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Person-related predictors of employment outcomes after participation in psychiatric vocational rehabilitation programmes

A systematic review

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Background

There is increasing recognition of the importance of psychiatric vocational rehabilitation (PVR) programmes in helping individuals with severe mental illnesses to find and secure jobs. However, little is known concerning the factors related to PVR outcomes.

Objective

This review identifies those person-related factors which most strongly influence employment outcomes after participation in PVR programmes.

Method

Medline, Psychinfo, Pubmed and CINAHL were searched for studies using multivariate analysis of longitudinal data, which analysed employment outcomes after at least 6 months of programme participation, and which analysed at least three predictor domains.

Results

Eight studies presented in 16 publications met all the criteria. Better employment outcomes were most strongly related to better work performance measured during PVR participation and to higher work-related self-efficacy. Better social functioning during PVR participation was also significantly related to positive employment outcomes, but this relationship was generally weaker than those of the two aforementioned factors. In most studies, employment outcomes after PVR were not related to past functioning, including work history and diagnosis. Findings on the severity of psychiatric symptoms measured during PVR were mixed. In terms of contribution to outcome, severity of symptoms usually ranked below work performance, when measured concurrently.

Conclusion

Contrary to previous reviews, this study suggests that the influence of past functioning, including work history, diagnosis and psychiatric history, is outweighed by work performance in PVR. Further prospective and controlled studies are needed to reach more definite conclusions about the individual contributions of person-related factors.

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References

  1. Mueser KT, Clark RE, Haines M, et al. (2004) The Hartford study of Supported Employment for persons with severe mental illness. J Consult Clin Psychol 72:479–490

    PubMed  Google Scholar 

  2. Twamley EW, Jeste DV, Lehman AF (2003) Vocational Rehabilitation in Schizophrenia and Other Psychotic Disorders. J Nerv Ment Dis 191:515–523

    PubMed  Google Scholar 

  3. Lehman AF, Goldberg R, Dixon LB, et al. (2002) Improving employment outcomes for persons with severe mental illnesses. Arch Gen Psychiatry 59:165–172

    Article  PubMed  Google Scholar 

  4. Crowther R, Marshall M, Bond GR, et al. (2001) Helping people with severe mental illness to obtain work: systematic review. BMJ 322:204–208

    Article  CAS  PubMed  Google Scholar 

  5. Crowther R, Marshall M, Bond GR, Huxley P (2004) Vocational rehabilitation for people with severe mental illness (Cochrane Review). The Cochrane Library [1] John Wiley and Sons, Ltd., Chichester UK

  6. Drake RE, McHugo GJ, Bebout R, et al. (1999) A randomized clinical trial of supported employment for inner-city patients with severe mental disorders. Arch Gen Psychiatry 56:627–633

    Article  CAS  PubMed  Google Scholar 

  7. Drake RE, McHugo GJ, Becker DR, et al. (1996) The New Hampshire study of supported employment for people with severe mental illness. J Consult Clin Psychol 64:391–399

    Article  CAS  PubMed  Google Scholar 

  8. Macias C, DeCarlo LT, Wang Q, et al. (2001) Work interest as a predictor of competitive employment: policy implications for psychiatric rehabilitation. Adm Policy Ment Health 28:279–297

    Article  CAS  PubMed  Google Scholar 

  9. Danley KS, Sciarappa K, MacDonald-Wilson K (1992) Chooseget-keep: a psychiatric rehabilitation approach to supported employment. In: Liberman RP (ed) Effective psychiatric rehabilitation, Jossey-Bass Publishers, San Francisco

  10. Anthony W, Cohen M, Farkas M, et al. (2002) Psychiatric Rehabilitation. 2nd edition, Center for Psychiatric Rehabilitation, Boston

  11. Boardman J, Grove B, Perkins R, et al. (2003) Work and employment for people with psychiatric disabilities. Br J Psychiatry 182:467–468

    PubMed  Google Scholar 

  12. Mintz J, Bond GR, Mintz LI (1999) Assessing work function in mental health research, in Cost effectiveness of psychotherapy. A guide for practitioners, researchers and policymakers, Edited by Miller NE, MacGruder K, Oxford University Press New York

  13. Bolton BF, Bellini JL, Brookings JB (2000) Predicting client employment. Rehabilitation Counseling Bulletin 44:10–21

    Google Scholar 

  14. Marwaha S, Johnson S (2004) Schizophrenia and employment; A review. Soc Psychiatry Psychiatr Epidemiol 39:337–349

    PubMed  Google Scholar 

  15. Cook JA, Razzano L (2000) Vocational Rehabilitation for Persons with Schizophrenia: Recent Research and Implications for Practice. Schizophr Bull 26:87–103

    CAS  PubMed  Google Scholar 

  16. Tsang H, Lam P, Ng B, et al. (2000) Predictors of Employment Outcome for People with Psychiatric Disabilities:A Review of the Literature Since the Mid ’80s. Journal of Rehabilitation 66:19–31

