This multi-site study tested the effectiveness of supported employment (SE) models combining clinical and vocational rehabilitation services to establish competitive employment. National probability surveys indicate that the majority of individuals with schizophrenia and other severe mental illnesses are unemployed. Twelve hundred seventy three outpatients with severe mental illness from 7 states were randomly assigned to either an experimental SE program or a comparison/services as usual condition and followed for 24 months. Participants were interviewed semi-annually, paid employment was tracked weekly, and vocational and clinical services were measured monthly. Mixed-effects random regression analysis was used to predict the likelihood of competitive employment, working forty or more hours in a given month, and monthly earnings. Cumulative results over 24 months show that experimental group participants were more likely than those in the comparison programs to achieve competitive employment. Similarly, patients in experimental group programs were more likely than those in comparison programs to work 40 or more hours in a given month. Finally, participants in experimental group programs had significantly higher monthly earnings than the comparison groups. In the multivariate longitudinal analysis, experimental condition subjects were more likely than comparison group subjects to be competitively employed, work 40 or more hours in a given month, and have higher earnings, despite controlling for demographic, clinical, work history, disability beneficiary status, and study site confounds. Moreover, the advantage of experimental over comparison group participants increased over the 24-month study period. Conclusions drawn from this study were that SE models tailored by integrating clinical and vocational services were more effective than services as usual or unenhanced services.
PIC ID: 7718; Agency Sponsor: SAMHSA-CMHS, Center for Mental Health Services; Federal Contact: Blyler, Crystal, 240-276-1910; Performer: University of Illinois, Champaign, IL