Day treatment centers were originally designed to provide "partial hospitalization" for patients with serious mental disorders who required intensive, comprehensive, and multidisciplinary treatment that was unavailable in an outpatient setting. These programs began to develop rehabilitative services, rather than "hospital diversion". However, research indicates that these centers do not assist clients in obtaining jobs in the community. Because of the expense involved in maintaining these centers, they are coming under closer scrutiny. As such, several day treatment centers were successfully converted to supported employment programs.
The intent of the study was to determine if phasing out day treatment centers in support of supported employment and other activities can be implemented statewide.
Three community day care treatment centers in Rhode Island participated in the study. Two were converted to supported employment programs, while the third remained a day treatment center until after the study was complete, for comparison purposes.
The study sample include 28 day treatment clients with severe mental illness in three community mental health centers.
"Participants were assessed at baseline and again at follow-up 30 to 36 months later; follow-up for clients in the converted programs took place 18 months after the conversion was completed. An independent research team conducted the interviews and evaluation." (p. 352)
The intervention related to conversion of two day treatment centers to ones offering supported employment services.
One of the centers remained as a rehabilitative day center.
"Former day treatment clients in the converted centers attained higher rates of competitive employment than those in the comparison group (44.2 percent and 56.7 percent versus 19.5 percent). Other employment outcomes also improved, and hospitalization rates and overall social functioning were unchanged." (p. 351)
"This study supports findings of previous studies suggesting that replacing rehabilitative day treatment programs with supported employment programs yields improvements in employment outcomes without adverse effects." (p. 351)