“Placement Budgets” for Supported Employment—Impact on Quality of Life in a Multicenter Randomized Controlled Trial

Abstract

Background: Employment is an important aspect of psychiatric rehabilitation. The objective of this analysis was to explore how quality of life (QoL) may affect the outcome of supported employment and vice versa.Methods: A total of 116 participants with severe mental disorders were randomly assigned to either 25, 40, or 55 h placement budgets, which comprises job coaches' time resources to support a client in finding a job. The intervention followed the individual placement and support model and lasted up to 36 months. Primary outcome was employment in the first labor market for at least 3 months. QoL was assessed 7 times over the entire 36-months observation period using the WHO QoL Bref, which comprises the dimensions physical health, psychological, social relationships, and environment.Results: The three placement budgets did not differentially relate to QoL, but QoL environment showed a significant increase over time across all three groups. Baseline QoL environment weakly predicted subsequent obtainment of employment (F = 4.08, df = 1, p = 0.046, Cohen's d = 0.39). Controlling for baseline QoL, those participants who obtained a job, as compared to those who did not, showed persistent increases in QoL physical health (b = 0.39, p = 0.002, Cohen's d = 0.50) and QoL psychological (b = 0.40, p < 0.001, Cohen's d = 0.47).Conclusion: Obtaining employment in the first labor market improves patients' QoL. Supported employment is a valuable intervention that may benefit patients with severe mental disorder.

Predictors of Employment for People With Mental Illness: Results of a Multicenter Randomized Trial on the Effectiveness of Placement Budgets for Supported Employment

“…These results contrast with those from other relevant studies, which have usually included participants with comparable functioning (as assessed by GAF or CGI), but from a different diagnostic spectrum. In this study, we included participants from outpatient clinics, with the majority being diagnosed with either a mood or a neurotic, stress-related, or somatoform disorder (ICD-10 F3 or F4 diagnosis), and only a minority with a schizophrenia [ICD-10 F2 diagnosis; see Rössler et al (25)]. Most other trials in SE have included only participants with severe mental illness, such as schizophrenia and bipolar disorder.…”

Supported employment in Switzerland—Are we on track?

“…The Zurich group also focused on factors that predicted the reintegration success in SE (Brantschen, Kawohl, Rössler, Bärtsch, & Nordt, 2014; Landolt et al, 2016; Viering, Jäger, & Kawohl, 2015). In their most recent paper, they showed that participants who obtained a job, as compared to those who did not, showed persistent increases in quality of life (Rössler et al, 2018).…”

‘Placement budgets’ for supported employment: impact on employment rates in a multicentre randomised controlled trial

“…6,7 Participation in supported employment programmes not only increases the chances of finding and keeping competitive employment, 4 but those who find work also show gains in self-esteem, social integration, relationships, reduced substance use and increased quality of life. 1,8,14 Those who found long-term employment through supported employment also had improved cognition and better symptom control. 1,8 In spite of these obvious advantages, most European countries continue to invest in costly traditional services like sheltered workshops, which are neither evidence based nor person centred.…”