title: A 10-year study of steady employment and non-vocational outcomes among people with serious mental illness and co-occurring substance use disorders.
abstract: OBJECTIVE
  Employment promotes recovery for persons with serious mental illness by providing extra income and a valued social role, but the impact of employment on other psychosocial and clinical outcomes remains unclear. This study examined non-vocational outcomes in relation to steady employment over 10 years among people with serious mental illness and co-occurring substance use disorders.
  
  
  METHODS
  Researchers interviewed people with co-occurring disorders at baseline and yearly for 10 years and tracked employment in relation to five non-vocational outcomes: independent living, psychiatric symptoms, substance use disorder, healthy (non-substance-abusing) relationships, and life satisfaction. Latent class trajectory analysis identified steady workers, and mixed-effects regression models compared steady workers with non-workers.
  
  
  RESULTS
  Both steady workers (n=51) and non-workers (n=79) improved substantially; for example, a majority of each group achieved independent housing and stable remission of substance use disorders. Steady workers achieved independent housing and higher quality of life during the first 5 years of follow-up, but the two groups achieved similar outcomes by 10 years.
  
  
  CONCLUSIONS
  People with co-occurring disorders can improve markedly. Those with steady employment may improve faster, but those without employment may achieve similar long-term outcomes at a slower pace.
authors.affiliation: Dartmouth Psychiatric Research Center, Rivermill Commercial Center, 85 Mechanic Street, Suite B4-1, Lebanon, NH 03766, USA. gregory.mchugo@dartmouth.edu
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: McHugo
authors.forename: Robert E
authors.initials: RE
authors.lastname: Drake
authors.forename: Haiyi
authors.initials: H
authors.lastname: Xie
authors.forename: Gary R
authors.initials: GR
authors.lastname: Bond
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000523:psychology / Q000534:rehabilitation*; D017831:Diagnosis, Dual (Psychiatry); D016832:Employment, Supported / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D057187:Independent Living / Q000706:statistics & numerical data*; D007398:Interpersonal Relations; D008137:Longitudinal Studies; D008297:Male; D010549:Personal Satisfaction; D011618:Psychotic Disorders / Q000523:psychology / Q000534:rehabilitation*; D012559:Schizophrenia / Q000534:rehabilitation*; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation*