A hybrid supported employment program for persons with schizophrenia in Japan

Authors: Gamble, D., & Moore, C. L.,
Year Published 2000
Publication Psychiatric Services
Volume 51
Number 7
Pages 864-866
Publisher Psychiatric Services

Individuals with Schizophrenia remain hospitalized for extended periods of time in Japan even after their symptoms have lessened. There are few community rehabilitation programs for this group. Most return to live with families, who may not be prepared, to provide the support the individuals requires to remain in the community. Getting involved in work activities can help facilitate successful community reentry.


This paper described an innovative hybrid program; that combined practices associated with transitional employment and supported employment models, to assist individuals with schizophrenia with employment.


The setting was a psychiatric hospital and various employment sites in Japan.


Charts were reviewed to determine social and vocational adjustment and rehospitalization rates of 52 individuals who had participated in the program and went to work. The average age of the participants at the time of the survey was 51 years. Thirty six were men and 16 were women who had been consecutively discharged between 1977 and 1990. The onset of mental illness was 23 years. All had a diagnosis of schizophrenia and on average had been hospitalized for 8.9 years prior to going to work.

Data Collection

Clinical records since the onset of illness were reviewed for each participant.


There was no control or comparison conditions.


Fifty two individuals worked from three months to seventeen years. The follow up survey indicated 20 individuals were employed and living in the community, 15 lived with families and were not working and 17 were hospitalized. On average participants were hospitalized an average of 1.5 times after supported employment as compared to 3.2 beforehand. Events associated with this included: more symptoms due to not taking medication and quitting a job. The time spent out of the hospital increased from 54% before supported employment to 68% afterwards.


The hybrid model of vocational rehabilitation helped many patients successfully integrate in to the community. Success rates at work were excellent for a population that typically experiences poor outcomes. There appears to be cross cultural validity in this approach.

URL http://www.ncbi.nlm.nih.gov/pubmed/10875948
Disabilities Emotional disturbance
Populations Asian | Male & Female
Outcomes Employment acquisition | Increase in tenure
Research Design Observational
Peer Reviewed No