    Google Scholar 

  17. Weeghel Jv (1997) Persoonsgebonden factoren als predictoren van arbeidsparticipatie bij psychiatrische patiënten; een overzicht van de onderzoeksliteratuur. Tijdschrift voor Sociale Geneeskunde 75:339–347

    Google Scholar 

  18. Lehman AF (1995) Vocational rehabilitation in schizophrenia. Schizophr Bull 21:645–656

    CAS  PubMed  Google Scholar 

  19. Anthony WA (1994) Characteristics of people with psychiatric disabilities that are predictive of entry into the rehabilitation process and successful employment. Psychosoc Rehabil J 17:3–13

    Google Scholar 

  20. McGurk SR, Mueser KT (2004) Cognitive functioning, symptoms, and work in Supported Employment: a review and heuristic model. Schizophr Res 70:147–173

    PubMed  Google Scholar 

  21. Cook JA, Razzano L (1994) Predictive validity of the McCarron-Dial testing battery for employment outcomes among psychiatric rehabilitation clientele. Vocational Evaluation and Work Adjustment Bulletin 27:39–47

    Google Scholar 

  22. Cook JA, Rosenberg H (1994) Predicting community employment among persons with psychiatric disability: a logistic regression analysis. J Rehabil Admin 18:6–22

    Google Scholar 

  23. Cook JA, Razzano L (1995) Discriminant function analysis of competitive employment outcomes in a transitional employment program for persons with severe mental illness. J Vocational Rehabil 5:127–139

    Google Scholar 

  24. Xie HY, Dain BJ, Becker DR, et al. (1997) Job tenure among persons with severe mental illness. Rehabil Counseling Bull 40:230–239

    Google Scholar 

  25. Becker DR, Drake RE, Bond GR, et al. (1998) Job terminations among persons with severe mental illness participating in supported employment. Community Ment Health J 34:71–82

    CAS  PubMed  Google Scholar 

  26. Hoffmann H, Kupper Z (1997) Relationships between social competence, psychopathology and work performance and their predictive value for vocational rehabilitation of schizophrenic outpatients. Schizophr Res 23:69–79

    CAS  PubMed  Google Scholar 

  27. Hoffmann H, Kupper Z, Kunz B (2000) Hopelessness and its impact on rehabilitation outcome in schizophrenia—an exploratory study. Schizophr Res 43:147–158

    CAS  PubMed  Google Scholar 

  28. Hoffmann H, Kupper Z, Zbinden M, et al. (2003) Predicting vocational functioning and outcome in schizophrenia outpatients attending a vocational rehabilitation program. Soc Psychiatry Psychiatr Epidemiol 38:76–82

    PubMed  Google Scholar 

  29. Hoffmann H, Kupper Z (2003) Prädiktive Faktoren einer erfolgreichen beruflichen Wiedereingliederung von schizophrenen Patienten/Predictive factors of successful vocational reintegration in patients with chronic schizophrenia. Psychiatrische Praxis 30:312–317

    PubMed  Google Scholar 

  30. Rogers ES, Anthony WA, Cohen M, et al. (1997) Prediction of vocational outcome based on clinical and demographic indicators among vocationally ready clients. Community Ment Health J 33:99–112

    CAS  PubMed  Google Scholar 

  31. Reker T, Eikelmann B (1998) Krankheits- und Rehabilitationsverläufe schizophrener Patienten in ambulanter Arbeitstherapie: eine prospektive Studie über 3 Jahre. Nervenarzt 69:210–218

    CAS  PubMed  Google Scholar 

  32. Reker T, Eikelmann B (1999) Prädiktoren einer erfolgreichen beruflichen Eingliederung; Ergebnisse einer prospectiven Studie. Psychiat Prax 26:218–233

    CAS  Google Scholar 

  33. Regenold M, Sherman MF, Fenzel M (1999) Getting back to work: self-efficacy as a predictor of employment outcome. Psychiatr Rehabil J 22:361–367

    Google Scholar 

  34. Jones CJ, Perkins DV, Born DL (2001) Predicting work outcomes and service use in supported employment services for persons with psychiatric disabilities. Psychiatr Rehabil J 25:53–59

    CAS  PubMed  Google Scholar 

  35. Henry AD, Barreira P, Banks S, et al. (2001) A retrospective study of clubhouse-based transitional employment. Psychiatr Rehabil J 24:344–354

    CAS  PubMed  Google Scholar 

  36. Arns PG, Linney JA (1993) Work, self, and life satisfaction for persons with severe and persistent mental disorders. Psychosoc Rehabil J 17:63–79

    Google Scholar 

  37. Lysaker P, Bell M, Milstein R, et al. (1993) Work capacity in schizophrenia. Hospital and Community Psychiatry 44:278–280

