title: Predictors of vocational activity over the first year in inner-city early intervention in psychosis services.
abstract: OBJECTIVE
  Work and educational activities are an important part of recovery for young people with psychosis, and improving vocational outcomes is a key target for early intervention services (EIS). This study evaluated predictors of vocational activity for first-episode psychosis (FEP) patients during the first year of EIS care. It was hypothesized that longer duration of untreated psychosis (DUP) and minority ethnic status would predict poorer vocational outcomes, whereas a history of good vocational functioning would predict better vocational functioning during follow up.
  
  
  METHODS
  FEP patients aged 14-35 years, who presented to seven EIS in London, UK, between 2003 and 2010, were followed for 1 year. Sociodemographic, clinical and vocational information (qualifications obtained and paid employment) were collected using the MiData audit tool at entry to EIS and 1 year later.
  
  
  RESULTS
  Approximately one-third of patients (n = 345/1013) were studying or employed at some point during the first year of EIS care. Baseline vocational activity was the strongest predictor of vocational functioning during 1 year of follow up. Moreover, employment prior to entry into EIS strongly predicted change in vocational activity during 1 year of follow up. Individuals with DUP <6 months or of Asian or black African origin were more likely to be studying than their white British counterparts.
  
  
  CONCLUSIONS
  This study confirms that a significant proportion of FEP patients are able to engage in meaningful vocational activities even within the first year of EIS care. However, services need to focus more resources on getting patients with poor educational or employment histories into training programmes to improve their vocational outcomes.
authors.affiliation: Lewisham Early Intervention Service, South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Tapfumaneyi
authors.affiliation: Camden and Islington Early Intervention Service, Camden and Islington NHS Foundation Trust, London, UK.|Mental Health Sciences Unit, University College London, London, UK.
authors.forename: Sonia
authors.initials: S
authors.lastname: Johnson
authors.affiliation: Lewisham Early Intervention Service, South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: John
authors.initials: J
authors.lastname: Joyce
authors.affiliation: EQUIP, Hackney, East London NHS Foundation Trust, London, UK.
authors.forename: Barnaby
authors.initials: B
authors.lastname: Major
authors.affiliation: STEP, Southwark, South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Jo
authors.initials: J
authors.lastname: Lawrence
authors.affiliation: Mental Health Sciences Unit, University College London, London, UK.
authors.forename: Farhana
authors.initials: F
authors.lastname: Mann
authors.affiliation: Wandsworth Early Intervention Service, Southwest London & St Georges' Mental Health NHS Trust, London, UK.
authors.forename: Brock
authors.initials: B
authors.lastname: Chisholm
authors.affiliation: Kensington, Chelsea, Westminster and Brent Early Intervention Service, Central & North West London NHS Foundation Trust, London, UK.
authors.forename: Nikola
authors.initials: N
authors.lastname: Rahaman
authors.affiliation: Wandsworth Early Intervention Service, Southwest London & St Georges' Mental Health NHS Trust, London, UK.
authors.forename: James
authors.initials: J
authors.lastname: Wooley
authors.affiliation: MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK.
authors.forename: Helen L
authors.initials: HL
authors.lastname: Fisher
mesh_terms: D000293:Adolescent; D000328:Adult; D061345:Early Medical Intervention / Q000379:methods*; D004651:Employment / Q000706:statistics & numerical data; D005006:Ethnicity / Q000523:psychology; D005260:Female; D006801:Humans; D008131:London; D008297:Male; D008605:Mental Health Services; D011618:Psychotic Disorders / Q000534:rehabilitation*; D012050:Rehabilitation, Vocational / Q000523:psychology* / Q000706:statistics & numerical data*; D013997:Time Factors; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: early intervention; education; employment; first-episode psychosis; vocational outcome