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Bergdolt J, Hubert S, Schreiter J, Jenderny S, Beblo T, Driessen M, Steinhart I, Dehn LB. Predictors of return to work in people with major depression: Results from a supported employment program in Germany. J Affect Disord 2024:S0165-0327(24)01141-8. [PMID: 39029690 DOI: 10.1016/j.jad.2024.07.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 06/26/2024] [Accepted: 07/14/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Depression is a common mental disorder and is associated with work disability. For the implementation of evidence-based interventions, such as Individual Placement and Support (IPS) for people with depression in Germany, the aim of this study was to investigate client variables that predict return to work. METHODS The sample consisted of 129 participants, initially treated in a psychiatric hospital due to major depression, who participated in IPS as part of a German clinical trial. Baseline demographic (age, sex, education, sickness absence days, employment status), psychiatric (symptom severity, comorbidity, general physical and mental health, disability), and neuropsychological (self-rated deficits, test performance) variables were included. Return to work within one year was predicted using separate and overall binary logistic regression analyses. RESULTS A total of 70 participants (56 %) returned to work within the one-year follow-up period. >100 days of sick leave in the year prior to study entry (vs. <100 days) and higher self-rated cognitive deficits were significantly associated with reduced odds of return to work within one year of IPS. LIMITATIONS The sample consisted of participants with a relatively good work history who were assigned to IPS by the treatment team, thus, the generalizability of the results is limited. CONCLUSIONS People with depression who participate in IPS interventions might benefit from specifically targeting perceived cognitive deficits. Factors associated with prolonged sick leave due to depression and their role in return to work with IPS need further investigation.
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Affiliation(s)
- Juliane Bergdolt
- Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel gGmbH, Universitätsklinikum OWL, Universität Bielefeld, Remterweg 69-71, 33617 Bielefeld, Germany; Department of Psychology, University of Bielefeld, Universitätsstraße 25, 33615 Bielefeld, Germany.
| | - Stella Hubert
- Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel gGmbH, Universitätsklinikum OWL, Universität Bielefeld, Remterweg 69-71, 33617 Bielefeld, Germany
| | - Julia Schreiter
- Institut für Sozialpsychiatrie Mecklenburg-Vorpommern e.V., Universität Greifswald, Greifswald, Germany
| | - Sarah Jenderny
- Institut für Sozialpsychiatrie Mecklenburg-Vorpommern e.V., Universität Greifswald, Greifswald, Germany
| | - Thomas Beblo
- Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel gGmbH, Universitätsklinikum OWL, Universität Bielefeld, Remterweg 69-71, 33617 Bielefeld, Germany; Department of Psychology, University of Bielefeld, Universitätsstraße 25, 33615 Bielefeld, Germany
| | - Martin Driessen
- Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel gGmbH, Universitätsklinikum OWL, Universität Bielefeld, Remterweg 69-71, 33617 Bielefeld, Germany; Department of Psychology, University of Bielefeld, Universitätsstraße 25, 33615 Bielefeld, Germany
| | - Ingmar Steinhart
- Institut für Sozialpsychiatrie Mecklenburg-Vorpommern e.V., Universität Greifswald, Greifswald, Germany
| | - Lorenz B Dehn
- Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel gGmbH, Universitätsklinikum OWL, Universität Bielefeld, Remterweg 69-71, 33617 Bielefeld, Germany; Department of Psychology, University of Bielefeld, Universitätsstraße 25, 33615 Bielefeld, Germany
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Cook JA, Steigman PJ, Burke-Miller JK, Pashka N, Ruiz A, Egli D, Cortez C, Prestipino J, Brown A, Furlong M, Razzano LA. Impact of Individual Budgets on Work and Financial Well-Being of Supported Employment Recipients With Serious Mental Illness. Psychiatr Serv 2024:appips20230597. [PMID: 38957051 DOI: 10.1176/appi.ps.20230597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
OBJECTIVE The authors sought to determine whether providing recipients of supported employment with individual budgets from which they could purchase employment-related goods and services would improve employment and financial outcomes. METHODS Sixty study participants were recruited from an individual placement and support (IPS) program and randomly assigned (1:1) to receive IPS services only (N=32) or IPS services with a 12-month $950 flexible fund called a career account (N=28). Participants receiving IPS and a career account met with staff who helped them identify employment goals and create a budget for purchases directly tied to these goals. The primary outcome was competitive employment; secondary outcomes included job tenure, days worked, total earnings, and financial well-being. Outcomes were analyzed by using adjusted generalized linear models (GLMs) with binary logistic, negative binomial, and linear distributions. RESULTS The proportion of participants who achieved competitive employment was largely similar for those in the career account+IPS group (54%) and in the IPS-only group (47%). However, the GLM analysis revealed that career account+IPS participants had significantly longer job tenure, more total days of employment, and higher total earnings than IPS-only participants. Feelings of financial well-being increased significantly among career account participants, whereas financial well-being declined among control participants. The amount of career account dollars participants spent was positively and significantly associated with longer job tenure, more days employed, and higher total earnings. CONCLUSIONS Combining flexible funds with IPS-supported employment achieved some superior outcomes compared with IPS only. Further research is needed to assess the longer-term effects of this practice and its cost-effectiveness.
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Affiliation(s)
- Judith A Cook
- Department of Psychiatry, College of Medicine, University of Illinois, Chicago (Cook, Steigman, Burke-Miller, Egli, Cortez, Razzano); Thresholds, Chicago (Pashka, Ruiz, Prestipino, Brown, Furlong, Razzano)
| | - Pamela J Steigman
- Department of Psychiatry, College of Medicine, University of Illinois, Chicago (Cook, Steigman, Burke-Miller, Egli, Cortez, Razzano); Thresholds, Chicago (Pashka, Ruiz, Prestipino, Brown, Furlong, Razzano)
| | - Jane K Burke-Miller
- Department of Psychiatry, College of Medicine, University of Illinois, Chicago (Cook, Steigman, Burke-Miller, Egli, Cortez, Razzano); Thresholds, Chicago (Pashka, Ruiz, Prestipino, Brown, Furlong, Razzano)
| | - Nicole Pashka
- Department of Psychiatry, College of Medicine, University of Illinois, Chicago (Cook, Steigman, Burke-Miller, Egli, Cortez, Razzano); Thresholds, Chicago (Pashka, Ruiz, Prestipino, Brown, Furlong, Razzano)
| | - Anabel Ruiz
- Department of Psychiatry, College of Medicine, University of Illinois, Chicago (Cook, Steigman, Burke-Miller, Egli, Cortez, Razzano); Thresholds, Chicago (Pashka, Ruiz, Prestipino, Brown, Furlong, Razzano)
| | - Drew Egli
- Department of Psychiatry, College of Medicine, University of Illinois, Chicago (Cook, Steigman, Burke-Miller, Egli, Cortez, Razzano); Thresholds, Chicago (Pashka, Ruiz, Prestipino, Brown, Furlong, Razzano)
| | - Claudia Cortez
- Department of Psychiatry, College of Medicine, University of Illinois, Chicago (Cook, Steigman, Burke-Miller, Egli, Cortez, Razzano); Thresholds, Chicago (Pashka, Ruiz, Prestipino, Brown, Furlong, Razzano)
| | - John Prestipino
- Department of Psychiatry, College of Medicine, University of Illinois, Chicago (Cook, Steigman, Burke-Miller, Egli, Cortez, Razzano); Thresholds, Chicago (Pashka, Ruiz, Prestipino, Brown, Furlong, Razzano)
| | - Adrienne Brown
- Department of Psychiatry, College of Medicine, University of Illinois, Chicago (Cook, Steigman, Burke-Miller, Egli, Cortez, Razzano); Thresholds, Chicago (Pashka, Ruiz, Prestipino, Brown, Furlong, Razzano)
| | - Mark Furlong
- Department of Psychiatry, College of Medicine, University of Illinois, Chicago (Cook, Steigman, Burke-Miller, Egli, Cortez, Razzano); Thresholds, Chicago (Pashka, Ruiz, Prestipino, Brown, Furlong, Razzano)
| | - Lisa A Razzano
- Department of Psychiatry, College of Medicine, University of Illinois, Chicago (Cook, Steigman, Burke-Miller, Egli, Cortez, Razzano); Thresholds, Chicago (Pashka, Ruiz, Prestipino, Brown, Furlong, Razzano)
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3
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Patmisari E, Huang Y, Orr M, Govindasamy S, Hielscher E, McLaren H. Supported employment interventions with people who have severe mental illness: Systematic mixed-methods umbrella review. PLoS One 2024; 19:e0304527. [PMID: 38838025 DOI: 10.1371/journal.pone.0304527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 05/14/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND/AIMS Primary and review studies show that supported employment interventions showed promise in assisting people with severe mental illness (SMI) in achieving successful employment and health-related outcomes. This umbrella review synthesises evidence from across review studies on supported employment interventions for individuals with SMI, to identify key findings and implementation challenges in relation to five key outcomes: (1) employment, (2) quality of life, (3) social functioning, (4) clinical/service utilisation, and (5) economic outcomes. METHODS A systematic search of eleven databases and registers (CINAHL, Cochrane, EmCare, JBI EBP, ProQuest, PsycINFO, PubMed, Scopus, and Web of Science, and Prospero and Campbell) was conducted to identify meta-analyses and systematic reviews on supported employment interventions for individuals with SMI, peer reviewed and published in English. Quality assessment and data extraction were performed using standardised Joanna Briggs Institute (JBI) tools. A mixed-methods synthesis approach was employed to integrate both quantitative and qualitative evidence. RESULTS The synthesis of 26 review studies primarily focused on the Individual Placement and Support (IPS) model among various supported employment interventions. Overall, combining supported employment with targeted interventions such as neurocognitive therapy and job-related social skill training showed a positive effect on employment (including job retention) and non-employment outcomes (e.g., health, quality of life, social functioning) relative to standard forms of supported employment for people with SMI. Contextual factors (intervention fidelity, settings, systemic barriers) were important considerations for intervention implementation and effectiveness. DISCUSSION Significant overlap of primary studies across 26 review studies exposed considerable variations in interpretation and conclusions drawn by authors, raising questions about their reliability. High volume of overlap reporting from the USA on IPS interventions in review studies is likely to have biased perceptions of effectiveness. There is no one-size-fits-all solution for supporting individuals with SMI in obtaining and maintaining employment. Tailoring strategies based on individual needs and circumstances appears crucial to address the complexity of mental health recovery. We propose creating centralised registries or databases to monitor primary studies included in reviews, thus avoiding redundancy. OTHER This umbrella study was registered with PROSPERO (No. CRD42023431191).
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Affiliation(s)
- Emi Patmisari
- Institute for Mental Health and Wellbeing, College of Education, Psychology and Social Work, Flinders University, Bedford Park, South Australia, Australia
| | - Yunong Huang
- Institute for Mental Health and Wellbeing, College of Education, Psychology and Social Work, Flinders University, Bedford Park, South Australia, Australia
| | - Mark Orr
- Flourish Australia, Sydney Olympic Park, New South Wales, Australia
| | | | - Emily Hielscher
- Flourish Australia, Sydney Olympic Park, New South Wales, Australia
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Helen McLaren
- Institute for Mental Health and Wellbeing, College of Education, Psychology and Social Work, Flinders University, Bedford Park, South Australia, Australia
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Almalky HA, Alasmari AN. Employers' perceptions of supports provided to their employees with disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 149:104750. [PMID: 38723430 DOI: 10.1016/j.ridd.2024.104750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/16/2024] [Accepted: 04/29/2024] [Indexed: 05/21/2024]
Abstract
The employment of individuals with disabilities is significantly low. Many factors are associated with this issue; however, support and accommodations that can be provided to such individuals can improve their employment rate and outcomes. This study aimed to examine the support provided to employees with disabilities in Saudi Arabia. The descriptive approach was utilized, and a survey was used to collect the data. The sample consisted of 86 employer participants to examine the support of their employees with disabilities. Findings revealed that the support provided was high, and the participants reported that such support facilitates finding and maintaining a job. In addition, the variables were all found to have no significant differences. Providing needed and necessary support is an effective strategy that leads to competitive employment for individuals with disabilities, especially for the long term. Implications and recommendations are also discussed.
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Affiliation(s)
- Hussain A Almalky
- Department of Special Education, College of Education in Al-Kharj, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia.
| | - Ali N Alasmari
- Department of Special Education, College of Education in Al-Kharj, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
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Marvin AF, Buckingham SL. "It's time for a change. I need to. I have to": Substance misuse recovery turning points of unhoused Alaskans. J Prev Interv Community 2024; 52:35-53. [PMID: 38622963 DOI: 10.1080/10852352.2024.2332124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
Substance misuse is a pernicious health concern for many unhoused people. A deep understanding of turning points - what propels someone to take concrete action toward addressing substance misuse - is needed to inform recovery policies and practices. This study sought to identify common elements in turning points among unhoused people vis-à-vis a phenomenological qualitative approach. Twenty people (Mage = 47.47, SD = 9.75; 50% female) who self-identified as being in recovery while unhoused participated in semi-structured interviews in Anchorage, Alaska, a community with high rates of both houselessness and substance misuse. Survival (life- and health-sustaining), individual (intrapersonal), and relational (interpersonal) motivations all shaped turning points. Limitations include the possible underrepresentation of individuals using a harm-reduction approach or capturing differences by housing type. Programs to address substance misuse should consider these motivations. Future research should identify and refine turning points and work to understand how they interact with change processes.
