Clinical Factors Associated With Employment Among People With Severe Mental Illness

Abstract

Research has shown that supported employment programs are effective in helping psychiatric outpatients achieve vocational outcomes, yet not all program participants are able to realize their employment goals. This study used 24 months of longitudinal data from a multisite study of supported employment interventions to examine the relationship of patient clinical factors to employment outcomes. Multivariate random regression analysis indicated that, even when controlling for an extensive series of demographic, study condition (experimental versus control), and work history covariates, clinical factors were associated with individuals' ability to achieve competitive jobs and to work 40 or more hours per month. Poor self-rated functioning, negative psychiatric symptoms, and recent hospitalizations were most consistently associated with failure to achieve these employment outcomes. These findings suggest ways that providers can tailor supported employment programs to achieve success with a diverse array of clinical subpopulations.

Posttraumatic stress disorder and employment in veterans participating in Veterans Health Administration Compensated Work Therapy

“…Among the other prominent factors that were associated with employment were greater education and prior work history, both commonly found to be predictors of employment in prior studies [18]. Factors associated with reduced employment, also consistent with other studies [13,19], included public support income, the number of medical conditions, and prior incarceration.…”

Reasons for job separations in a cohort of workers with psychiatric disabilities

“…Characteristics of the 892 individuals included in the job separation analysis were compared with the remainder of the EIDP cohort not included in the present analysis (n = 756). Consistent with prior research on predictors of employment in the EIDP [29][30], inclusion in the job separation analysis sample was statistically associated with receiving supported employment services, better prior work history, younger age, and not having a substance abuse diagnosis (univariate chi-square p < 0.05). Otherwise, the group we analyzed did not differ from the larger study population in terms of sex, race and/or ethnicity, number of coresident children, presence of a schizophrenia spectrum or bipolar diagnosis, comorbid medical conditions, self-reported functioning, or Social Security Administration (SSA) disability income beneficiary status (i.e., Supplemental Security Income [SSI] and/or Social Security Disability Insurance [SSDI]).…”

Cognitive function and competitive employment in schizophrenia: relative contribution of insight and psychopathology

“…not contracted with a social service agency) [38]. Written informed consent was obtained from all subjects after a complete description of the study.…”