Article Details

Research Database: Article Details

Citation:  Drake, R.E., McHugo, G.J., Bebout, R.R. Becker, D.R., Harris, M., Bond, G.R., & Quimby, E. (1999). A randomized clinical trial of supported employment for inner-city patients with severe mental disorders. Archives of General Psychiatry, 56 (7), 627-633.
Title:  A randomized clinical trial of supported employment for inner-city patients with severe mental disorders
Authors:  Drake, R.E., McHugo, G.J., Bebout, R.R. Becker, D.R., Harris, M., Bond, G.R., & Quimby, E.
Year:  1999
Journal/Publication:  Archives of General Psychiatry
Publisher:  American Medical Association
DOI:  https://doi.org/10.1001/archpsyc.56.7.627
Full text:  http://proxy.library.vcu.edu/login?url=http://archpsyc.jamanetwork....    |   PDF   
Peer-reviewed?  Yes
NIDILRR-funded?  No
Research design:  Randomized controlled trial

Structured abstract:

Background:  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.
Purpose:  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.
Setting:  "Community Connections, an agency in southeast Washington, DC that serves people with severe mental disorders who need intensive case management" (p. 628)
Study sample:  152 unemployed, inner-city patients with severe mental disorders
Intervention:  The intervention was the Individual Placement and Support (IPS) model of supported employment.
Control or comparison condition:  The control group received Enhanced Vocational Rehabilitation (EVR)
Data collection and analysis:  Clients received the DSM-III-R assessment to determine eligibility; monthly assessments were conducted at baseline and at 6-, 12-, and 18-month follow-up points. In addition, bi-monthly interviews were conducted by researchers. Analysis was conducted using standard statistics. A mixed effects (SAS PRO MIXED) was used for longitudinal data.
Findings:  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.
Conclusions:  IPS appears to be superior to EVR; however, a lack of evidence exists for the IPS model producing negative results in nonvocational 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.

Disabilities served:  Chronic mental illness
Populations served:  Gender: Female and Male
Race: Asian
Race: Black / African American
Race: White / Caucasian
Ethnicity: Not Hispanic or Latino
Interventions:  Individual Placement and Support (IPS) model of supported employment
Outcomes:  Employment acquisition