Measures and predictors of community-based employment and earnings of persons with schizophrenia in a multisite study.
OBJECTIVE
Data from a national study of persons with schizophrenia-related disorders were examined to determine clinical factors and labor-market conditions related to employment outcomes.


METHODS
Data were obtained from the U.S. Schizophrenia Care and Assessment Program, a naturalistic study of more than 2,300 persons from organized care systems in six U.S. regions. Data were collected via surveys and from medical records and clinical assessments at baseline and for three years. Outcome measures included any community-based (nonsheltered) employment, 40 or more hours of work in the past month, employment at or above the federal minimum wage, days and hours of work, and earnings. Bivariate and multiple regression analyses of data from more than 7,000 assessments tested relationships between outcomes and sociodemographic, clinical, and local labor market characteristics.


RESULTS
The employment rate was 17.2%; only 57.1% of participants who worked reported 40 or more hours of past-month employment. The mean hourly wage was $7.05, and mean monthly earnings were $494.20. Employment rates and number of hours worked were substantially below those found in household surveys or in baseline data from trials of employment programs but substantially higher than those found in a recent large clinical trial. Strong positive relationships were found between clinical factors and work outcomes, but evidence of a relationship between local unemployment rates and outcomes was weak.


CONCLUSIONS
Work attachment and earnings were substantially lower than in previous survey data, not very sensitive to labor market conditions, and strongly related to clinical status.
Salkever
David S
DS
Department of Public Policy, University of Maryland, Baltimore County, 1000 Hilltop Circle, Public Policy 418, Baltimore, MD 21205, USA. salkever@umbc.edu.
Karakus
Mustafa C
MC
Slade
Eric P
EP
Harding
Courtenay M
CM
Hough
Richard L
RL
Rosenheck
Robert A
RA
Swartz
Marvin S
MS
Barrio
Concepcion
C
Yamada
Anne Marie
AM
D000328:Adult; D003159:Community-Institutional Relations; D003625:Data Collection; D039721:Diagnostic and Statistical Manual of Mental Disorders; D016832:Employment, Supported / Q000191:economics* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008396:Maryland / Q000453:epidemiology; D011446:Prospective Studies; D012456:Salaries and Fringe Benefits / Q000191:economics*; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology*; D012959:Socioeconomic Factors