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Drake RE, Bond GR. Individual placement and support: History, current status, and future directions. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e122. [PMID: 38867819 PMCID: PMC11114326 DOI: 10.1002/pcn5.122] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 06/06/2023] [Accepted: 06/28/2023] [Indexed: 06/14/2024]
Abstract
Over the past three decades, Individual Placement and Support (IPS) has emerged as a robust evidence-based approach to helping people with severe mental illnesses, such as schizophrenia, bipolar disorder, and major depression, to obtain and succeed in competitive employment. This review addresses the history, principles, research, and future directions of IPS. It covers current evidence on employment outcomes, cost-effectiveness, and nonvocational outcomes. It also describes current attempts to extend IPS to new populations. The authors provide an overview of numerous systematic reviews and meta-analyses of randomized controlled trials involving people with serious mental illness. For studies addressing nonvocational outcomes and new populations, the review uses best available evidence. Published reviews agree that IPS enables patients with serious mental illness in high-income countries to succeed in competitive employment at a higher rate than patients who receive other vocational interventions. Within IPS programs, quality of implementation, measured by standardized fidelity scales, correlates with better outcomes. Employment itself leads to enhanced income, psychosocial outcomes, clinical improvements, and decreased mental health service use. As IPS steadily spreads to new populations and new settings, research is active across high-income countries and spreading slowly to middle-income countries. IPS is an evidence-based practice for people with serious mental illness in high-income countries. It shows promise to help other disability groups also, and emerging research aims to clarify adaptations and outcomes.
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Affiliation(s)
- Robert E. Drake
- Department of PsychiatryColumbia University Vagelos College of Physicians and SurgeonsNew York CityNew YorkUSA
- Westat CorporationRockvilleMarylandUSA
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7
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Al-Abdulmunem M, Bond GR, Ressler DR, Becker DR, Swanson SJ, Marbacher J. Individual placement and support programmes for young adults: Where are they and whom do they serve? Early Interv Psychiatry 2023; 17:824-836. [PMID: 37211370 PMCID: PMC10524614 DOI: 10.1111/eip.13440] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 02/08/2023] [Accepted: 05/05/2023] [Indexed: 05/23/2023]
Abstract
AIM Individual Placement and Support (IPS), an evidence-based supported employment model developed for adults with serious mental illness, has been recently targeted to young adults with mental health conditions, but little is known about its adoption in this age group in the United States. METHODS We recruited a volunteer sample of nine IPS programmes in five states serving young adults with mental health conditions aged 16 to 24. IPS team leaders reported programme and participant characteristics and rated barriers to employment and education. RESULTS Most IPS programmes were located in community mental health centres, served a small number of young adults, and received most referrals from external sources. The study sample of 111 participants included 53% female, 47% under 21 years old, 60% diagnosed with a depressive disorder; 92% had an employment goal, and 40% had an education goal. IPS specialists reported that managing mental health symptoms was the most common barrier to achieving employment and education goals. CONCLUSION Future research should examine how IPS programmes could best provide services to young adults.
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Affiliation(s)
- Monirah Al-Abdulmunem
- Social Policy and Economics Research, Westat, Rivermill Commercial Center, Lebanon, New Hampshire, USA
| | - Gary R. Bond
- Social Policy and Economics Research, Westat, Rivermill Commercial Center, Lebanon, New Hampshire, USA
| | - Daniel R. Ressler
- Social Policy and Economics Research, Westat, Rivermill Commercial Center, Lebanon, New Hampshire, USA
| | - Deborah R. Becker
- The IPS Employment Center, Research Foundation for Mental Hygiene, New York, New York, USA
| | - Sarah J. Swanson
- The IPS Employment Center, Research Foundation for Mental Hygiene, New York, New York, USA
| | - Jessica Marbacher
- The IPS Employment Center, Research Foundation for Mental Hygiene, New York, New York, USA
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8
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DeTore NR, Balogun-Mwangi O, Mueser KT, McGurk SR. Comparison of Black and White participants with severe mental illness in response to cognitive remediation as an augmentation of vocational rehabilitation. Schizophr Res 2023; 253:60-67. [PMID: 34772592 PMCID: PMC9088896 DOI: 10.1016/j.schres.2021.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/01/2021] [Accepted: 09/03/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Despite evidence that cognitive remediation improves cognitive and employment outcomes in persons with severe mental illnesses (SMI), its effects have not been systematically compared between Black and White participants. Considering that Black adults have more negative experiences receiving mental health treatment, providers may have greater difficulty engaging and retaining Black Americans in cognitive remediation. Due to the effects of structural racism on reducing employment opportunities for Black Americans, it is unclear whether Black participants will reap the same benefits of cognitive remediation on work outcomes as White Americans. This paper addressed this question. METHODS A secondary analysis was conducted of five randomized controlled trials comparing cognitive remediation (the Thinking Skills for Work program: TSW) and vocational rehabilitation vs. vocational rehabilitation only in 137 Black and 147 White Americans (64.2% schizophrenia-schizoaffective disorder) who were followed up for two years. RESULTS Comparable proportions of Black and White participants were engaged and retained in TSW (>75%). Participants who received TSW improved significantly more in cognition than those receiving vocational services alone, with no racial differences in benefit. Participants in TSW obtained more work, earned more wages, and worked more weeks than those receiving vocational services alone, with no differences between the races. CONCLUSIONS The findings indicate that Black Americans with SMI receiving vocational services could be successfully engaged in and benefit from cognitive remediation, highlighting the vital role of healthcare service systems in giving credence to structural racism to more effectively mitigate racial disparities in treatment outcomes.
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Affiliation(s)
- N R DeTore
- Massachusetts General Hospital, United States of America; Department of Psychiatry, Harvard Medical School, United States of America
| | | | - K T Mueser
- Center for Psychiatric Rehabilitation, Boston University, United States of America; Department of Occupational Therapy, Boston University, United States of America.
| | - S R McGurk
- Center for Psychiatric Rehabilitation, Boston University, United States of America; Department of Occupational Therapy, Boston University, United States of America
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Bond GR, Mascayano F, Metcalfe JD, Riley J, Drake RE. Access, retention, and effectiveness of individual placement and support in the US: Are there racial or ethnic differences? JOURNAL OF VOCATIONAL REHABILITATION 2023. [DOI: 10.3233/jvr-230007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND: Increased federal attention to advancing racial equity and support for underserved communities suggests the need for data on racial and ethnic differences in evidence-based employment services for people with serious mental illness. Individual Placement and Support (IPS) is an evidence-based model of supported employment for this population. OBJECTIVE: The objective was to identify differences based on race and ethnicity in IPS services. METHODS: This narrative review examined the empirical literature on IPS services in the U.S., assessing evidence of differences in access, retention, and outcomes for Black and Hispanic IPS clients, relative to non-Hispanic Whites. RESULTS: We identified 12 studies examining racial and ethnic differences in access (4 studies), retention (3 studies), and effectiveness (6 studies). The findings for access to IPS were mixed, with two studies showing no differences, one finding less access for Blacks, and another finding greater access for Blacks but less access for Hispanics. Three studies found better retention rates for clients enrolled in IPS regardless of race or ethnicity. Compared to clients receiving usual vocational services, all studies found better employment outcomes for IPS clients regardless of race or ethnicity. CONCLUSION: Unlike for most of health care, few racial and ethnic differences have been found for IPS employment services in the U.S. Access to IPS is inadequate for all groups, with conflicting evidence whether Blacks and Hispanics have even less access. Based on the available evidence, Black and Hispanic clients have comparable retention and employment outcomes in IPS as non-Hispanic White clients. State and local mental health leaders responsible for monitoring IPS outcomes should routinely report statistics on race and ethnicity. They should also give active attention to client needs and equity. Research designs should answer multifaceted questions regarding disparities for historically underserved populations.
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Rennhack F, Lindahl-Jacobsen LE, Schori D. Pre-vocational therapy in mental health. Clients' desired and achieved productivity status. Scand J Occup Ther 2023; 30:195-210. [PMID: 34602019 DOI: 10.1080/11038128.2021.1968950] [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: 02/03/2023]
Abstract
BACKGROUND Knowledge about work-related occupational therapy in psychiatric inpatient and day hospital clients is limited. AIMS The aim of the study was to explore the desired and achieved productivity status in mental health service users participating in a pre-vocational therapy (PVT) intervention. Outcome variables were productivity status and achievement of desired productivity status at discharge, and change or persistence of productivity status between admission and discharge. METHODS This is a short-term prospective study based on observational data from health records (N = 98). RESULTS At admission, 53.2% of participants named a clear desired productivity status; 46.8% did not. Of the former, 76.9% expressed a desire for employment or education on the regular job market; 28.0% achieved their desired outcome at discharge, whereas 72.0% did not. Overall, 58.5% retained, established or increased productive activities, while 41.5% were not engaged in or had reduced productive activities at discharge. These two groups differed in socio-economic and social-security-related characteristics, treatment-related characteristics and psychiatric diagnosis. CONCLUSIONS AND SIGNIFICANCE Some, but not all kinds of clients in acute psychiatric inpatient and day hospital settings manage to take a first step towards productive activities during the first phase of treatment.
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Affiliation(s)
- Frauke Rennhack
- Directorate of Nursing, Therapies and Social Work, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | | | - Dominik Schori
- Directorate of Nursing, Therapies and Social Work, University Hospital of Psychiatry Zurich, Zurich, Switzerland
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11
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Witte I, Strandberg T, Granberg S, Gustafsson J. Intersectional perspectives on the employment rate in Supported Employment for people with psychiatric, neuropsychiatric, or intellectual disabilities: A scoping review. Work 2023; 74:435-454. [PMID: 36278382 PMCID: PMC9986703 DOI: 10.3233/wor-211155] [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: 11/05/2022] Open
Abstract
BACKGROUND Supported Employment (SE) has shown better results in the employment rate for persons with disabilities than other methods within vocational rehabilitation, but how SE affects the employment rate for subgroups in the interventions needs further attention. OBJECTIVE To examine previous research regarding the influence of intersecting statuses on the employment rate in SE for people with psychiatric, neuropsychiatric, or intellectual disabilities according to type of diagnosis, sex, race/ethnicity, age, level of education and previous work history. METHODS A systematic literature search was conducted in nine databases including peer-reviewed articles from 2000 to April 2021. Articles presenting the employment rate in SE interventions according to the intersecting statuses listed in the objective were included. RESULTS The searches identified 3777 unique records, of which 53 articles were included in data extraction. In most of the included articles, intersecting statuses did not affect the employment rate for people in the SE interventions with psychiatric disabilities. Few studies have examined neuropsychiatric and intellectual disabilities. A majority of the studies subjected to full-text analysis were excluded due to a lack of reporting of the effects of intersecting statuses on the employment rate. The studies that reported on the effects of intersecting statuses on the employment rate often had small samples and lacked statistical power. CONCLUSIONS Intersecting statuses do not appear to affect the employment rate for people receiving SE interventions, but systematic reviews with pooled samples need to be undertaken because of the low reporting rate and underpowered sample sizes in existing studies.
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Affiliation(s)
- Ingrid Witte
- School of Health Sciences, Örebro University, Örebro, Sweden.,The Swedish Institute for Disability Research, Örebro University, Örebro, Sweden
| | - Thomas Strandberg
- School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden.,The Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.,School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Sarah Granberg
- School of Health Sciences, Örebro University, Örebro, Sweden.,The Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.,Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Johanna Gustafsson
- School of Health Sciences, Örebro University, Örebro, Sweden.,The Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.,Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,Centre for the Study of Professions, Oslo Metropolitan University, Oslo, Norway
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Bobsin TS, Camilo SPO, Cardoso L. Supported employment as a driver for the social inclusion of people with disabilities in the labor market. Work 2023; 76:289-301. [PMID: 36872835 DOI: 10.3233/wor-220563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Based on the need for organizational institutions to act, through public policies, in the establishment of programs focused on the inclusion of People with Disabilities (PwD) in the labor market in Brazil. The Supported Employment methodology (SE) was constituted by directing and providing support, in the workplace, to PwD. OBJECTIVE The purpose of this article is to evaluate the intra-organizational management of the inclusion of people with disabilities in the labor market in the southern region of Santa Catarina and the alignment with the precepts of Supported Employment (SE). METHODS Using a qualitative approach, the multi-case study was carried out through interviews, based on semi-structured questions, in five companies in the southern region of SC that are required to hire PwD. RESULTS The research points out the movement of companies in the development of policies and practices for the inclusion of PwD in the job market. However, there is still a significant gap between company practices and SE precepts. There are no formal programs and policies with wide internal dissemination, about the drivers for PwD. CONCLUSION This study helps to address eventual difficulties of companies regarding practices in the inclusion of PwD, contributes to the definition of guidelines aimed at improving existing policies or in the development of new practices aimed at the inclusion of PwD.
