes, transitional employment interventions, supported employment, supported employment augmented with other specific interventions, and psychiatric care only. DATA COLLECTION AND ANALYSIS Two authors independently identified trials, performed data extraction, including adverse events, and assessed trial quality. We performed direct meta-analyses and a network meta-analysis including measurements of the surface under the cumulative ranking curve (SUCRA). We assessed the quality of the evidence for outcomes within the network meta-analysis according to GRADE. MAIN RESULTS We included 48 randomised controlled trials involving 8743 participants. Of these, 30 studied supported employment, 13 augmented supported employment, 17 prevocational training, and 6 transitional employment. Psychiatric care only was the control condition in 13 studies. Direct comparison meta-analysis of obtaining competitive employmentWe could include 18 trials with short-term follow-up in a direct meta-analysis (N = 2291) of the following comparisons. Supported employment was more effective than prevocational training (RR 2.52, 95% CI 1.21 to 5.24) and transitional employment (RR 3.49, 95% CI 1.77 to 6.89) and prevocational training was more effective than psychiatric care only (RR 8.96, 95% CI 1.77 to 45.51) in obtaining competitive employment.For the long-term follow-up direct meta-analysis, we could include 22 trials (N = 5233). Augmented supported employment (RR 4.32, 95% CI 1.49 to 12.48), supported employment (RR 1.51, 95% CI 1.36 to 1.68) and prevocational training (RR 2.19, 95% CI 1.07 to 4.46) were more effective than psychiatric care only. Augmented supported employment was more effective than supported employment (RR 1.94, 95% CI 1.03 to 3.65), transitional employment (RR 2.45, 95% CI 1.69 to 3.55) and prevocational training (RR 5.42, 95% CI 1.08 to 27.11). Supported employment was more effective than transitional employment (RR 3.28, 95% CI 2.13 to 5.04) and prevocational training (RR 2.31, 95% CI 1.85 to 2.89). Network meta-analysis of obtaining competitive employmentWe could include 22 trials with long-term follow-up in a network meta-analysis.Augmented supported employment was the most effective intervention versus psychiatric care only in obtaining competitive employment (RR 3.81, 95% CI 1.99 to 7.31, SUCRA 98.5, moderate-quality evidence), followed by supported employment (RR 2.72 95% CI 1.55 to 4.76; SUCRA 76.5, low-quality evidence).Prevocational training (RR 1.26, 95% CI 0.73 to 2.19; SUCRA 40.3, very low-quality evidence) and transitional employment were not considerably different from psychiatric care only (RR 1.00,95% CI 0.51 to 1.96; SUCRA 17.2, low-quality evidence) in achieving competitive employment, but prevocational training stood out in the SUCRA value and rank.Augmented supported employment was slightly better than supported employment, but not significantly (RR 1.40, 95% CI 0.92 to 2.14). The SUCRA value and mean rank were higher for augmented supported employment.The results of the network meta-analysis of the intervention subgroups favoured augmented supported employment interventions, but also cognitive training. However, supported employment augmented with symptom-related skills training showed the best results (RR compared to psychiatric care only 3.61 with 95% CI 1.03 to 12.63, SUCRA 80.3).We graded the quality of the evidence of the network ranking as very low because of potential risk of bias in the included studies, inconsistency and publication bias. Direct meta-analysis of maintaining competitive employment Based on the direct meta-analysis of the short-term follow-up of maintaining employment, supported employment was more effective than: psychiatric care only, transitional employment, prevocational training, and augmented supported employment.In the long-term follow-up direct meta-analysis, augmented supported employment was more effective than prevocational training (MD 22.79 weeks, 95% CI 15.96 to 29.62) and supported employment (MD 10.09, 95% CI 0.32 to 19.85) in maintaining competitive employment. Participants receiving supported employment worked more weeks than those receiving transitional employment (MD 17.36, 95% CI 11.53 to 23.18) or prevocational training (MD 11.56, 95% CI 5.99 to 17.13).We did not find differences between interventions in the risk of dropouts or hospital admissions. AUTHORS' CONCLUSIONS Supported employment and augmented supported employment were the most effective interventions for people with severe mental illness in terms of obtaining and maintaining employment, based on both the direct comparison analysis and the network meta-analysis, without increasing the risk of adverse events. These results are based on moderate- to low-quality evidence, meaning that future studies with lower risk of bias could change these results. Augmented supported employment may be slightly more effective compared to supported employment alone. However, this difference was small, based on the direct comparison analysis, and further decreased with the network meta-analysis meaning that this difference should be interpreted cautiously. More studies on maintaining competitive employment are needed to get a better understanding of whether the costs and efforts are worthwhile in the long term for both the individual and society.
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Affiliation(s)
- Yvonne B Suijkerbuijk
- VU University Medical CenterDepartment of Public and Occupational Health, Amsterdam Public Health Research InstituteVan der Boechorststraat 7Postbus 7057AmsterdamNetherlands1007 MB
- AMC‐UMCG‐UWV‐VUmcResearch Centre for Insurance MedicineAmsterdamNetherlands
| | - Frederieke G Schaafsma
- VU University Medical CenterDepartment of Public and Occupational Health, Amsterdam Public Health Research InstituteVan der Boechorststraat 7Postbus 7057AmsterdamNetherlands1007 MB
- AMC‐UMCG‐UWV‐VUmcResearch Centre for Insurance MedicineAmsterdamNetherlands
| | - Joost C van Mechelen
- VU University Medical CenterDepartment of Public and Occupational Health, Amsterdam Public Health Research InstituteVan der Boechorststraat 7Postbus 7057AmsterdamNetherlands1007 MB
| | - Anneli Ojajärvi
- Finnish Institute of Occupational HealthTopeliuksenkatu 41 a AHelsinkiFinlandFI‐00250
| | - Marc Corbière
- Université du Québec à Montréal (UQAM)Department of Education and Pedagogy ‐ Career CounselingMontrealQCCanada
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal (CR‐IUSMM)MontrealCanada
| | - Johannes R Anema
- VU University Medical CenterDepartment of Public and Occupational Health, Amsterdam Public Health Research InstituteVan der Boechorststraat 7Postbus 7057AmsterdamNetherlands1007 MB
- AMC‐UMCG‐UWV‐VUmcResearch Centre for Insurance MedicineAmsterdamNetherlands
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