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PS 1997; 48:335-346
Copyright © 1997 by American Psychiatric Association
An update on supported employment for people with severe mental illness
GR Bond, RE Drake, KT Mueser and DR Becker
Department of Psychology, Indiana University-Purdue University, Indianapolis 46202, USA.
OBJECTIVE: This review examines the effectiveness of supported employment
for people with severe mental illness. METHODS: A comprehensive search was
made for quantitative studies, primarily in the published literature.
RESULTS: Seven descriptive studies, three surveys, one quasi-experimental
study, and six experimental studies were found. All studies suggested
significant gains in obtaining employment for persons enrolled in supported
employment programs. In experimental studies, a mean of 58 percent of
clients in supported employment programs achieved competitive employment,
compared with 21 percent for control subjects, who typically received
traditional vocational services. Employment outcomes relating to time
employed and employment earnings also favored clients in supported
employment over control subjects. No evidence was found that supported
employment led to stress levels precipitating higher rehospitalization
rates. Two features of many supported employment programs have the most
empirical support: integration of mental health and vocational services
within a single service team and the avoidance of preplacement training.
Two other widely held principles-ongoing support and attention to client
preferences-have not been systematically evaluated. CONCLUSIONS: Supported
employment appears to be a promising approach for people with severe mental
illness, but more studies are needed, with close attention to program
implementation and long-term follow-up.
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