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Affiliation(s)
| | | | - Luana Cardoso
- University of the Extreme South of Santa Catarina, Criciúma, SC, Brazil
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Efficacy and acceptability of psychosocial interventions in schizophrenia: systematic overview and quality appraisal of the meta-analytic evidence. Mol Psychiatry 2023; 28:354-368. [PMID: 35999275 DOI: 10.1038/s41380-022-01727-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/21/2022] [Accepted: 07/26/2022] [Indexed: 01/11/2023]
Abstract
Psychosocial interventions are recommended in schizophrenia and first-episode psychosis/early psychosis (EP). Nevertheless, literature is heterogeneous and often contradictory. We conducted an umbrella review of (network) meta-analyses of randomized controlled trials (RCTs) comparing psychosocial interventions vs treatment as usual (TAU)/active interventions(ACTIVE)/MIXED controls. Primary outcome was total symptoms (TS); secondary outcomes were positive/negative/depressive symptoms (PS/NS/DS), cognition, functioning, relapse, hospitalization, quality of life (QoL), treatment discontinuation. Standardized mean difference (SMD)/odds ratio (OR)/risk ratio (RR) vs TAU/ACTIVE/MIXED were summarized at end-of-treatment (EoT)/follow-up (FU). Quality was rated as high/medium/low (AMSTAR-PLUS). Eighty-three meta-analyses were included (RCTs = 1246; n = 84,925). Against TAU, regarding TS, Early Intervention Services (EIS) were superior EoT/FU in EP (SMD = -0.32/-0.21), cognitive behavioral therapy (CBT) in schizophrenia EoT/FU (SMD = -0.38/-0.19). Regarding secondary outcomes, in EP, EIS were superior for all outcomes EoT except cognition, and at FU for PS/NS/QoL, specific family interventions (FI-s) prevented relapse EoT; in schizophrenia, superiority emerged EoT for CBT for PS/NS/relapse/functioning/QoL; psychoeducation (EDU)/any FI for relapse; cognitive remediation therapy (CRT) for cognition/functioning; and hallucination-focused integrative treatment for PS. Against ACTIVE, in EP, mixed family interventions (FI-m) were superior at FU regarding TS (SMD = -0.61) and for functioning/relapse among secondary outcomes. In schizophrenia, regarding TS, mindfulness and social skills training (SST) were superior EoT, CBT at FU; regarding secondary outcomes superiority emerged at EoT for computerized cognitive drill-and-practice training for PS/DS, CRT for cognition/functioning, EDU for relapse, individual placement and support (IPS) for employment; and at FU CBT for PS/NS. Against MIXED, in schizophrenia, CRT/EDU were superior for TS EoT (d = -0.14/SMD = -0.33), CRT regarding secondary outcomes EoT for DS/social functioning, both EoT/FU for NS/cognition/global functioning; compensatory cognitive interventions for PS/functioning EoT/FU and NS EoT; CBT for PS at FU, and EDU/SST for relapse EoT. In conclusion, mental health services should consider prioritizing EIS/any FI in EP and CBT/CRT/any FI/IPS for schizophrenia, but other interventions may be helpful for specific outcomes.
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Bond GR, Al-Abdulmunem M, Marbacher J, Christensen TN, Sveinsdottir V, Drake RE. A Systematic Review and Meta-analysis of IPS Supported Employment for Young Adults with Mental Health Conditions. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:160-172. [PMID: 36219318 DOI: 10.1007/s10488-022-01228-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2022] [Indexed: 02/04/2023]
Abstract
Young adults with mental health conditions want to work and advance their education, but many need help attaining these goals. Individual Placement and Support (IPS), originally developed for working-age adults with serious mental illness, is an evidence-based employment model that may benefit young adults. This study is the first systematic review and meta-analysis of randomized controlled trials (RCTs) of IPS for this population. We conducted a systematic review of the effectiveness of IPS for young adults with mental health conditions, supplementing our electronic search of the published literature with secondary analyses of two published RCTs. Using meta-analysis, we evaluated employment rate, job duration, and education rate. Seven studies met the inclusion criteria. Four evaluated IPS for young adults with early psychosis and three evaluated IPS for other young adult subgroups. All found a significantly higher employment rate for IPS than the control group. Overall, 208 (58.3%) of 357 IPS participants and 110 (32.4%) of 340 control participants were competitively employed during follow-up, yielding an overall risk ratio of 1.69 (95% CI 1.43, 1.99), z = 6.24, p < 0.001. Six of the seven studies also reported longer job duration for IPS than the control group, yielding an overall g = 0.34 (95% CI 0.09, 0.58), z = 2.72, p < 0.01. None of four RCTs examining education outcomes found a significant difference favoring IPS, but the overall risk ratio was significant: 1.33 (95% CI 1.06, 1.66), z = 2.51, p < 0.01. Although the empirical literature is limited, IPS appears to be effective in helping young adults with serious mental illness or early psychosis gain and keep competitive jobs. The impact of IPS on education outcomes is unclear. Future research should evaluate the generalizability of these findings to the broad range of young adults with mental health conditions needing help with their employment goals.
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Affiliation(s)
- Gary R Bond
- Social Policy and Economics Research, Westat, Rivermill Commercial Center, 85 Mechanic St., Lebanon, NH, 03766, USA.
- Social Policy and Economics Research, Westat, Rivermill Commercial Center, 85 Mechanic Street, Suite C3-1, Lebanon, NH, 03766, USA.
| | - Monirah Al-Abdulmunem
- Social Policy and Economics Research, Westat, Rivermill Commercial Center, 85 Mechanic St., Lebanon, NH, 03766, USA
| | | | - Thomas N Christensen
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen, Denmark
| | | | - Robert E Drake
- Social Policy and Economics Research, Westat, Rivermill Commercial Center, 85 Mechanic St., Lebanon, NH, 03766, USA
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Ow N, Leon A, Thom B, Herwynen J, Mathias SM, Barbic S. "I Felt Supported by the Peers in My Group": Analyzing Experiences of Youths with Mental Health Challenges of a Supported Employment Program in Canada. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:753-763. [PMID: 35451694 PMCID: PMC9025999 DOI: 10.1007/s10926-022-10039-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/30/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE The objectives of this study were to gain an understanding of the experiences of youths with mental health conditions who have undergone a 16-week supported employment program (SEP) conducted in an urban centre in Canada. METHODS Focus groups and individual semi-structured interviews were used to capture the experience of youths who had completed the program. Youths were eligible if they were aged 19 to 30 years diagnosed with a mental illness and enrolled in the program. Purposeful sampling was used to recruit participants. Thematic analysis was conducted to analyze the data. Primary codes were organized and mapped onto Donebedian's Structure-Process-Outcome Model. RESULTS Altogether, 34 participants, aged 17 to 30 years old, described their experiences participating in this 16-week supported employment program. Participants' experiences of this program and with employment were categorized into four main themes focusing on the (1) structure of program, (2) process of care (3) outcomes of program, and (4) improvements to the program. CONCLUSION Overall, the experience of a supported employment program was perceived as valuable, with unexpected benefits of the program beyond employment including the establishment of routine, friendship, and self-confidence. The proposed model can be used as a structure for monitoring and evaluating SEP.
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Affiliation(s)
- Nikki Ow
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, The University of British Columbia, St. Paul's Hospital, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada
| | - Adelena Leon
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, The University of British Columbia, St. Paul's Hospital, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada
| | - Breanna Thom
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, The University of British Columbia, St. Paul's Hospital, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada
| | - Jessica Herwynen
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, The University of British Columbia, St. Paul's Hospital, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada
| | - Steven M Mathias
- Department of Psychiatry, UBC, Vancouver, BC, Canada
- Foundry Central Office, Vancouver, BC, Canada
| | - Skye Barbic
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, The University of British Columbia, St. Paul's Hospital, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada.
- Centre for Health Evaluation Outcome Sciences, Vancouver, BC, Canada.
- Foundry Central Office, Vancouver, BC, Canada.
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Poulsen CH, Christensen TN, Madsen T, Nordentoft M, Eplov LF. Trajectories of Vocational Recovery Among Persons with Severe Mental Illness Participating in a Randomized Three-Group Superiority Trial of Individual Placement and Support (IPS) in Denmark. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:260-271. [PMID: 34510308 DOI: 10.1007/s10926-021-10003-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/06/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE To investigate longitudinal trajectories of vocational recovery (VR) among individuals with severe mental illness (SMI) who participated in the Danish Individual Placement and Support (IPS) trial, and whether the IPS intervention, socio-demographic and disease-specific characteristics predicted trajectory membership. METHODS In an observational study design, we used previously collected data from the Danish IPS trial (N = 720). VR was defined as 'weeks in competitive employment or education in the past 6 months and was measured after 0.5, 1, 1.5, 2 and 2.5 years, using data from the Danish Register for Evaluation of Marginalization (DREAM) database. Latent growth mixture modelling in Mplus statistical software (version 7) was applied to identify trajectories of VR. Multinomial logistic regression analyses were used to estimate predictors for trajectory membership. RESULTS Four trajectories were identified: 'Low VR' (61.3%), 'Low Increasing VR (8.2%), 'Increasing Decreasing VR' (7.2%) and 'High VR' (23.4%). Receiving the IPS intervention increased odds of membership in 'High VR' compared to 'Low VR' (OR = 2.18; 95% CI 1.37-3.48) and so did higher education (OR = 2.25; 95% CI 1.39-3.64), higher cognitive function (OR = 1.17; 95% CI 1.02-1.35), higher motivation to change (OR = 1.04; 95% CI 1.02-1.05) and previous work history (OR = 1.64; 95% CI 1.09-2.46). Higher age decreased odds of membership in the 'High VR' (OR = 0.95; 95% CI 0.93-0.98) compared to 'Low VR'. CONCLUSION There was high heterogeneity in the identified VR trajectories, despite that all participants expressed a desire for work and education at baseline. Improvements of the IPS intervention are needed to support specific groups in achieving and retaining employment.
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Affiliation(s)
- Chalotte Heinsvig Poulsen
- Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, University of Copenhagen, Copenhagen, Denmark.
| | - Thomas Nordahl Christensen
- Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Trine Madsen
- Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Merete Nordentoft
- Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Lene Falgaard Eplov
- Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, University of Copenhagen, Copenhagen, Denmark
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Ditchman N, Thomas JA, Johnson K, Haak C, Rafajko S. The impact of employment on quality of life for adults with brain injury. JOURNAL OF VOCATIONAL REHABILITATION 2022. [DOI: 10.3233/jvr-211168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Employment is associated with greater quality of life (QOL) for people with disabilities. Yet, for individuals with traumatic brain injury (TBI), the benefits of work are not often realized given high rates of unemployment. OBJECTIVE: This study examined the unique impact of psychosocial variables and employment status (working vs. not working) on self-reported QOL among adults with TBI. METHODS: Participants included 116 adults with TBI between the ages of 18-65, recruited through state brain injury associations in the United States to complete an anonymous online survey. Hierarchical regression analysis was used to examine the incremental impact of psychosocial variables (sense of community, social support, social network, and problem-solving confidence) and employment status on QOL controlling for age and symptom severity. RESULTS: In the final model, employment status, informal and formal support network ties, problem-solving confidence, sense of community, and emotional support explained 59% of the variance in QOL, which is considered a large effect size. Employment status uniquely explained 5% of the variance in QOL. CONCLUSIONS: Findings support the positive benefits of work for adults with TBI. Rehabilitation services that emphasize vocational considerations and employment supports are needed to impact work status and ultimately QOL for individuals with TBI.
