Effects of co-occurring disorders on employment outcomes in a multisite randomized study of supported employment for people with severe mental illness.
Effects of co-occurring disorders on work outcomes were explored among individuals with severe mental illness who were participating in a multisite randomized study of supported employment. At seven sites, 1,273 people were randomly assigned to an experimental supported employment program or a control condition and followed for 2 years. Multivariate regression analysis examined work outcomes including earnings, hours worked, and competitive employment, as well as whether psychiatric disability was disclosed to coworkers and supervisors. Individuals with any comorbidity had lower earnings and were less likely to work competitively. Those with physical comorbidities had lower earnings, worked fewer hours, and were less likely to work competitively. Disclosure was more likely among those with both cognitive and physical comorbidities, as well as those with learning disabilities. Competitive employment was less likely among those with intellectual disability, visual impairment, and human immunodeficiency virus/acquired immuno-deficiency syndrome. The experimental condition was positively related to all outcomes except disclosure. The results suggest that, with some exceptions, comorbidities affect employment outcomes, requiring tailored services and supports to promote vocational success.
Cook
Judith A
JA
Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60612, USA. cook@ripco.com
Razzano
Lisa A
LA
Burke-Miller
Jane K
JK
Blyler
Crystal R
CR
Leff
H Stephen
HS
Mueser
Kim T
KT
Gold
Paul B
PB
Goldberg
Richard W
RW
Shafer
Michael S
MS
Onken
Steven J
SJ
McFarlane
William R
WR
Donegan
Kate
K
Carey
Martha Ann
MA
Kaufmann
Caroline
C
Grey
Dennis D
DD
D000328:Adult; D000553:Ambulatory Care; D004185:Disability Evaluation; D016832:Employment, Supported / Q000379:methods*; D019317:Evidence-Based Medicine / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D017063:Outcome Assessment, Health Care; D018579:Patient Selection; D012050:Rehabilitation, Vocational / Q000379:methods*; D014481:United States; D014829:Vocational Education / Q000379:methods*