title: Predictors of employment for people with severe mental illness: results of an international six-centre randomised controlled trial.
abstract: BACKGROUND
  An international six-centre randomised controlled trial comparing individual placement and support (IPS) with usual vocational rehabilitation for people with serious mental illness found IPS to be more effective for all vocational outcomes.
  
  
  OBJECTIVE
  To determine which patients with severe mental illness do well in vocational services and which process and service factors are associated with better outcomes.
  
  
  METHODS
  Patient characteristics and early process variables were tested as predictors of employment outcomes. Service characteristics were explored as predictors of the effectiveness of IPS.
  
  
  RESULTS
  Patients with previous work history, fewer met social needs and better relationships with their vocational workers were more likely to obtain employment and work for longer. Remission and swifter service uptake were associated with working more. Having an IPS service closer to the original IPS model was the only service characteristic associated with greater effectiveness.
  
  
  CONCLUSIONS
  The IPS service was found to be more effective for all vocational outcomes. In addition, maintaining high IPS fidelity and targeting relational skills would be a valuable focus for all vocational interventions, leading to improved employment outcomes. Motivation to find work may be decreased by satisfaction with current life circumstances.
authors.affiliation: Division of Mental Health, St Geroge's, University of London, UK.
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Catty
authors.forename: Pascale
authors.initials: P
authors.lastname: Lissouba
authors.forename: Sarah
authors.initials: S
authors.lastname: White
authors.forename: Thomas
authors.initials: T
authors.lastname: Becker
authors.forename: Robert E
authors.initials: RE
authors.lastname: Drake
authors.forename: Angelo
authors.initials: A
authors.lastname: Fioritti
authors.forename: Martin
authors.initials: M
authors.lastname: Knapp
authors.forename: Christoph
authors.initials: C
authors.lastname: Lauber
authors.forename: Wulf
authors.initials: W
authors.lastname: Rössler
authors.forename: Toma
authors.initials: T
authors.lastname: Tomov
authors.forename: Jooske
authors.initials: J
authors.lastname: van Busschbach
authors.forename: Durk
authors.initials: D
authors.lastname: Wiersma
authors.forename: Tom
authors.initials: T
authors.lastname: Burns
mesh_terms: D000293:Adolescent; D000328:Adult; D004651:Employment; D016832:Employment, Supported; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000534:rehabilitation*; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000379:methods; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012047:Rehabilitation Centers; D012050:Rehabilitation, Vocational / Q000379:methods*; D012559:Schizophrenia / Q000534:rehabilitation