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Affiliation(s)
- Nicole Ditchman
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA
| | - Julia A. Thomas
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA
| | - Kristina Johnson
- Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Christopher Haak
- Center for Disabilities and Development, University of Iowa, Iowa City, IA, USA
| | - Sean Rafajko
- Gersten Center for Behavioral Health, Chicago, IL, USA
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Kawano K, Haga S, Endo K, Shimada T, Kobayashi M. Outcomes of an employment support program in psychiatric day care collaborate with the public employment service: a single-arm preliminary study. ENVIRONMENTAL AND OCCUPATIONAL HEALTH PRACTICE 2022. [DOI: 10.1539/eohp.2021-0009-oa] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Kojiro Kawano
- Medical Corporation Yuaikai Tikumaso Mental Hospital
| | - Saori Haga
- Medical Corporation Yuaikai Tikumaso Mental Hospital
| | - Kenji Endo
- Medical Corporation Yuaikai Tikumaso Mental Hospital
| | - Takeshi Shimada
- Medical Corporation Seitaikai Mental Support Soyokaze Hospital
| | - Masayoshi Kobayashi
- Department of Health Sciences, Graduate School of Medicine, Shinshu University
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Hellström L, Pedersen P, Christensen TN, Wallstroem IG, Bojesen AB, Stenager E, Bejerholm U, van Busschbach J, Michon H, Mueser KT, Reme SE, White S, Eplov LF. Vocational Outcomes of the Individual Placement and Support Model in Subgroups of Diagnoses, Substance Abuse, and Forensic Conditions: A Systematic Review and Analysis of Pooled Original Data. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:699-710. [PMID: 33661452 DOI: 10.1007/s10926-021-09960-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/08/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE To investigate the effect of Individual Placement and Support (IPS) according to diagnoses of schizophrenia, bipolar disorder, major depression, substance use disorders, or forensic psychiatric conditions. METHODS A systematic search of the literature was conducted in June 2017 and repeated in December 2020. The systematic review included 13 studies. Analyses of pooled original data were based on the six studies providing data (n = 1594). No studies on forensic psychiatric conditions were eligible. Hours and weeks worked were analyzed using linear regression. Employment, and time to employment was analyzed using logistic regression, and cox-regression, respectively. RESULTS The effects on hours and weeks in employment after 18 months were comparable for participants with schizophrenia, and bipolar disorder but only statistically significant for participants with schizophrenia compared to services as usual (SAU) (EMD 109.1 h (95% CI 60.5-157.7), 6.1 weeks (95% CI 3.9-8.4)). The effect was also significant for participants with any drug use disorder (121.2 h (95% CI 23.6-218.7), 6.8 weeks (95% CI 1.8-11.8)). Participants with schizophrenia, bipolar disorder, and any drug use disorder had higher odds of being competitively employed (OR 2.1 (95% CI 1.6-2.7); 2.4 (95% CI 1.3-4.4); 3.0 (95% CI 1.5-5.8)) and returned to work faster than SAU (HR 2.1 (95% CI 1.6-2.6); 1.8 (95% CI 1.1-3.1); 3.0 (95% CI 1.6-5.7)). No statistically significant effects were found regarding depression. CONCLUSIONS IPS was effective regarding schizophrenia, bipolar disorder, and substance use disorder; however, the effect on hours, and weeks worked was not statistically significant regarding bipolar disorder. For people with depression the impact of IPS remains inconclusive. Non-significant results may be due to lack of power. TRIAL REGISTRATION PROSPERO protocol nr. CRD42017060524.
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Affiliation(s)
- Lone Hellström
- CORE: Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Gentofte Hospitalsvej 15, 2900, Hellerup, Denmark.
| | - Pernille Pedersen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | - Thomas Nordahl Christensen
- CORE: Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Gentofte Hospitalsvej 15, 2900, Hellerup, Denmark
- Institute of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Iben Gammelgaard Wallstroem
- Research Unit of Mental Health, Odense, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Anders Bo Bojesen
- CORE: Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Gentofte Hospitalsvej 15, 2900, Hellerup, Denmark
| | - Elsebeth Stenager
- Research Unit of Mental Health, Aabenraa, Institute of Regional Health Services, University of Southern Denmark, Odense, Denmark
| | | | - Jooske van Busschbach
- University Medical Center Groningen, Groningen, Netherlands
- University Center of Psychiatry, Groningen, Netherlands
- Department of Movement and Education, Windesheim University of Applied Sciences, Zwolle, Netherlands
| | | | - Kim T Mueser
- Center for Psychiatric Rehabilitation, Boston University, Boston, USA
| | | | - Sarah White
- Population Health Research Institute St George's, University of London, London, UK
| | - Lene Falgaard Eplov
- CORE: Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Gentofte Hospitalsvej 15, 2900, Hellerup, Denmark
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Morant N, Milton A, Gilbert E, Johnson S, Parsons N, Singh S, Marwaha S. Vocational rehabilitation via social firms: a qualitative investigation of the views and experiences of employees with mental health problems, social firm managers and clinicians. BMC Psychiatry 2021; 21:566. [PMID: 34772380 PMCID: PMC8590221 DOI: 10.1186/s12888-021-03577-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Employment within social firms in the UK is under-developed and under-researched, but a potentially beneficial route to vocational rehabilitation for people with mental health problems. This study explores the views and experiences of employees with mental ill-health, managers of social firms and mental health clinicians, in order to understand the potential value of social firms for the vocational rehabilitation, employment and well-being of people with mental health problems. METHODS Semi-structured interviews were conducted with 23 employees with mental health problems in 11 social firms in England. A focus group and individual interviews were conducted with 12 managers of social firms. Two focus groups were held with 16 mental health clinicians. Data were analysed using thematic analysis. RESULTS Most employees expressed very positive views about working in a social firm. In responses from both employees and social firm managers, an overarching theme regarding the supportive ethos of social firms encompassed several related features: openness about mental health issues; peer, team and management support; flexibility; and support to progress and develop skills over time. Managers identified benefits of employing people with mental health problems who were sufficiently recovered. Knowledge of social firms within clinician focus groups was very limited, although clinicians thought they could be a welcome additional vocational resource. CONCLUSIONS High levels of job satisfaction among social firm employees may be explained by the supportive ethos of these working environments. Social firms have potential to be a helpful addition to the range of vocational pathways available for people with mental ill-health. Further mixed methods investigations of experiences and outcomes in order to understand who engages with and benefits from this form of vocational rehabilitation would be valuable in informing decisions about scaling up the model.
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Affiliation(s)
- Nicola Morant
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, W1T 7NF, London, UK.
| | - Alyssa Milton
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, W1T 7NF, London, UK
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Eleanor Gilbert
- Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Sonia Johnson
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, W1T 7NF, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Nicholas Parsons
- Statistics and Epidemiology Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Swaran Singh
- Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Steven Marwaha
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
- Birmingham and Solihull Mental Health Trust, Birmingham, UK
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İNCEDERE A, YILDIZ M. Şizofreni Hastalarında Destekli İşe Yerleştirim: Üç Yıllık İzlem Sonucunun Değerlendirmesi. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2021. [DOI: 10.30934/kusbed.901262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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22
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Christensen TN, Wallstrøm IG, Bojesen AB, Nordentoft M, Eplov LF. Predictors of work and education among people with severe mental illness who participated in the Danish individual placement and support study: findings from a randomized clinical trial. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1669-1677. [PMID: 34032866 DOI: 10.1007/s00127-021-02107-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 05/10/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE People with severe mental illness experience disproportionately high rates of unemployment. Nonetheless, a substantial amount of research has demonstrated vocational benefits of the Individual Placement and Support (IPS) model and IPS supplemented with cognitive remediation (IPSE). The present study sought to examine demographic and clinical predictors of employment or education among people with severe mental illness and to investigate if IPS or IPSE can compensate for risk factors for unemployment. METHODS Seven hundred twenty participants were randomly assigned to IPS, IPSE or Service as Usual. During the 18-month follow-up period participants in the two experimental groups obtained significantly more work or education. A series of univariate and multiple logistic regression analyses were conducted to assess the predictive power of demographic and clinical factors for the total population and for the three groups individually. RESULTS The strongest predictor for vocational recovery, besides treatment allocation, was previous work history (OR = 1.78; 95% CI = 1.28-2.47). Men had a lower probability for vocational recovery compared to women (OR = 0.71; 95% CI = 0.50-0.99) and higher age was also negatively associated with work or education (OR = 0.79; 95% CI = 0.67-0.93). Moreover, vocational recovery was predicted by higher readiness for change, measured on the readiness for change scale (OR = 1.42; 95% CI = 1.19-1.70). Participation in IPS or IPSE could not compensate for negative risk factors such as low cognitive function or negative symptoms. CONCLUSIONS In a multiple logistic regression analysis age, previous work history and motivation for change were statistically significant predictors of obtaining work or education among people with severe mental illness who participated in the Danish IPS trial.
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Affiliation(s)
- Thomas Nordahl Christensen
- Copenhagen Research Center for Mental Health (CORE), Mental Health Centre Copenhagen, Copenhagen, Denmark.
| | - Iben Gammelgård Wallstrøm
- Research Unit of Psychiatry, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Anders Bo Bojesen
- Copenhagen Research Center for Mental Health (CORE), Mental Health Centre Copenhagen, Copenhagen, Denmark
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health (CORE), Mental Health Centre Copenhagen, Copenhagen, Denmark
| | - Lene Falgaard Eplov
- Copenhagen Research Center for Mental Health (CORE), Mental Health Centre Copenhagen, Copenhagen, Denmark
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Vlachou A, Roka O, Stavroussi P. Experiences of workers with disabilities receiving supported employment services in Greece. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2021; 25:151-167. [PMID: 31476953 DOI: 10.1177/1744629519871172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
People with disabilities (PwDs) are under-represented in the workforce, especially during times of economic recession. Supported employment is recognized as an effective practice for promoting work inclusion of PwDs, including people with intellectual disabilities (IDs). This study aimed at exploring the experiences of workers with ID or mental health conditions who received supported employment services in Greece. Semi-structured interviews were conducted with nine workers with ID and five with mental health conditions. The thematic analysis revealed that emotional pressure was experienced by the participants with mental health conditions and those with ID during the job search and the adaptation period, respectively. On-the-job training was available for the participants with ID and assistance in finding suitable job opportunities was given to those with mental health conditions. All participants highlighted the importance of maintaining employment. The findings can inform efforts on developing employment services targeting social and work inclusion for PwDs.
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Drake RE, Sederer LI, Becker DR, Bond GR. COVID-19, Unemployment, and Behavioral Health Conditions: The Need for Supported Employment. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2021; 48:388-392. [PMID: 33791925 PMCID: PMC8011768 DOI: 10.1007/s10488-021-01130-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2021] [Indexed: 11/25/2022]
Abstract
The COVID-19 pandemic has caused massive unemployment, exacerbated pre-existing behavioral health (mental health and substance use) disorders for many people, and created new disorders for others. Although policy changes have increased health care and unemployment benefits, most people want jobs and self-sufficiency rather than handouts. A robust evidence base shows that supported employment can enable unemployed people with behavioral health conditions to find competitive, integrated employment and behavioral health supports. Millions of U.S. citizens may need these services as the pandemic recedes and jobs become available. Government attention to supported employment is necessary now more than ever.
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Affiliation(s)
- Robert E Drake
- Westat, Rivermill Commercial Center, 85 Mechanic Street Suite C3-1, Lebanon, NH, 03766, USA
| | | | - Deborah R Becker
- Westat, Rivermill Commercial Center, 85 Mechanic Street Suite C3-1, Lebanon, NH, 03766, USA
| | - Gary R Bond
- Westat, Rivermill Commercial Center, 85 Mechanic Street Suite C3-1, Lebanon, NH, 03766, USA.
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Pichler EM, Stulz N, Wyder L, Heim S, Watzke B, Kawohl W. Long-Term Effects of the Individual Placement and Support Intervention on Employment Status: 6-Year Follow-Up of a Randomized Controlled Trial. Front Psychiatry 2021; 12:709732. [PMID: 34712153 PMCID: PMC8546221 DOI: 10.3389/fpsyt.2021.709732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 09/10/2021] [Indexed: 11/13/2022] Open
Abstract
People with mental illness often experience difficulties with reintegration into the workplace, although employment is known to assist these individuals in their recovery process. Traditional approaches of "first train, then place" have been recently replaced by supported employment (SE) methods that carry strategy of "first place, then train." Individual placement and support (IPS) is one of the best-studied methods of SE, which core principles are individualized assistance in rapid job search with consequent placement in a paid employment position. A considerable amount of high-quality evidence supported the superiority of IPS over conventional methods in providing improved employment rates, longer job tenure, as well as higher salaries in competitive job markets. Nonetheless, our knowledge about the IPS-mediated long-term effects is limited. This non-interventional follow-up study of a previously published randomized controlled trial (RCT) called ZhEPP aimed to understand the long-term impact of IPS after 6 years since the initial intervention. Participants from the ZhEPP trial, where 250 disability pensioners with mental illnesses were randomized into either IPS intervention group or treatment as usual group (TAU), were invited to face-to-face interviews, during which employment status, job tenure, workload, and salaries were assessed. One hundred and fourteen individuals agreed to participate in this follow-up study. Although during the first 2 years post-intervention, the IPS group had higher employment rates (40% (IPS) vs. 28% (TAU), p < 0.05 at 24 months), these differences disappeared by the time of follow-up assessments (72 months). The results indicated no substantial differences in primary outcome measures between IPS and TAU groups: employment rate (36 vs. 33%), workload (10.57 vs. 10.07 h per week), job tenure (29 vs. 28 months), and salary (20.21CHF vs. 25.02 CHF). These findings provide important insights regarding the long-term effects of IPS among individuals with mental health illnesses. Further research is required to advance the current knowledge about IPS intervention and its years-long impact.