    CAS  PubMed  Google Scholar 

  38. Suslow T, Schonauer K, Ohrmann P, et al. (2000) Prediction of work performance by clinical symptoms and cognitive skills in schizophrenic outpatients. J Nerv Ment Dis 188:116–118

    CAS  PubMed  Google Scholar 

  39. Pirfo E, Albera C, Arizio I, et al. (1994) Job Preparation and Improvement of the Quality of Life of Schizophrenic Patients in Today’s Metropolis. Int J Ment Health 23:11–22

    Google Scholar 

  40. Lysaker PH, Morris DB, Zito WS, et al. (1995) Social skills at work. J Nerv Ment Dis 183:688–692

    CAS  PubMed  Google Scholar 

  41. Goldberg RW, Lucksted A, McNary S, et al. (2001) Correlates of long-term unemployment among inner-city adults with serious and persistent mental illness. Psychiatr Serv 52:101–103

    CAS  PubMed  Google Scholar 

  42. Bryson G, Bell MD, Greig T, et al. (1999) The work behavior inventory: prediction of future work success of people with schizophrenia. Psychiatr Rehabil J 23:113–117

    Google Scholar 

  43. Rogers ES, Martin R, Anthony W, et al. (2001) Assessing Readiness for Change Among Persons with Severe Mental Illness. Community Ment Health J 37:97–112

    CAS  PubMed  Google Scholar 

  44. Siu AMH (1997) Predicting Employment Outcomes for People with Chronic Psychiatric Illness. Occupational Therapy in Mental Health 13:45–58

    Google Scholar 

  45. McCrum BW, Burnside LK, Duffy ThL (1997) Organising for work: A job clinic for people with mental health needs. J Ment Health 6:503–513

    Google Scholar 

  46. Chandler D, Levin S, Barry P (1999) The menu approach to employment services: philosophy and five-year outcomes. Psychiatr Rehabil J 23:24–33

    Google Scholar 

  47. Cook JA, Razzano L, Cappelleri JC (2000) Canonical correlation analysis of residential and vocational outcomes following psychiatric rehabilitation. Evaluation and Program Planning 19:351–363

    Google Scholar 

  48. Heinrichs RW (1989) Neuropsychological test performance and employment status in patients referred for assessment. Percept Mot Skills 69:899–902

    CAS  PubMed  Google Scholar 

  49. Lysaker PH, Bell MD, Bioty SM (1995) Cognitive deficits in schizophrenia: prediction of symptom change for participators in work rehabilitation. J Nerv Ment Dis 183:332–336

    CAS  PubMed  Google Scholar 

  50. Kupper Z, Hoffmann H (2000) Course patterns of psychosocial functioning in schizophrenia patients attending a vocational rehabilitation program. Schizophr Bull 26:681–698

    CAS  PubMed  Google Scholar 

  51. McGurk SR, Mueser KT, Harvey PD, et al. (2003) Cognitive and symptom predictors of work outcomes for clients with schizophrenia in supported employment. Psychiatr Serv 54:1129–1135

    PubMed  Google Scholar 

  52. Gold JM, Goldberg RW, McNary SW, et al. (2002) Cognitive correlates of job tenure among patients with severe mental illness. Am J Psychiatry 159:1395–1402

    PubMed  Google Scholar 

  53. McGurk SR, Meltzer HY (2000) The role of cognition in vocational functioning in schizophrenia. Schizophr Res 45:175–184

    CAS  PubMed  Google Scholar 

  54. Dickerson FB, Boronow JJ, Stallings CR, et al. (2004) Association between cognitive functioning and employment status of persons with bipolar disorder. Psychiatr Serv 55:54–58

    PubMed  Google Scholar 

  55. Ferdinandi AD, Yoottanasumpun V, Pollack S, et al. (1998) Rehab Rounds: Predicting rehabilitation outcome among patients with schizophrenia. Psychiatr Serv 49:907–910

    CAS  PubMed  Google Scholar 

  56. Bond GR, Meyer PS (1999) The role of medications in the employment of people with schizophrenia. J Rehabil 65:9–16

    Google Scholar 

  57. Alverson H, Alverson M, Drake RE, et al. (1998) Social correlates of competitive employment among people with severe mental illness. Psychiatr Rehabil J 22:34–40

    Google Scholar 

  58. The ESEMeD/MHEDEA 2000 investigators (2004) Disability and quality of life impact of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) Project. Acta Psychiatr Scand 109:38–46

    PubMed  Google Scholar 

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Correspondence to Harry W. C. Michon M.A..

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Michon, H.W.C., van Weeghel, J., Kroon, H. et al. Person-related predictors of employment outcomes after participation in psychiatric vocational rehabilitation programmes. Soc Psychiat Epidemiol 40, 408–416 (2005). https://doi.org/10.1007/s00127-005-0910-5

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