Who benefits from supported employment: A meta-analytic study | Knowledge Translation for Employment Research Center

Authors:	Carolina, H., Ellice, S., Strobel Gower, W.
Year Published	2011
Publication	Schizophrenia Bulletin
Volume	37
Number	2
Pages	370-380
Publisher	Oxford University Press
Background	Individual Randomized Controlled Trials (RCTs) of supported employment often have not had sufficient power to examine individual client subgroups. Research is needed that examines the question: Among various subgroups of clients with SMI ( by work history, demographic, and clinical variables), which subgroups benefit from evidence-based supported employment? Alternatively, which subgroups benefit more from brokered stepwise vocational models?
Purpose	Meta-analysis sought to identify which subgroups of clients with severe mental illness (SMI) benefited from evidence-based supported employment.
Setting	This study is a systematic review. The included studies were undertaken in various locations and settings. This included mental health programs in Washington DC, Hartford CT, Concord and Manchester N.H,, and Chicago IL.
Sample	The sample consisted of study participants from 4 RCTs of IPS vs usual services.31‚Äì34 All 4 studies compared a newly established IPS program with one or more well-established vocational programs. In all 4 studies, participants were recruited from mental health centers (or a psychiatric rehabilitation agency in the Chicago Study). Participants were adults who met each state's criteria for SMI, typically a Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV) Axis I or II diagnosis plus severe and persistent impairment in psychosocial functioning. All participants were unemployed at the time of study admission.
Data Collection	This meta-analytic study used archival data from 4 independent RCTs to determine the magnitude of effects for IPS within specific client subgroups ( by 2 work history, 7 sociodemographic, and 8 clinical variables) on 3 competitive employment outcomes (obtaining a job, total weeks worked, and job tenure).
Control	Standardized vocational rehabilitation services such as transitional employment, brokered supported employment (which lacked the integrated services offered by IPS), and paid work adjustment services.
Findings	The findings strongly favored IPS, with large effect sizes across all outcomes: 0.96 for job acquisition, 0.79 for total weeks worked, and 0.74 for job tenure. Overall, 90 (77%) of the 117 effect sizes calculated for the 39 subgroups exceeded 0.70, and all 117 favored IPS.
Conclusions	IPS produces better competitive employment outcomes for persons with SMI than alternative vocational programs regardless of background demographic, clinical, and employment characteristics.
URL	http://www.ncbi.nlm.nih.gov/pubmed/19661196
Disabilities	Emotional disturbance
Populations	Male & Female
Outcomes	Employment acquisition \| Full-time employment \| Part-time employment
NIDILRR Funded	Yes
Research Design	Systematic reviews and meta-analysis
Peer Reviewed	Yes

Year Published

2011

Publication

Schizophrenia Bulletin

Volume

37

Number

2

Pages

370-380

Publisher

Oxford University Press

Background

Individual Randomized Controlled Trials (RCTs) of supported employment often have not had sufficient power to examine individual client subgroups. Research is needed that examines the question: Among various subgroups of clients with SMI ( by work history, demographic, and clinical variables), which subgroups benefit from evidence-based supported employment? Alternatively, which subgroups benefit more from brokered stepwise vocational models?

Purpose

Meta-analysis sought to identify which subgroups of clients with severe mental illness (SMI) benefited from evidence-based supported employment.

Setting

This study is a systematic review. The included studies were undertaken in various locations and settings. This included mental health programs in Washington DC, Hartford CT, Concord and Manchester N.H,, and Chicago IL.

Sample

The sample consisted of study participants from 4 RCTs of IPS vs usual services.31‚Äì34 All 4 studies compared a newly established IPS program with one or more well-established vocational programs. In all 4 studies, participants were recruited from mental health centers (or a psychiatric rehabilitation agency in the Chicago Study). Participants were adults who met each state's criteria for SMI, typically a Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV) Axis I or II diagnosis plus severe and persistent impairment in psychosocial functioning. All participants were unemployed at the time of study admission.

Data Collection

This meta-analytic study used archival data from 4 independent RCTs to determine the magnitude of effects for IPS within specific client subgroups ( by 2 work history, 7 sociodemographic, and 8 clinical variables) on 3 competitive employment outcomes (obtaining a job, total weeks worked, and job tenure).

Control

Standardized vocational rehabilitation services such as transitional employment, brokered supported employment (which lacked the integrated services offered by IPS), and paid work adjustment services.

Findings

The findings strongly favored IPS, with large effect sizes across all outcomes: 0.96 for job acquisition, 0.79 for total weeks worked, and 0.74 for job tenure. Overall, 90 (77%) of the 117 effect sizes calculated for the 39 subgroups exceeded 0.70, and all 117 favored IPS.

Conclusions

IPS produces better competitive employment outcomes for persons with SMI than alternative vocational programs regardless of background demographic, clinical, and employment characteristics.

URL

http://www.ncbi.nlm.nih.gov/pubmed/19661196

Disabilities

Emotional disturbance

Populations

Male & Female

Outcomes

Employment acquisition | Full-time employment | Part-time employment

NIDILRR Funded

Yes

Research Design

Systematic reviews and meta-analysis

Peer Reviewed

Yes