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Affiliation(s)
- Eva-Maria Pichler
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland.,Psychiatric Services Aargau, Windisch, Switzerland
| | - Niklaus Stulz
- Psychiatric Services Aargau, Windisch, Switzerland.,Integrated Psychiatric Services Winterthur-Zurcher Unterland (IPW), Winterthur, Switzerland
| | - Lea Wyder
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland.,Psychiatric Services Aargau, Windisch, Switzerland
| | - Simone Heim
- Psychiatric Services Aargau, Windisch, Switzerland.,Praxis Dr. Pramstaller, Uetikon am See, Switzerland
| | - Birgit Watzke
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Wolfram Kawohl
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland.,Psychiatric Services Aargau, Windisch, Switzerland.,Clienia Schlössli AG, Oetwil am See, Switzerland
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Abstract
Many people with serious mental disorders want to work. Individual placement and support (IPS), an evidence-based program that helps such individuals find and maintain jobs of their choice, has spread steadily across the United States (which has more than 1,000 IPS programs) and to at least 19 other countries during the past 20 years. Four factors explain the program's success. First, IPS is client-centered-IPS specialists follow their clients' preferences regarding issues such as type of employment, style of job search, and type of job support needed. Second, research has undergirded IPS's evolution, helping to refine its effectiveness. Third, support from private foundations and federal agencies has helped to foster implementation, research, and dissemination efforts. Fourth, an international learning community has consolidated cooperation among stakeholders and mental health and vocational rehabilitation agencies and has facilitated continuous quality improvement through data sharing and extensive interactions.
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Affiliation(s)
| | | | - Gary R Bond
- IPS Employment Center, Westat, Lebanon, New Hampshire
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Jagannathan A, Harish N, Venkatalakshmi C, Kumar CN, Thirthallli J, Kumar D, Bhola P, Prasad MK, Thanapal S, Hareesh A, Jayarajan D, Govindan R, Chaturvedi SK. Supported employment programme for persons with severe mental disorders in India: A feasibility study. Int J Soc Psychiatry 2020; 66:607-613. [PMID: 32475320 DOI: 10.1177/0020764020918278] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND A number of persons with severe mental illnesses are unable to prepare for, find or keep a job due to factors linked to their illness as well as psychosocial issues. AIM To test the feasibility of a supported employment programme to help persons with severe mental disorders obtain and sustain employment. METHODS A supported employment programme was developed for persons with severe mental disorders with components of (a) assessment of vocational potential, (b) vocational counselling, (c) networking and liaison with prospective employers, (d) job-related training and placement and (e) continued support for 6 months. Job placement status, social occupational functioning and disability (quantitative data) and benefits of enrolling in the employment programme (qualitative data) were assessed. RESULTS A total of 40 employers were liaised with for providing job placement and reasonable accommodation. Out of 63 participants recruited into the study, 32 (50.8%) participants were placed in competitive jobs, placement was actively attempted for 17 (27.0%) participants, 7 (11.1%) were referred for skill training and 7 (11.1%) dropped out from the study. The disability score significantly reduced and socio-occupational functioning significantly improved in those who were placed over a period of 6 months. CONCLUSION The supported employment programme was found to be feasible as it showed good placement rates and improvement in socio-occupational functioning and disability scores.
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Affiliation(s)
- Aarti Jagannathan
- Faculty of Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Nikitha Harish
- Senior Research Fellow, Department of Empowerment of Persons with Disabilities (DEPD), Govt of India funded research project, NIMHANS, Bengaluru, India
| | - C Venkatalakshmi
- Senior Research Fellow, Department of Empowerment of Persons with Disabilities (DEPD), Govt of India funded research project, NIMHANS, Bengaluru, India
| | - C Naveen Kumar
- Faculty of Department of Psychiatry, NIMHANS, Bengaluru, India
| | | | - Devvarta Kumar
- Faculty of Department of Clinical Psychology, NIMHANS, Bengaluru, India
| | - Poornima Bhola
- Faculty of Department of Clinical Psychology, NIMHANS, Bengaluru, India
| | | | | | - A Hareesh
- Faculty of Department of Psychiatry, NIMHANS, Bengaluru, India
| | | | | | - S K Chaturvedi
- Faculty of Department of Psychiatry, NIMHANS, Bengaluru, India
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Prior S, Maciver D, Aas RW, Kirsh B, Lexen A, van Niekerk L, Irvine Fitzpatrick L, Forsyth K. An enhanced individual placement and support (IPS) intervention based on the Model of Human Occupation (MOHO); a prospective cohort study. BMC Psychiatry 2020; 20:361. [PMID: 32641009 PMCID: PMC7346406 DOI: 10.1186/s12888-020-02745-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 06/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Employment is good for physical and mental health, however people with severe mental illness (SMI) are often excluded from employment. Standard Individual Placement and Support (IPS) is effective in supporting around 55% of people with SMI into employment or education. Current research considers enhancements to IPS to improve outcomes for those requiring more complex interventions. Clinicians need to better understand who will benefit from these enhanced IPS interventions. This study offers a new enhanced IPS intervention and an approach to predicting who may achieve successful outcomes. METHODS This prospective cohort study included people with SMI who participated in an enhanced IPS service and had prolonged absence from employment. Secondary data analysis was conducted of data gathered in routine clinical practice. Univariate analysis coupled with previous research and clinical consultation was used to select variables to be included in the initial model, followed by a backward stepwise approach to model building for the final multiple logistic regression model with an outcome of successful or unsuccessful goal attainment (employment or education). RESULTS Sixty-three percent of participants in the enhanced IPS successfully attained employment or education. Significant relationships from bivariate analyses were identified between outcomes (employment or education) and seven psychosocial variables. Adapting Routines to Minimise Difficulties, Work Related Goals, and Living in an Area of Lesser Deprivation were found to be significant in predicting employment or education in the final multiple logistic regression model R2 = 0.16 (Hosmer-Lemeshow), 0.19 (Cox-Snell), 0.26 (Nagelkerke). Model χ2(7) = 41.38 p < .001. CONCLUSION An enhanced IPS service had a 63% rate success in achieving employment or education, higher than comparable studies and provides an alternative to IPS-Lite and IPS-standard for more complex populations. Motivational and habitual psychosocial variables are helpful in predicting who may benefit from an enhanced IPS intervention supporting people after prolonged absence from employment. TRIAL REGISTRATION NCT04083404 Registered 05 September 2019 (retrospectively registered).
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Affiliation(s)
- Susan Prior
- Queen Margaret University, Edinburgh, EH21 6UU, UK.
| | - Donald Maciver
- grid.104846.fQueen Margaret University, Edinburgh, EH21 6UU UK
| | - Randi W. Aas
- Faculty of Health Sciences, University of Stavanger & Oslo Metropolitan University, Oslo, Norway
| | - Bonnie Kirsh
- grid.17063.330000 0001 2157 2938Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Annika Lexen
- grid.4514.40000 0001 0930 2361Department of Health Sciences/Mental Health Activity and Participation (MAP), Lund University, Lund, Sweden
| | - Lana van Niekerk
- grid.11956.3a0000 0001 2214 904XDivision of Occupational Therapy, University Stellenbosch, Stellenbosch, South Africa
| | - Linda Irvine Fitzpatrick
- Mental Health and Wellbeing, City of Edinburgh Health and Social Care Partnership, Waverley Court, Edinburgh, EH8 8BG UK
| | - Kirsty Forsyth
- grid.104846.fQueen Margaret University, Edinburgh, EH21 6UU UK
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Abstract
PURPOSE OF REVIEW To provide an overview of the update of the evidence-based and consensus-based German S3 guideline on psychosocial therapies for severe mental illnesses (SMI), with particular attention to current developments and future research tasks. RECENT FINDINGS There has been a significant increase in studies on the effectiveness of psychosocial interventions in treatment of people with SMI. In the guideline a distinction is made between system-level interventions (e.g. multidisciplinary team-based psychiatric community care) and single-handed (nonteam-based) interventions (e.g. psychoeducation). Furthermore, principles of treatment (e.g. recovery-orientation) and self-help interventions (e.g. peer support) are addressed. The update of the guideline includes 33 recommendations and 12 statements. Compared with the first edition, there were upgrades in the recommendation of Supported Employment (A) and Supported Housing (A). Interventions such as peer support (B) and lifestyle interventions (A) were included for the first time. Developments are discussed in the context of most recent literature. Areas for further research are highlighted and fields for next updates such as antistigma interventions and supported parenting were identified. SUMMARY The present guideline offers an important opportunity to further improve health services for people with SMI. However, guideline implementation is challenging.
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Kordsmeyer AC, Lengen JC, Kiepe N, Harth V, Mache S. Working Conditions in Social Firms and Health Promotion Interventions in Relation to Employees' Health and Work-Related Outcomes-A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113963. [PMID: 32503252 PMCID: PMC7312385 DOI: 10.3390/ijerph17113963] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/25/2020] [Accepted: 05/27/2020] [Indexed: 12/31/2022]
Abstract
Background: Social firms—a type of social enterprise—offer people with severe disabilities the possibility of employment and integration into the labor market. Since 01 January 2018, social firms in Germany are obligated to provide health promotion interventions for their employees. Therefore, the study aims to provide an overview of the current state of research on working conditions, coping strategies, work- and health-related outcomes, and health promotion interventions in social firms to derive recommendations for action. Methods: The databases PubMed, MEDLINE, PsycINFO, PSYNDEX, CINAHL, and Web of Science were searched. The study selection was based on predefined inclusion and exclusion criteria in the time period between 2000 and 2019. The quality of the studies was critically appraised in a standardized way using the Mixed-Methods Appraisal Tool. Results: A total of 25 studies were included. The current state of research indicated that employees with disabilities were provided with several environmental resources like social support, flexibility, structured work tasks or options for training. A mix of environmental and personal resources impacted several work- and health-related outcomes like well-being, job satisfaction, productivity, work engagement, the motivation to work, or job tenure. Conclusions: There is a need for further (longitudinal) research concerning the work and health situation of employees working in social firms and the development of health promotion interventions.
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Juurlink TT, Lamers F, van Marle HJF, Michon H, van Busschbach JT, Beekman ATF, Anema JR. Employment in Personality Disorders and the Effectiveness of Individual Placement and Support: Outcomes from a Secondary Data Analysis. JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:255-262. [PMID: 31820219 PMCID: PMC7293674 DOI: 10.1007/s10926-019-09868-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Purpose Personality disorders (PDs) are associated with severe functional impairment and subsequent high societal costs, increasing the need to improve occupational functioning in PD. Individual placement and support (IPS) is an effective, evidence-based method of supported employment, which so far has been tested in various mixed patient populations with severe mental illness (SMI, including PDs). However, the effectiveness of IPS for PDs per se remains uninvestigated. Methods Data from the SCION trial were used, including 31 SMI patients with PDs and 115 SMI patients with other primary diagnoses (primarily psychotic disorders). First, the interaction effect of diagnosis (PD vs other SMI) and intervention (IPS vs traditional vocational rehabilitation) was studied. Second, in the IPS condition, difference between diagnostic groups in time to first job was studied. Results We did not find evidence of a moderating effect of PD diagnosis on the primary effect of IPS (proportion who started in regular employment) (OR = 0.592, 95% CI 0.80-4.350, p = 0.606) after 30 months. Also, PD diagnosis did not moderate the effect of time until first job in IPS. Conclusions From the present explorative analysis we did not find evidence for a moderating effect of PD diagnosis on the effectiveness of IPS among PD participants. This indicates that IPS could be as effective in gaining employment in participants with PD as it is in participants with other SMI. Future studies, implementing larger numbers, should confirm whether IPS is equally effective in PDs and study whether augmentations or alterations to the standard IPS model might be beneficiary for PD.
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Affiliation(s)
- T T Juurlink
- Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, De Boelelaan 1117, Amsterdam, The Netherlands.
