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Predictors of employment for people with severe mental illness: results of an international six-centre randomised controlled trial


Catty, J; Lissouba, P; White, S; Becker, T; Drake, R E; Fioritti, A; Knapp, M; Lauber, C; Rössler, W; Tomov, T; van Busschbach, J; Wiersma, D; Burns, T (2008). Predictors of employment for people with severe mental illness: results of an international six-centre randomised controlled trial. British Journal of Psychiatry, 192(3):224-231.

Abstract

BACKGROUND: An international six-centre randomised controlled trial comparing individual placement and support (IPS) with usual vocational rehabilitation for people with serious mental illness found IPS to be more effective for all vocational outcomes. AIMS: To determine which patients with severe mental illness do well in vocational services and which process and service factors are associated with better outcomes. METHOD: Patient characteristics and early process variables were tested as predictors of employment outcomes. Service characteristics were explored as predictors of the effectiveness of IPS. RESULTS: Patients with previous work history, fewer met social needs and better relationships with their vocational workers were more likely to obtain employment and work for longer. Remission and swifter service uptake were associated with working more. Having an IPS service closer to the original IPS model was the only service characteristic associated with greater effectiveness. CONCLUSIONS: The IPS service was found to be more effective for all vocational outcomes. In addition, maintaining high IPS fidelity and targeting relational skills would be a valuable focus for all vocational interventions, leading to improved employment outcomes. Motivation to find work may be decreased by satisfaction with current life circumstances.

BACKGROUND: An international six-centre randomised controlled trial comparing individual placement and support (IPS) with usual vocational rehabilitation for people with serious mental illness found IPS to be more effective for all vocational outcomes. AIMS: To determine which patients with severe mental illness do well in vocational services and which process and service factors are associated with better outcomes. METHOD: Patient characteristics and early process variables were tested as predictors of employment outcomes. Service characteristics were explored as predictors of the effectiveness of IPS. RESULTS: Patients with previous work history, fewer met social needs and better relationships with their vocational workers were more likely to obtain employment and work for longer. Remission and swifter service uptake were associated with working more. Having an IPS service closer to the original IPS model was the only service characteristic associated with greater effectiveness. CONCLUSIONS: The IPS service was found to be more effective for all vocational outcomes. In addition, maintaining high IPS fidelity and targeting relational skills would be a valuable focus for all vocational interventions, leading to improved employment outcomes. Motivation to find work may be decreased by satisfaction with current life circumstances.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Psychiatric University Hospital Zurich > Clinic for Clinical and Social Psychiatry Zurich West (former)
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2008
Deposited On:21 Jan 2009 13:46
Last Modified:05 Apr 2016 12:38
Publisher:Royal College of Psychiatrists
ISSN:0007-1250
Publisher DOI:10.1192/bjp.bp.107.041475
PubMed ID:18310585
Permanent URL: http://doi.org/10.5167/uzh-6816

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