Modifiable Predictors of Supported Employment Outcomes Among People With Severe Mental Illness

Mahmood, Zanjbeel; Keller, Amber V.; Burton, Cynthia; Vella, Lea; Matt, Georg E.; McGurk, Susan R.; Twamley, Elizabeth W.

doi:10.1176/appi.ps.201800562

Cited by 25 publications

(29 citation statements)

References 50 publications

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“…Although not examined in the present study, there are several plausible mechanisms, which likely explain why individuals with serious mental disorders have difficulties in getting and maintaining jobs. From the psychosocial factors, for example, poor neurocognitive functioning, problems with intrapersonal and/or social functioning, current or residual symptoms such as paranoia or anhedonia, untypical behavior, and poor motivation are likely important (8,(13)(14)(15). In addition to these factors, poor educational attainment, absenteeism due to time spent in hospital care, and stigmatization further limits possibilities of finding and maintaining stable employment (16,17).…”

Section: Discussionmentioning

confidence: 99%

Employment Status and Personal Income Before and After Onset of a Severe Mental Disorder: A Case-Control Study

Hakulinen

Elovainio

Arffman

et al. 2020

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Objective: Individuals with severe mental disorders have an impaired ability to work and are likely to receive income transfer payments as their main source of income. However, the magnitude of this phenomenon remains unclear. Using longitudinal population cohort register data we conducted a case-control study to examine the levels of employment and income before and after first hospitalization for a serious mental disorder. Methods: All individuals (n=50,551) who had been hospitalized for schizophrenia, other nonaffective psychosis, and bipolar disorder in Finland between 1988 and 2015 were identified and matched with five randomly selected participants who had the same birth year and month, and sex. Employment status and earnings, social income transfers, and total income in euros were measured annually from 1988 to 2015. Results: Individuals with serious mental disorders have notably low levels of employment already before, and especially after, the diagnosis of severe mental disorder. Their total income mostly constituted of social income transfers, especially in schizophrenia, and over half of all individuals with serious mental disorders did not have any earnings after they received the diagnosis. Conclusions: Present study shows how large proportion of individuals with serious mental are dependent solely on social income transfers after an onset of mental disorder.

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Section: Discussionmentioning

confidence: 99%

Employment Status and Personal Income Before and After Onset of a Severe Mental Disorder: A Case-Control Study

Hakulinen

Elovainio

Arffman

et al. 2020

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“…Cognitive impairment can be experienced by people with severe mental illnesses and is a predictor of psychosocial functioning and performance at work (81). A recent study investigating modifiable predictors of supported employment outcomes found that cognitive impairment was associated with shorter job tenure in competitive employment (82). Cognitive remediation is proposed as an intervention to improve vocational outcomes.…”

Section: Cognitive Remediationmentioning

confidence: 99%

Vocational Service Models and Approaches to Improve Job Tenure of People With Severe and Enduring Mental Illness: A Narrative Review

2021

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Employment is a valued occupation that offers a sense of meaning, identity, and belonging. For people with severe and enduring mental illness, employment has also been associated with personal recovery and decreased use of mental health services. However, this population continues to be underrepresented in the labor market. Sustainable employment is often challenging for people with severe and enduring mental illness, due to a combination of personal, organizational and systemic issues. While Individual Placement and Support is an evidence-based model of employment support known to improve job attainment for people with mental illness, job retention and sustained workforce participation continue to be challenges. This narrative literature review was undertaken to address the question: “What vocational service models and approaches improve job tenure for this population?” CinAHL, Medline, Embase, PsycINFO, and Cochrane Library were searched for the period 2005–2020, using key terms and subject headings, including “severe mental illness,” “psychiatric disabilit*,” “job tenure,” and “job retention.” Several adjunct interventions may enhance job retention, including skills training, cognitive interventions, psychological interventions, and supported education, while social firms offer a different approach focused on creating new, sustainable job opportunities. Peer support and support from family and friends also appear to be important, and emerging evidence suggests that employment specialist practices, technology, self-management, and workplace accommodations may each also influence job tenure. Service providers could make more use of these non-clinical vocational approaches to improve employment retention for people with severe and enduring mental illness.

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“…37 In addition, higher neuropsychological abilities in patients with schizophrenia predict more favorable vocational outcomes. 38 Therefore, our finding of the decreased risk of sudden cardiac death in patients with (physical and psychiatric comorbidities) with P < 0.001 were remained in the final adjusted model.…”

Section: Discussionmentioning

confidence: 96%

Age Effect on Incidence, Physical, and Psychiatric Comorbidity for Sudden Cardiac Death in Schizophrenia: Effet de l’âge sur l’incidence, la comorbidité physique et psychiatrique de la mort cardiaque subite dans la schizophrénie

et al. 2020

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Objective: The pathogenesis of sudden cardiac death may differ between younger and older adults in schizophrenia, but evidence remains scant. This study investigated the age effect on the incidence and risk of the physical and psychiatric comorbidity for sudden cardiac death. Methods: Using 2000 to 2016 data from the Taiwan National Health Insurance Research Database and Department of Health Death Certification System, we identified a national cohort of 170,322 patients with schizophrenia, 1,836 of whom had a sudden cardiac death. Standardized mortality ratios (SMRs) were estimated. Hazard ratios and population attributable fractions of distinctive comorbidities for sudden cardiac death were assessed. Results: The SMRs of sudden cardiac death were all >1.00 across each age group for both sexes, with the highest SMR in male patients aged <35 years (30.88, 95% CI: 26.18–36.18). The fractions of sudden cardiac death attributable to hypertension and congestive heart failure noticeably increased with age. By contrast, the fraction attributable to drug-induced mental disorder decreased with age. Additionally, chronic hepatic disease and sleep disorder increased the risk of sudden cardiac death in patients aged <35 years. Dementia and organic mental disorder elevated the risk in patients aged between 35–54 years. Ischemic heart disease raised the risk in patients aged ≥55 years. Conclusions: The risk is increased across the lifespan in schizophrenia, particularly for younger male patients. Furthermore, physical and psychiatric comorbidities have age-dependent risks. The findings suggest that prevention strategies targeted toward sudden cardiac death in patients with schizophrenia must consider the age effect.

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Modifiable Predictors of Supported Employment Outcomes Among People With Severe Mental Illness

Cited by 25 publications

References 50 publications

Employment Status and Personal Income Before and After Onset of a Severe Mental Disorder: A Case-Control Study

Employment Status and Personal Income Before and After Onset of a Severe Mental Disorder: A Case-Control Study

Vocational Service Models and Approaches to Improve Job Tenure of People With Severe and Enduring Mental Illness: A Narrative Review

Age Effect on Incidence, Physical, and Psychiatric Comorbidity for Sudden Cardiac Death in Schizophrenia: Effet de l’âge sur l’incidence, la comorbidité physique et psychiatrique de la mort cardiaque subite dans la schizophrénie

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