- GGZ inGeest Specialized Mental Health Care, Oldenaller 1, 1081 HJ, Amsterdam, The Netherlands.
| | - F Lamers
- Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, De Boelelaan 1117, Amsterdam, The Netherlands
- GGZ inGeest Specialized Mental Health Care, Oldenaller 1, 1081 HJ, Amsterdam, The Netherlands
| | - H J F van Marle
- Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, De Boelelaan 1117, Amsterdam, The Netherlands
- GGZ inGeest Specialized Mental Health Care, Oldenaller 1, 1081 HJ, Amsterdam, The Netherlands
| | - H Michon
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - J T van Busschbach
- University Medical Center Groningen, University Center of Psychiatry, University of Groningen, Groningen, The Netherlands
| | - A T F Beekman
- Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, De Boelelaan 1117, Amsterdam, The Netherlands
- GGZ inGeest Specialized Mental Health Care, Oldenaller 1, 1081 HJ, Amsterdam, The Netherlands
| | - J R Anema
- Social Medicine, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
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Gaebel W, Becker T, Janssen B, Munk-Jorgensen P, Musalek M, Rössler W, Sommerlad K, Tansella M, Thornicroft G, Zielasek J. EPA guidance on the quality of mental health services. Eur Psychiatry 2020; 27:87-113. [DOI: 10.1016/j.eurpsy.2011.12.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Revised: 12/10/2011] [Accepted: 12/13/2011] [Indexed: 01/13/2023] Open
Abstract
AbstractThe main aim of this guidance of the European Psychiatric Association is to provide evidence-based recommendations on the quality of mental health services in Europe. The recommendations were derived from a systematic search of the best available evidence in the scientific literature, supplemented by information from documents retrieved upon reviewing the identified articles. While most recommendations could be based on empirical studies (although of varying quality), some had to be based on expert opinion alone, but were deemed necessary as well. Another limitation was that the wide variety of service models and service traditions for the mentally ill worldwide often made generalisations difficult. In spite of these limitations, we arrived at 30 recommendations covering structure, process and outcome quality both on a generic and a setting-specific level. Operationalisations for each recommendation with measures to be considered as denominators and numerators are given as well to suggest quality indicators for future benchmarking across European countries. Further pan-European research will need to show whether the implementation of this guidance will lead to improved quality of mental healthcare, and may help to develop useful country-specific cutoffs for the suggested quality indicators.
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[Psychosocial vocational rehabilitation in a world of work 4.0-Between demands and needs]. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2020; 34:5-14. [PMID: 31270695 DOI: 10.1007/s40211-019-0316-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 06/21/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND This study provides insights into the work demands associated with the "world of work 4.0" as well as employee needs from the perspectives of clients, staff, and executives of an Austrian work integration social enterprise (WISE). The WISE offers two main types of rehabilitation and support programs for individuals with psychological health conditions: 1) counselling and assistance programs, and 2) training and employment programs. METHODS The study employed a mixed-method design, using both quantitative (online survey) and qualitative methods (semi-structured interviews). N = 620 clients and N = 188 employees from of the rehabilitation programs were invited to take part in an online survey on work demands and employee needs. The response rates were 40.81% (n = 253) among clients and 54.79% (n = 103) among employees. Additionally, semi-structured interviews were conducted among six executives. RESULTS The results demonstrate that, with respect to the future labour market, participants feel that it is important to develop competences related to new technologies and resilience, but also to train social competences. Employees and clients in counselling and advice programs evaluated the support (provided by the WISE) in achieving methodological competences, resilience, and social competences more positively as compared with employees and clients in training and employment programs. The latter, however, evaluated the support in achieving manual skills more positively. CONCLUSIONS FOR PRACTICE In general, the rehabilitation programs do well in fostering social competences and resilience among their clients, but need to improve their promotion of media competences. Participants' needs can hardly be satisfied through the future labour market, especially the need for low-demand work and the needs for autonomy and personal growth. Additionally, the executives noted that in the future labour market, many jobs in the production sector would be cut, jobs would become more complex, and high technical know-how would be required. They feel that these trends will make it more difficult to place participants into first labour market employment. Accordingly, it would be especially important to secure the second labour market.
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Lecomte T, Corbière M, Giguère CE, Titone D, Lysaker P. Group cognitive behaviour therapy for supported employment - Results of a randomized controlled cohort trial. Schizophr Res 2020; 215:126-133. [PMID: 31780346 DOI: 10.1016/j.schres.2019.10.063] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 09/27/2019] [Accepted: 10/31/2019] [Indexed: 10/25/2022]
Abstract
The merging of evidence-based interventions with supported employment programs are being increasingly studied, with encouraging results. The current study is aimed at determining the impact of a brief cognitive behaviour therapy group intervention adapted for supported employment programs (called CBT-SE) on the work outcomes of: obtaining a competitive job, number of weeks worked, and number of hours worked per week. Participants were randomized to either receive the 8-session CBT-SE group on top of their supported employment program, or to only receive their support employment program. The results show that those who received CBT-SE were significantly more likely to obtain a job (75% vs 58%), and worked a significantly greater number of hours (24 vs 18 hours per week). No differences were found in terms of number of weeks worked. Those in the CBT-SE condition also experienced a significant decrease in their negative symptoms over time, compared to the control condition. Although replication is needed, these results suggest that a brief cognitive-behavioural intervention specifically tailored to work-related issues can be greatly beneficial.
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Affiliation(s)
- Tania Lecomte
- University of Montreal, Department of Psychology, Bur. C-358, 90 avenue Vincent d'Indy, Pavillon Marie-Victorin, succ Centre-Ville, CP6128, Montréal, QC, H2C 3J7, Canada; Centre de recherche de l'Institut Universitaire en Santé mentale de Montréal, 7331 rue Hochelaga, Montreal, QC, H1N 3V2, Canada.
| | - Marc Corbière
- Université du Québec à Montréal, Département d'éducation et Pédagogie - Counseling de carrière, Pavillon Paul-Gérin-Lajoie, Local N-6720, C.P. 8888, Succursale Centre-Ville, Montréal, QC, H3C 3P8, Canada; Centre de recherche de l'Institut Universitaire en Santé mentale de Montréal, 7331 rue Hochelaga, Montreal, QC, H1N 3V2, Canada.
| | - Charles-Edouard Giguère
- Centre de recherche de l'Institut Universitaire en Santé mentale de Montréal, 7331 rue Hochelaga, Montreal, QC, H1N 3V2, Canada.
| | - Debra Titone
- Department of Psychology, McGill University, 2001 McGill College Ave., Montreal, QC, H3A 1B1, Canada.
| | - Paul Lysaker
- Department of Psychiatry, Richard L. Roudebush VA Medical Center, Indiana University School of Medicine, 1481 West 10th Street, Indianapolis, IN, 46202, USA.
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Harrison J, Krieger MJ, Johnson HA. Review of Individual Placement and Support Employment Intervention for Persons with Substance Use Disorder. Subst Use Misuse 2020; 55:636-643. [PMID: 31782349 DOI: 10.1080/10826084.2019.1692035] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: Work is a critical part of recovery for many people with chronic health conditions, including Substance Use Disorders (SUD). Individual Placement and Support (IPS) is an evidence-based practice designed initially for adults with mental illness. Although the evidence for using IPS with individuals with severe mental illness is well documented, less is known about the efficacy of using IPS with consumers with substance use disorders, and the results have yet to be systematically evaluated and organized. Key components of zero exclusion, rapid competitive job search, and incorporation with treatment services as well as benefits are components that make IPS a strong practice to incorporate into substance abuse treatment. This study aims to evaluate and organize the evidence base of using IPS with adults with substance use disorders. Results: A systematic review was conducted of meta-analyses, reviews, and individual studies from 2000 through 2019, measuring the efficacy of IPS with individuals with SUD or comorbid SUD. Databases searched were Scopus, PubMed, and PsychInfo. Experimental and quasi-experimental studies are reviewed and critiqued for their application to a SUD population. Then, barriers and facilitators of IPS implementation with this population are discussed. Conclusions/Importance: There is a high evidence to support to application of IPS for persons with SUD, both singly and when combined with a mental health disorder. Barriers to IPS implementation including episodic treatment, risk of relapse, and housing or criminal justice instability make the IPS program a useful best practice to consider for this population.
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Affiliation(s)
- Jennifer Harrison
- School of Social Work, Western Michigan University, Kalamazoo, Michigan, USA
| | - Matthew J Krieger
- School of Social Work, Western Michigan University, Kalamazoo, Michigan, USA
| | - Hillary A Johnson
- School of Social Work, Western Michigan University, Kalamazoo, Michigan, USA
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Rodríguez Pulido F, Caballero Estebaranz N, González Dávila E, Melián Cartaya MJ. Cognitive remediation to improve the vocational outcomes of people with severe mental illness. Neuropsychol Rehabil 2019; 31:293-315. [PMID: 31752647 DOI: 10.1080/09602011.2019.1692671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The present study investigates the effects of cognitive remediation (CR) training with Individual Placement and Support (IPS) in people suffering from severe mental illness in European population (Spanish). Sixty-five participants (83% with schizophrenia or bipolar disorder) were recruited from community mental health teams. Fifty-seven met the criteria and agreed to participate in the study. The conditions of cognitive rehabilitation were assigned randomly with support employment CR + IPS (n = 28) and IPS alone (n = 29). Two groups were followed at 8 and 12 months after the baseline. Participants in the CR + IPS group improved more than the IPS only group during the follow-up period in measures of cognitive functioning (significantly higher in executive functions, verbal learning and memory) and obtained higher employment percentages during the follow-up period, including people who got a job after 8 months (52.2% versus 29.2%, p = .023) and after 1 year (60.9% versus 37.5%, p = .025), as well as, in the weekly hours worked (37.2 versus 26.7 h, p = .023). Retention in the CR + IPS program was high (82.14%). The calculated global cognitive score showed that the evolution over time differed significantly between groups (p < .001).
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Affiliation(s)
- Francisco Rodríguez Pulido
- Department of Medicina Interna, Dermatología y Psiquiatría, University of La Laguna, Santa Cruz de Tenerife, Spain
| | - Nayra Caballero Estebaranz
- Psychologist, SInpromi (Sociedad Insular para la promoción de las personas con discapacidad), Santa Cruz de Tenerife, Spain
| | - Enrique González Dávila
- Department of Matemáticas, Estadística e Investigación Operativa, University of La Laguna, Santa Cruz de Tenerife, Spain
| | - Maria Jesús Melián Cartaya
- Psychologist, SInpromi (Sociedad Insular para la promoción de las personas con discapacidad), Santa Cruz de Tenerife, Spain
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Lannigan EG, Noyes S. Occupational Therapy Interventions for Adults Living With Serious Mental Illness. Am J Occup Ther 2019; 73:7305395010p1-7305395010p5. [PMID: 31484037 DOI: 10.5014/ajot.2019.735001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Occupational therapy practitioners have education, skills, and knowledge to provide occupational therapy interventions for adults living with serious mental illness. Evidence-based interventions demonstrate that occupational therapy practitioners can enable this population to engage in meaningful occupations, participate in community living, and contribute to society. Systematic review findings for occupational therapy interventions for adults living with serious mental illness were published in the September/October 2018 issue of the American Journal of Occupational Therapy and in the Occupational Therapy Practice Guidelines for Adults Living With Serious Mental Illness. Each article in the Evidence Connection series summarizes evidence from the published reviews on a given topic and presents an application of the evidence to a related clinical case. These articles illustrate how research evidence from the reviews can be used to inform and guide clinical decision making. Through a case story, this article illustrates how current evidence is applied for effective occupational therapy intervention with an adult living with serious mental illness.
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Affiliation(s)
- Elizabeth Griffin Lannigan
- Elizabeth Griffin Lannigan, PhD, OTR/L, FAOTA, is Adjunct Faculty, Department of Occupational Therapy, College of Health and Human Services, University of New Hampshire, Durham;
| | - Susan Noyes
- Susan Noyes, PhD, OTR/L, is Associate Professor, Master of Occupational Therapy Program, University of Southern Maine, Lewiston
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Mahmood Z, Keller AV, Burton CZ, Vella L, Matt GE, McGurk SR, Twamley EW. Modifiable Predictors of Supported Employment Outcomes Among People With Severe Mental Illness. Psychiatr Serv 2019; 70:782-792. [PMID: 31185856 PMCID: PMC6718295 DOI: 10.1176/appi.ps.201800562] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Among people with severe mental illnesses, neuropsychological abilities may contribute to vocational outcomes, such as job attainment, job tenure, and wages earned. The current study aimed to determine the strongest neuropsychological and other modifiable predictors of work outcomes in 153 people with severe mental illness (schizophrenia, 38%; bipolar disorder, 24%; and major depression, 38%) who participated in a 2-year supported employment study. METHODS Assessments of neuropsychological performance, functional capacity, social skills, and psychiatric symptom severity were administered at baseline; work outcomes (job attainment, weeks worked, and wages earned) were collected weekly for 2 years. RESULTS Independent of education, diagnosis, and estimated intellectual functioning, more recent work history and less severe negative symptoms significantly predicted job attainment during the 2-year study. Among the 47% who obtained jobs, better global neuropsychological performance (i.e., lower global deficit score) was a significant predictor of greater weeks worked. Both global neuropsychological performance and more recent work history predicted higher wages earned. CONCLUSIONS Modifiable predictors of supported employment outcomes included cognitive functioning and negative symptom severity; thus, interventions to improve these factors may improve work outcomes and decrease the loss of productivity associated with severe mental illness.
