A randomized clinical trial of supported employment for inner-city patients with severe mental disorders
|Authors:||Dutta, A., Gervey R., Chan, E. F., Chou, C., & Ditchman, N.|
|Publication||Archives of General Psychiatry|
|Publisher||American Medical Association|
One primary goal for people with psychiatric disabilities is competitive employment. However, the actual rate of employment is less than 15%. The authors hypothesize two reasons: individuals with psychiatric disorders are discouraged from seeking competitive employment because health professionals believe that "the stress of competitive work produces adverse effects" (p. 627), and once in the standard vocational system, people tend to stay in sheltered workshops instead of transitioning to competitive work.
The purpose of this study was to replicate the New Hampshire study in Washington, D.C., with a more diverse and disadvantaged group of patients and a variety of vocational agencies.
"Community Connections, an agency in southeast Washington, DC that serves people with severe mental disorders who need intensive case management" (p. 628)
152 unemployed, inner-city patients with severe mental disorders
Interviews were used to gain information about demographics, employment histories, income sources and amounts, clinical symptoms and other relevant information at the beginning of the study and then at 6 month intervals for 24 months. A variety of employment data was gathered such as hours worked, wages, job duties, benefits. Psychiatric symptoms were assessed using the PANSS a semi structured rating scale.
The control group received Enhanced Vocational Rehabilitation (EVR)
During the 18-month study period, participants receiving IPS were more likely than those in EVR to obtain competitive employment. IPS participants "also had superior outcomes in other dimensions of competitive employment" (p. 629). In addition, IPS participants were more satisfied than their EVR counterparts.
IPS appears to be superior to EVR; however, a lack of evidence exists for the IPS model producing negative results in non-vocational areas, such as self-esteem and quality of life. In fact, the study validated an increase in those two areas, in both IPS and EVR. IPS increased the rate of competitive employment as compared to EVR.
|Populations||Male & Female | Asian | Black / African American | White / Caucasian|
|Research Design||Randomized Controlled Trials (RCTs)|