Article Details

Research Database: Article Details

Citation:  Bond, G. & Drake, R. (2008). Predictors of competitive employment among patients with schizophrenia. Current Opinion in Psychiatry, 21 (4), 362-369.
Title:  Predictors of competitive employment among patients with schizophrenia
Authors:  Bond, G. & Drake, R.
Year:  2008
Journal/Publication:  Current Opinion in Psychiatry
Publisher:  Wolters Kluwer Health/Lippincott Williams and Wilkins
Full text:   
Peer-reviewed?  Yes
NIDILRR-funded?  No
Research design:  Systematic review / meta-analysis

Structured abstract:

Background:  Researches continue to examples predictors of employment among three types of variables: patient characteristics, environmental characteristics, and interventions. Provision of supported employment is the strongest predictor of competitive employment among patients with schizophrenia. Patent characteristics show modest association with employment outcomes; environmental factors are presumed to have major influences, but have been little studied.
Purpose:  "Researchers continue to study factors that are relatively easy to study rather than those that are powerful and meaningful from a public health perspective. Truly critical factors are first, disability, insurance, and employment regulations that discourage most people from trying to work, and second, failure to align finances and organization of services with evidenced based practices." Article reviews current literature on the various factors being researched that impact employment outcomes for patients with schizophrenia.
Setting:  This study is a systematic review. The included studies were undertaken in various locations and settings.
Study sample:  The study sample was recently published studies examining predictors of competitive employment for patients with schizophrenia.
Intervention:  Predictors/interventions were grouped in three categories: patient characteristics, environmental factors, and interventions. Patients characteristics included demographics, criminal justice involvement, physical co morbidity, co occurring substance use disorder, cognitive factors, clinical factors, self efficacy, and patient motivation, and social skills and work performance. Environmental factors included societal and cultural, influences, local unemployment rate, access to supported employment, and regulatory factors. Interventions included mental health treatment, vocational services, and individual placement and support process studies.
Control or comparison condition:  There were no comparison or control conditions.
Data collection and analysis:  Literature search included a combination of strategies,, including PubMed search with keywords, examination of table of contents from major journals in related fields, and consultation with leading researches.
Findings:  Implementing supported employment services with high fidelity to the IPS model clearly improves competitive employment outcomes. While the core principles of IPS are well established, many important aspects such as job development and job support strategies need further research to enhance effectiveness. Few mental health or rehabilitation organizations have solved the multifarious problems of financing, organizations, capacity, integration, education, training, supervision, fidelity, and so forth that would facilitate access to evidenced based supported employment for all of those who cold benefit.
Conclusions:  "According to the published literature, the single best predictor of competitive employment for patients with schizophrenia is supported employment. Despite numerous studies seeking to identify patients characteristics predicting employment, the reported findings have been generally unimpressive. Many factors influencing employment outcomes continue to be understudied, including societal and cultural factors, access to supported employment, regulatory factors, and criminal justice involvement.

Disabilities served:  Schizophrenia
Interventions:  Benefits counseling
Individual Placement and Support (IPS) model of supported employment
Job search and placement assistance
Outcomes:  Employment acquisition