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Affiliation(s)
- Zanjbeel Mahmood
- San Diego State University and University of California, San Diego (SDSU/UC San Diego), Joint Doctoral Program in Clinical Psychology, San Diego (Mahmood); Research Service (Mahmood, Keller) and Center of Excellence for Stress and Mental Health (Twamley), U.S. Department of Veterans Affairs San Diego Healthcare System, San Diego; Department of Psychiatry, University of California, San Diego (Twamley); Department of Psychiatry, University of Michigan, Ann Arbor (Burton), Department of Quality, University of California, San Francisco Health, San Francisco (Vella); Department of Psychology, San Diego State University, San Diego (Matt); Department of Occupational Therapy and Psychological and Brain Sciences, Center for Psychiatric Rehabilitation, Boston University, Boston (McGurk). Drs. Burton and Vella were with the SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology at the time of this research
| | - Amber V Keller
- San Diego State University and University of California, San Diego (SDSU/UC San Diego), Joint Doctoral Program in Clinical Psychology, San Diego (Mahmood); Research Service (Mahmood, Keller) and Center of Excellence for Stress and Mental Health (Twamley), U.S. Department of Veterans Affairs San Diego Healthcare System, San Diego; Department of Psychiatry, University of California, San Diego (Twamley); Department of Psychiatry, University of Michigan, Ann Arbor (Burton), Department of Quality, University of California, San Francisco Health, San Francisco (Vella); Department of Psychology, San Diego State University, San Diego (Matt); Department of Occupational Therapy and Psychological and Brain Sciences, Center for Psychiatric Rehabilitation, Boston University, Boston (McGurk). Drs. Burton and Vella were with the SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology at the time of this research
| | - Cynthia Z Burton
- San Diego State University and University of California, San Diego (SDSU/UC San Diego), Joint Doctoral Program in Clinical Psychology, San Diego (Mahmood); Research Service (Mahmood, Keller) and Center of Excellence for Stress and Mental Health (Twamley), U.S. Department of Veterans Affairs San Diego Healthcare System, San Diego; Department of Psychiatry, University of California, San Diego (Twamley); Department of Psychiatry, University of Michigan, Ann Arbor (Burton), Department of Quality, University of California, San Francisco Health, San Francisco (Vella); Department of Psychology, San Diego State University, San Diego (Matt); Department of Occupational Therapy and Psychological and Brain Sciences, Center for Psychiatric Rehabilitation, Boston University, Boston (McGurk). Drs. Burton and Vella were with the SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology at the time of this research
| | - Lea Vella
- San Diego State University and University of California, San Diego (SDSU/UC San Diego), Joint Doctoral Program in Clinical Psychology, San Diego (Mahmood); Research Service (Mahmood, Keller) and Center of Excellence for Stress and Mental Health (Twamley), U.S. Department of Veterans Affairs San Diego Healthcare System, San Diego; Department of Psychiatry, University of California, San Diego (Twamley); Department of Psychiatry, University of Michigan, Ann Arbor (Burton), Department of Quality, University of California, San Francisco Health, San Francisco (Vella); Department of Psychology, San Diego State University, San Diego (Matt); Department of Occupational Therapy and Psychological and Brain Sciences, Center for Psychiatric Rehabilitation, Boston University, Boston (McGurk). Drs. Burton and Vella were with the SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology at the time of this research
| | - Georg E Matt
- San Diego State University and University of California, San Diego (SDSU/UC San Diego), Joint Doctoral Program in Clinical Psychology, San Diego (Mahmood); Research Service (Mahmood, Keller) and Center of Excellence for Stress and Mental Health (Twamley), U.S. Department of Veterans Affairs San Diego Healthcare System, San Diego; Department of Psychiatry, University of California, San Diego (Twamley); Department of Psychiatry, University of Michigan, Ann Arbor (Burton), Department of Quality, University of California, San Francisco Health, San Francisco (Vella); Department of Psychology, San Diego State University, San Diego (Matt); Department of Occupational Therapy and Psychological and Brain Sciences, Center for Psychiatric Rehabilitation, Boston University, Boston (McGurk). Drs. Burton and Vella were with the SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology at the time of this research
| | - Susan R McGurk
- San Diego State University and University of California, San Diego (SDSU/UC San Diego), Joint Doctoral Program in Clinical Psychology, San Diego (Mahmood); Research Service (Mahmood, Keller) and Center of Excellence for Stress and Mental Health (Twamley), U.S. Department of Veterans Affairs San Diego Healthcare System, San Diego; Department of Psychiatry, University of California, San Diego (Twamley); Department of Psychiatry, University of Michigan, Ann Arbor (Burton), Department of Quality, University of California, San Francisco Health, San Francisco (Vella); Department of Psychology, San Diego State University, San Diego (Matt); Department of Occupational Therapy and Psychological and Brain Sciences, Center for Psychiatric Rehabilitation, Boston University, Boston (McGurk). Drs. Burton and Vella were with the SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology at the time of this research
| | - Elizabeth W Twamley
- San Diego State University and University of California, San Diego (SDSU/UC San Diego), Joint Doctoral Program in Clinical Psychology, San Diego (Mahmood); Research Service (Mahmood, Keller) and Center of Excellence for Stress and Mental Health (Twamley), U.S. Department of Veterans Affairs San Diego Healthcare System, San Diego; Department of Psychiatry, University of California, San Diego (Twamley); Department of Psychiatry, University of Michigan, Ann Arbor (Burton), Department of Quality, University of California, San Francisco Health, San Francisco (Vella); Department of Psychology, San Diego State University, San Diego (Matt); Department of Occupational Therapy and Psychological and Brain Sciences, Center for Psychiatric Rehabilitation, Boston University, Boston (McGurk). Drs. Burton and Vella were with the SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology at the time of this research
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Drake RE, Becker DR, Bond GR. Introducing Individual Placement and Support (IPS) supported employment in Japan. Psychiatry Clin Neurosci 2019; 73:47-49. [PMID: 30370626 DOI: 10.1111/pcn.12792] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 10/05/2018] [Accepted: 10/12/2018] [Indexed: 11/30/2022]
Abstract
Individual Placement and Support is a standardized model of supported employment, developed initially for people with serious mental disorders and now applied to people with a range of disabilities. More than two dozen randomized controlled trials around the world show that the approach helps a majority of participants to succeed in competitive employment. Individual Placement and Support is spreading rapidly across the USA and in many other high-income countries, with facilitation by an international learning community.
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Jetha A, Shaw R, Sinden AR, Mahood Q, Gignac MA, McColl MA, Martin Ginis KA. Work-focused interventions that promote the labour market transition of young adults with chronic disabling health conditions: a systematic review. Occup Environ Med 2019; 76:189-198. [PMID: 30635432 PMCID: PMC6581100 DOI: 10.1136/oemed-2018-105454] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 12/03/2018] [Accepted: 12/17/2018] [Indexed: 01/25/2023]
Abstract
Objective Young adulthood is an important transitional life phase where careers are established. Young adults with chronic disabling health conditions are underrepresented in the labour market. Our study aims to examine the effectiveness of work-focused interventions that support the labour market transition of young adults with chronic disabling health conditions; and to examine whether the effectiveness of work-focused interventions differ across work transition phase (eg, preparation, entry and sustaining work, employment advancement) and disability type. Methods A systematic review of articles published between January 1990 and July 2018 was conducted. Medline, EMBASE and PsycInfo were searched, and titles/abstracts and full texts of articles were reviewed for eligibility. Relevant articles were appraised for methodological quality. A best evidence synthesis was applied to medium-quality/high-quality studies to develop recommendations. Results 5816 articles were identified; 10 articles were relevant and of moderate–high methodological quality. Six intervention categories were identified which focused on young adults with mental health or intellectual/learning disabilities (n=3) and addressed employment preparation (n=10) and/or work entry (n=9). No interventions addressed at-work issues or career advancement. Strong evidence existed for tailored supported employment (SE) interventions having a positive impact on preparation and entry into competitive employment. Also, moderate evidence existed for the positive impact of SE on preparation and entry into competitive employment for young adults with mental health conditions. Conclusions Tailored SE is recommended to foster preparation and entry into the labour market. Evidence-based interventions are needed to facilitate sustained work and career advancement of young adults living with different disabling health conditions.
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Affiliation(s)
- Arif Jetha
- Institute for Work and Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Robert Shaw
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | | | - Quenby Mahood
- Institute for Work and Health, Toronto, Ontario, Canada
| | - Monique Am Gignac
- Institute for Work and Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Krembil Research Institute, Toronto, Ontario, Canada
| | - Mary Ann McColl
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Kathleen A Martin Ginis
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
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Noyes S, Sokolow H, Arbesman M. Evidence for Occupational Therapy Intervention With Employment and Education for Adults With Serious Mental Illness: A Systematic Review. Am J Occup Ther 2018; 72:7205190010p1-7205190010p10. [PMID: 30157005 DOI: 10.5014/ajot.2018.033068] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Many of the estimated 9.8 million American adults with serious mental illness (SMI) want to engage in employment and education, yet the majority report a need for more skills training. This review presents evidence for the effectiveness of interventions that occupational therapy practitioners can provide to help people with SMI improve and maintain performance and participation in employment and education. METHOD Citations, abstracts, and full-text articles in databases including MEDLINE, PsycINFO, CINAHL, OTseeker, and the Cochrane Database of Systematic Reviews were reviewed for inclusion and analysis. RESULTS Fifty-seven articles met criteria for inclusion. For employment, strong evidence was found for the Individual Placement and Support (IPS) model and cognitive interventions. For education, moderate evidence was found for supported education interventions. CONCLUSION This systematic review supports the role of occupational therapy practitioners in promoting the implementation of IPS, cognitive-based, and social skills programs to improve vocational and educational outcomes for adults with SMI.
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Affiliation(s)
- Susan Noyes
- Susan Noyes, PhD, OTR/L, is Assistant Professor, Occupational Therapy Program, University of Southern Maine, Lewiston;
| | - Helena Sokolow
- Helena Sokolow, MOT, OTR, is Adjunct Instructor, Occupational Therapy Program, University of Southern Maine, Lewiston
| | - Marian Arbesman
- Marian Arbesman, PhD, OTR/L, FAOTA, is Adjunct Associate Professor, Department of Clinical Research and Leadership, George Washington University School of Medicine and Health Sciences, Washington, DC, and President, ArbesIdeas, Inc., Williamsville, NY
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Nicholson J, Wright SM, Carlisle AM, Sweeney MA, McHugo GJ. The WorkingWell Mobile Phone App for Individuals With Serious Mental Illnesses: Proof-of-Concept, Mixed-Methods Feasibility Study. JMIR Ment Health 2018; 5:e11383. [PMID: 30361199 PMCID: PMC6231827 DOI: 10.2196/11383] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 07/30/2018] [Accepted: 08/01/2018] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The disparities in employment for individuals with serious mental illnesses have been well documented, as have the benefits of work. Mobile technology can provide accessible in-the-moment support for these individuals. The WorkingWell mobile app was developed to meet the need for accessible follow-along supports for individuals with serious mental illnesses in the workplace. OBJECTIVE We explore the usability, usage, usefulness, and overall feasibility of the WorkingWell mobile app with individuals with serious mental illnesses who are actively employed and receiving community-based services. METHODS In this proof-of-concept, mixed-methods, 2-month feasibility study (N=40), employed individuals with serious mental illnesses were recruited in mental health agencies. Participants completed surveys regarding background characteristics and cellphone use at enrollment and responded to interview items regarding app usability, usage, and usefulness in technical assistance calls at 1, 2, 4, and 6 weeks of participation and in the exit interview at 8 weeks. Data on the frequency of app usage were downloaded on a daily basis. A version of the System Usability Scale (SUS) was administered in the exit interview. Overall feasibility was determined by the percent of users completing the study, responses to an interview item regarding continued use, and findings on usability, usage, and usefulness. General impressions were obtained from users regarding user support materials, technical assistance, and study procedures. RESULTS Most participants were male (60%, 24/40), aged 55 or younger (70%, 28/40), white (80%, 32/40), had less than a 4-year college education (78%, 31/40), were employed part-time (98%, 39/40), had been working more than 6 months (60%, 24/40), and indicated a diagnosis of bipolar, schizoaffective, or depressive disorder (84%, 16/25). The majority of participants owned cellphones (95%, 38/40) and used them multiple times per day (83%, 33/40). Their average rating on SUS usability items was 3.93 (SD 0.77, range 1.57-5.00), reflecting positive responses. In general, participants indicated WorkingWell was "very easy," "straightforward," "simple," and "user friendly." Usability challenges were related to personal issues (eg, memory) or to difficulties with the phone or app. Data on app usage varied considerably. The most frequent navigations were to the home screen, followed by Rate My Day and My Progress, and then by Manage the Moment and Remind Me. The app was described as useful by most participants; 86% (30/35) agreed the app would help them manage better on the job. Of the 40 original participants, 35 (87%) completed the study. CONCLUSIONS The WorkingWell app is a feasible approach to providing accessible, as-needed employment support for individuals with serious mental illnesses. The app would benefit from modifications to address recommendations from feasibility testing. Controlled research with larger samples, more diverse in individual characteristics and workplace settings, is essential to demonstrating the effectiveness of the app.
