The future of supported employment for people with severe mental illness

Authors: Drake, R. E., McHugo, G. J., Bebout, R. R. Becker, D. R., Harris, M., Bond, G. R., & Quimby, E.
Year Published 2008
Publication Psychiatric Rehabilitation Journal
Volume 31
Number 4
Pages 367-376
Publisher American Psychological Association

People with psychiatric disabilities have been able to be competitively employed using supported employment. However, limits to supported employment include: not everyone with psychiatric disabilities wants to work; people are afraid of losing benefits; they lack confidence; they receive little reinforcement from their counselors; or they may not receive the help they need. In addition, finding competitive employment may be difficult due to employee illness, inadequate services, and fear of losing benefits.


The article "reviews current research on innovative attempts to improve the dissemination and effectiveness of supported employment" (p. 367). The intent is to expand the success of supported employment.


This is a review of literature. The included studies were undertaken in various locations and settings.


he sample included published literature in MEDLINE, PubMed, PsychlNFO, and Scopus; currently funded grant titles, such as NIMH, NIDILRR, and the Social Security Administration. The researchers also discussed the current research with individual investigators.

Data Collection

Research was reviewed in each of the 9 areas identified in the Intervention section.


Control conditions varied across the studies. Conditions included Group skills training, enhanced vocational rehabilitation, psychosocial rehabilitation, diversified placement, train-place, sheltered workshop, brokered vocational rehabilitation, and traditional vocational services.


With regard to organization and financing of services, clinical and vocational services should be integrated at the client level, which would offer the client "single team of providers who provide a consistent message" (p. 368). Disability policies actually "socialize people into disability" rather than supporting them. Increasing the quality of vocational services will address several of the areas identified in the Intervention section, in addition to learning to implement, maintain, and update supported employment programs as research becomes available. Motivating people with psychiatric disabilities to work can be difficult, especially with the overwhelming issues they face, such as treatment itself, applying for benefits, obtaining insurance, or societal stigma. Job development is critical to supported employment; none of the approaches mentioned have been studied empirically. Individuals with greater symptoms are less likely to be employed unless vocational and psychiatric services are integrated.

Improving job supports would enhance the employability of the individual, such as increasing the use of natural supports and skills training. Career development implies a pattern of growth and increasing satisfaction in employment over time. And lastly, supported employment was proven as a successful technique in the field of developmental disabilities; it is being evaluated as a technique for use with populations other than those with psychiatric disabilities.


Supported employment is an evidence-based practice that needs improvement.

Disabilities Emotional disturbance
Populations Hispanic or Latino | Black / African American | White / Caucasian | Male & Female
Outcomes Employment acquisition
NIDILRR Funded Not Reported
Research Design Systematic reviews and meta-analysis
Peer Reviewed Yes