Effects of job development and job support on competitive employment of persons with severe mental illness

Authors: Lehman, A.F., Goldberg, R., Dixon, L.B., McNary, S., Postrado, L., Hackman, A., & McDonnell, K.
Year Published 2005
Publication Psychiatric Services
Volume 56
Number 10
Pages 1237-1244
Publisher American Psychiatric Association

Few studies have tried to determine which specific supported employment services improve employment outcomes for people with psychiatric disabilities. This study examined the effects of job development and job support among other services on acquisitions and retention of competitive employment for individuals with a psychiatric disability. It found that job development is a very effective service when the goal is job acquisition. Job support is associated with retention in first competitive job, but it's casual role is questionable.


The study hypothesized that participants who received job development would be more likely to acquire competitive employment than those who did not receive it, and would likely be more prepared for work and more likely to acquire competitive jobs than those who received it later. It was further hypothesized that those who received job support would work more months and hours that those who did not.


This study is a systematic review. The included studies were undertaken in various locations and settings. Data used in the analysis came from the two year EIDP (Employment Demonstration Intervention Project)that collected data from sites in seven different states.


A total of 1,340 persons from the seven state employment demonstration sites were included in the analysis. Persons doing paid work at baseline (N=28) and those with no follow-up employment data (N=98) were excluded. Individuals included in the study if they were 18 years old or older at enrollment, were willing and able to provide informed consent, had a DSM diagnosis of mental illness, and were unemployed.

Data Collection

Interview assessments with EIDP participants elicited information about demographic characteristics, previous employment, current income, clinical indicators, and other relevant information at six month intervals for 24 months. Sites also collected data on the types of vocational and clinical services received by EIDP participants. Recruitment of study participants took place between February 1996 and May 2000. Random effects meta analysis were fist to the data over multiple sites. All analyses showed consistency between sites. Effect sizes for the job acquisition and job retention variables were calculated using Comprehensive Meta-Analysis statistical software. A;; hypothesis were two-tailed, and the standard p value of p<.05 was used for rejection of the null hypothesis.


Comparison services included for example a variety of employment services such as vocational assessment and evaluation and off site job skills training, vocational treatment planning or career development, and vocational support groups.


Job development helped participants obtain competitive employment. Individuals who received job development sere almost five times more likely to obtain competitive employment than individuals who not received job development. Individuals with no previous work experience had virtually no chance of acquiring competitive employment without job development.
A significant association between months in the first competitive job and receipt of job support was found.


Data from this study support the importance of job development and job supports to successful job acquisition and job retention. On average, receipt of job support was positively correlated with the number of months and hours worked in the first competitive job.

URL http://ps.psychiatryonline.org/doi/pdf/10.1176/appi.ps.56.10.1237
Disabilities Emotional disturbance
Populations Male & Female
Outcomes Employment acquisition | Increase in tenure
Research Design Systematic reviews and meta-analysis
Peer Reviewed Yes