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Affiliation(s)
- Joanne Nicholson
- Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States
| | - Spenser M Wright
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Alyssa M Carlisle
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Mary Ann Sweeney
- Department of Psychiatry, The Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Gregory J McHugo
- Department of Psychiatry, The Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
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Sá-Fernandes L, Jorge-Monteiro MF, Ornelas J. Empowerment promotion through competitive employment for people with psychiatric disabilities. JOURNAL OF VOCATIONAL REHABILITATION 2018. [DOI: 10.3233/jvr-180971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Luis Sá-Fernandes
- AEIPS - Associação para o Estudo e Integração Psicossocial, Lisbon, Portugal
| | - Maria F. Jorge-Monteiro
- APPsyC&I – Applied Psychology Research Center Capabilities & Inclusion; ISPA-Instituto Universitário, Lisbon, Portugal
| | - José Ornelas
- APPsyC&I – Applied Psychology Research Center Capabilities & Inclusion; ISPA-Instituto Universitário, Lisbon, Portugal
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Hara KW, Bjørngaard JH, Brage S, Borchgrevink PC, Halsteinli V, Stiles TC, Johnsen R, Woodhouse A. Randomized Controlled Trial of Adding Telephone Follow-Up to an Occupational Rehabilitation Program to Increase Work Participation. JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:265-278. [PMID: 28597308 PMCID: PMC5978834 DOI: 10.1007/s10926-017-9711-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Purpose Transfer from on-site rehabilitation to the participant's daily environment is considered a weak link in the rehabilitation chain. The main objective of this study is to see if adding boosted telephone follow-up directly after completing an occupational rehabilitation program effects work participation. Methods A randomized controlled study included participants with chronic pain, chronic fatigue or common mental disorders on long-term sick leave. After completing 3½ weeks of acceptance and commitment therapy based occupational rehabilitation, participants were randomized to boosted follow-up or a control group before returning to their daily environment. The intervention was delivered over 6 months by on-site RTW coordinators mainly via telephone. Primary outcome was RTW categorized as participation in competitive work ≥1 day per week on average over 8 weeks. Results There were 213 participants of mean age 42 years old. Main diagnoses of sick leave certification were mental disorders (38%) and musculoskeletal disorders (30%). One year after discharge the intervention group had 87% increased odds (OR 1.87, 95% confidence interval 1.06-3.31, p = 0.031), of (re)entry to competitive work ≥1 day per week compared with the controls, with similar positive results for sensitivity analysis of participation half time (≥2.5 days per week). The cost of boosted follow-up was 390.5 EUR per participant. Conclusion Participants receiving boosted RTW follow-up had higher (re)entry to competitive work ≥1 day per week at 1 year when compared to the control group. Adding low-cost boosted follow-up by telephone after completing an occupational rehabilitation program augmented the effect on return-to-work.
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Affiliation(s)
- Karen Walseth Hara
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway.
- Norwegian Advisory Unit on Complex Symptom Disorders, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
- The Norwegian Labour and Welfare Service of Sør-Trøndelag, Trondheim, Norway.
| | - Johan Håkon Bjørngaard
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway
- Forensic Department and Research Centre Brøset, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Søren Brage
- The Norwegian Directorate for Labour and Welfare, Oslo, Norway
| | - Petter Christian Borchgrevink
- Norwegian Advisory Unit on Complex Symptom Disorders, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Hysnes Rehabilitation Center, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Vidar Halsteinli
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway
- Centre for Health Care Improvement, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Tore Charles Stiles
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Roar Johnsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway
| | - Astrid Woodhouse
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway
- Norwegian Advisory Unit on Complex Symptom Disorders, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Alegria M, Drake RE, Kang HA, Metcalfe J, Liu J, DiMarzio K, Ali N. Simulations Test Impact Of Education, Employment, And Income Improvements On Minority Patients With Mental Illness. Health Aff (Millwood) 2018; 36:1024-1031. [PMID: 28583960 DOI: 10.1377/hlthaff.2017.0044] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Social determinants of health, such as poverty and minority background, severely disadvantage many people with mental disorders. A variety of innovative federal, state, and local programs have combined social services with mental health interventions. To explore the potential effects of such supports for addressing poverty and disadvantage on mental health outcomes, we simulated improvements in three social determinants-education, employment, and income. We used two large data sets: one from the National Institute of Mental Health that contained information about people with common mental disorders such as anxiety and depression, and another from the Social Security Administration that contained information about people who were disabled due to severe mental disorders such as schizophrenia and bipolar disorder. Our simulations showed that increasing employment was significantly correlated with improvements in mental health outcomes, while increasing education and income produced weak or nonsignificant correlations. In general, minority groups as well as the majority group of non-Latino whites improved in the desired outcomes. We recommend that health policy leaders, state and federal agencies, and insurers provide evidence-based employment services as a standard treatment for people with mental disorders.
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Affiliation(s)
- Margarita Alegria
- Margarita Alegria is a professor in the Departments of Medicine and Psychiatry at Harvard Medical School and chief of the Disparities Research Unit, Department of Medicine, at Massachusetts General Hospital, both in Boston
| | - Robert E Drake
- Robert E. Drake is at the IPS Employment Center at Westat, in Lebanon, New Hampshire
| | - Hyeon-Ah Kang
- Hyeon-Ah Kang is a postdoctoral research scientist in the Department of Statistics, Columbia University, in New York City
| | - Justin Metcalfe
- Justin Metcalfe is a doctoral candidate at the Dartmouth Institute, in Lebanon, New Hampshire
| | - Jingchen Liu
- Jingchen Liu is an associate professor in the Department of Statistics at Columbia University
| | - Karissa DiMarzio
- Karissa DiMarzio is a research assistant in the Disparities Research Unit, Department of Medicine, Massachusetts General Hospital
| | - Naomi Ali
- Naomi Ali is a research assistant in the Disparities Research Unit, Department of Medicine, Massachusetts General Hospital
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Leahy MJ, Del Valle RJ, Landon TJ, Iwanaga K, Sherman SG, Reyes A, Chan F. Promising and evidence-based practices in vocational rehabilitation: Results of a national Delphi study. JOURNAL OF VOCATIONAL REHABILITATION 2018. [DOI: 10.3233/jvr-170914] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | | | | | | | | | | | - Fong Chan
- University of Wisconsin-Madison, Madison, WI, USA
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Lipskaya-Velikovsky L, Elgerisi D, Easterbrook A, Ratzon NZ. Motor skills, cognition, and work performance of people with severe mental illness. Disabil Rehabil 2018; 41:1396-1402. [PMID: 29327599 DOI: 10.1080/09638288.2018.1425744] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE Employment offers many benefits to people with mental illness, yet their employment rate is much lower than that of the general population. We investigated the effect of work-related motor skills, neurocognition, and job attitudes on the work performance of people with mental illness, comparing those working in sheltered workshops, with controls working in similar jobs. METHODS Twenty-nine adults with severe mental illness and 27 controls matched by gender and age were enrolled into the study using convenience sampling. They were assessed for gross and fine motor hand functioning, job attitudes, work performance, and cognition. RESULTS People with mental illness scored lower on work performance, cognitive functioning, and hand dexterity while sitting and working with tools. They were assigned lower job loads than were controls, and perceived the physical environment at work as more constraining than did controls. Assembling motor skills significantly explained the work performance of people with mental illness. CONCLUSIONS The results expand our understanding of the complexities involved in the employment of people with severe mental illness, and point to new paths for improving vocational outcomes of people with severe mental illness, taking into account their motor skills and job attitudes. Implications for rehabilitation Therapists should be aware that employed people with severe mental illness may have various unmet needs, affecting their work performance and experience of stress. This study results demonstrate importance of motor skills and perception of the work environment for the promotion of vocational outcomes among individuals with severe mental illness. Employment of people with severe mental illness should be viewed from holistic perspective as with general population, rather than focused on traditionally illness-related factors.
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Affiliation(s)
- Lena Lipskaya-Velikovsky
- a Department of Occupational Therapy , School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University , Tel Aviv , Israel
| | - Dikla Elgerisi
- b Beer-Ya'akov-Ness-Ziona Mental Health Center , Beer-Ya'akov , Israel
| | - Adam Easterbrook
- c Alberta Centre for Child, Family, and Community Research , Edmonton , Canada
| | - Navah Z Ratzon
- a Department of Occupational Therapy , School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University , Tel Aviv , Israel
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Rogers ES, Millner UC, Brandt D, Chan L, Jette A, Marfeo E, Ni P, Rasch E. Concordance of assessments of clients' mental and behavioral health with in vivo assessment of work performance. Work 2018; 61:11-20. [PMID: 30223409 PMCID: PMC10009694 DOI: 10.3233/wor-182776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Assessing functioning and disability among individuals with mental and behavioral health disorders has historically relied on deriving accurate psychiatric diagnoses and assessing symptoms. However, growing empirical evidence suggests that this approach is inadequate to determine real world performance, particularly with respect to work. OBJECTIVE We examined a performance-based approach to the assessment of work functioning and its relationship to mental and behavioral health status. METHODS A cross-sectional study was conducted at two mental health programs. Trained employment providers conducted performance-based assessments of work function and ratings of mental and behavioral health while study participants self-reported their mental/behavioral health functioning. We hypothesized that participant and provider ratings of mental/behavioral health would be moderately correlated with performance-based assessments of work function. RESULTS We found no significant correlation between participants' self-report of their mental and behavioral health and performance-based assessments of work. Employment providers' ratings of participants' mental/behavioral health were moderately correlated with performance-based measures of work. Finally, we found low concordance between employment providers and study participants' with respect to ratings of their mental/behavioral health. CONCLUSIONS Contrary to our hypotheses, ratings of mental/behavioral health were only moderately correlated with performance-based measures of work. Results confirm earlier research suggesting that it is difficult to predict work performance from participants' self-reports of their mental/behavioral health alone. Performance-based assessments of work capacity as well as ratings of mental and behavioral health may both be needed for a more complete and complimentary picture of the ability of individuals with mental and behavioral health disorders to function in the work place.
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Affiliation(s)
- E Sally Rogers
- Center for Psychiatric Rehabilitation, Sargent College, Boston University, Boston, MA, USA
| | - Uma Chandrika Millner
- Center for Psychiatric Rehabilitation, Sargent College, Boston University, Boston, MA, USA
| | - Diane Brandt
- Department of Rehabilitation Medicine, National Institutes of Health, Bethesda, MD, USA
| | - Leighton Chan
- Department of Rehabilitation Medicine, National Institutes of Health, Bethesda, MD, USA
| | - Alan Jette
- Health and Disability Research Institute, School of Public Health, Boston University, Boston, MA, USA
| | - Elizabeth Marfeo
- Department of Occupational Therapy, Tufts University, Medford, MA, USA
| | - Pengsheng Ni
- Health and Disability Research Institute, School of Public Health, Boston University, Boston, MA, USA
| | - Elizabeth Rasch
- Department of Rehabilitation Medicine, National Institutes of Health, Bethesda, MD, USA
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Westcott C, Waghorn G, McLean D, Statham D, Mowry B. Correlates of employment interest among adults with schizophrenia. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2017. [DOI: 10.12968/ijtr.2017.24.12.510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims: Role functioning is an important part of recovery and psychiatric rehabilitation for people with schizophrenia. However, little is known about why some people and not others return to socially valued roles such as employment. While the demographic and clinical correlates of employment have been extensively studied, little is known about how employment interest forms and develops into actual employment activity. The aim was to compare demographic and clinical correlates of employment interest to correlates of actual employment participation. Methods: A community sample of 255 working-age adults with schizophrenia or schizoaffective disorder were interviewed about their current employment status and current employment interest. Univariate logistic regression was used to examine the demographic and clinical correlates of both employment interest and participation. Findings: Age, employment history and severity of current hallucinations were associated with both employment interest and participation, while illness severity pattern, illness course, severity of disability, and severity of avolition were associated only with employment participation. Conclusions: Resilience of employment interest to the clinical symptoms of schizophrenia is a promising finding. Those with more severe illness patterns and more impaired functioning can remain good candidates for vocational rehabilitation, because interest and motivation for employment may be unaffected.
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Affiliation(s)
- Cassandra Westcott
- Researcher, Psychology Clinic, University of Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Geoffrey Waghorn
- Associate Professor, Queensland Centre for Mental Health Research, West Moreton Hospital and Health Service, The Park Centre for Mental Health, Wacol, Queensland; School of Applied Psychology, Griffith University, Mount Gravatt Queensland, Australia
| | - Duncan McLean
- Assistant Director, Queensland Centre for Mental Health Research, West Moreton Hospital and Health Service, The Park Centre for Mental Health, Queensland, Wacol, Australia
| | - Dixie Statham
- Director, Psychology Clinic, University of Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Bryan Mowry
- Professor, Queensland Centre for Mental Health Research, West Moreton Hospital and Health Service, The Park Centre for Mental Health, Wacol, Queensland; Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
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Impacting Entry into Evidence-Based Supported Employment: A Population-Based Empirical Analysis of a Statewide Public Mental Health Program in Maryland. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2017; 45:328-341. [DOI: 10.1007/s10488-017-0827-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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