Original ArticlesPredictors of Sustained Employment Among Individuals With Serious Mental Illness Findings From a 5-Year Naturalistic Longitudinal StudyRussinova, Zlatka PhD*; Bloch, Philippe MEd*; Wewiorski, Nancy PhD†; Shappell, Heather PhD‡; Rogers, E. Sally ScD*Author Information *Center for Psychiatric Rehabilitation, Sargent College, Boston University, Massachusetts; †Bedford VA Medical Center, Massachusetts; and ‡Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland. This study was supported by a grant (H133G80124) funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) and by a grant (H133B0023) jointly funded by the National Institute on Disability, Independent Living, and Rehabilitation Research and by the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, US Department of Health and Human Services. NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). Results do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government. Send reprint requests to Zlatka Russinova, PhD, Center for Psychiatric Rehabilitation, Sargent College, Boston University, 940 Commonwealth Ave West, Boston, MA 02215. E-mail: [email protected]. The Journal of Nervous and Mental Disease: September 2018 - Volume 206 - Issue 9 - p 669-679 doi: 10.1097/NMD.0000000000000876 Buy Metrics Abstract Despite decades of research, understanding of the employment trajectories of individuals with serious mental illnesses remains elusive. We conducted a 5-year prospective, longitudinal study using a geographically broad sample of individuals who met established criteria for sustained competitive employment (N = 529). We collected data on an annual basis with a specifically designed survey instrument. Despite stable employment at study entry, more than half of the participants experienced work interruptions during the 5-year follow-up period. Predictors of sustained employment included the absence of a trauma diagnosis, Social Security disability income, psychiatric hospitalizations, and difficulties with daily functioning. The presence of a higher quality of life, workplace supports, and a flexible job were also predictive. Results dispel the myth that people with serious mental illnesses cannot be employed for prolonged periods. Interruptions in work trajectories, however, suggest that longer-term supports may increase individuals' capacity to maintain stable employment. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.