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Clinical Factors Associated With Employment Among People With Severe Mental Illness: Findings From the Employment Intervention Demonstration Program

Razzano, Lisa A. PhD*; Cook, Judith A. PhD*; Burke-Miller, Jane K. MS*; Mueser, Kim T. PhD; Pickett-Schenk, Susan A. PhD*; Grey, Dennis D. BA*; Goldberg, Richard W. PhD; Blyler, Crystal R. PhD§; Gold, Paul B. PhD; Leff, H Stephen PhD; Lehman, Anthony F. MD; Shafer, Michael S. PhD#; Blankertz, Laura E. PhD**; McFarlane, William R. MD††; Toprac, Marcia G. PhD‡‡; Ann Carey, Martha PhD, RN§

The Journal of Nervous and Mental Disease: November 2005 - Volume 193 - Issue 11 - p 705-713
doi: 10.1097/01.nmd.0000185939.11282.3e
Original Articles

Research has shown that supported employment programs are effective in helping psychiatric outpatients achieve vocational outcomes, yet not all program participants are able to realize their employment goals. This study used 24 months of longitudinal data from a multisite study of supported employment interventions to examine the relationship of patient clinical factors to employment outcomes. Multivariate random regression analysis indicated that, even when controlling for an extensive series of demographic, study condition (experimental versus control), and work history covariates, clinical factors were associated with individuals’ ability to achieve competitive jobs and to work 40 or more hours per month. Poor self-rated functioning, negative psychiatric symptoms, and recent hospitalizations were most consistently associated with failure to achieve these employment outcomes. These findings suggest ways that providers can tailor supported employment programs to achieve success with a diverse array of clinical subpopulations.

*Center on Mental Health Services Research and Policy, Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois; †New Hampshire-Dartmouth Psychiatric Research Center and Dartmouth Medical School, Concord, New Hampshire; ‡Department of Psychiatry, University of Maryland, Baltimore, Maryland; §Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, Rockville, Maryland; ∥Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina; ¶Human Services Research Institute, Cambridge, Massachusetts; #Community Rehabilitation Division, University of Arizona, Tucson, Arizona; **School of Social Work and Social Research, Bryn Mawr College, Bryn Mawr, Pennsylvania; ††Department of Psychiatry, Maine Medical Center, Portland, Maine; and ‡‡Texas Department of Mental Health and Mental Retardation, Austin, Texas.

Send reprint requests to Lisa Razzano, PhD, UIC Center on Mental Health Services Research and Policy, Department of Psychiatry, 104 South Michigan Ave., Suite 900, Chicago, IL 60603.

© 2005 Lippincott Williams & Wilkins, Inc.