Supported employment: evidence for an evidence-based practice

Area of Science:

• Psychiatric Rehabilitation
• Vocational Rehabilitation
• Mental Health Services Research

Background:

• Supported employment is an evidence-based practice for individuals with severe mental illnesses.
• Previous research includes studies on converting day treatment programs and randomized controlled trials.

Purpose of the Study:

• To evaluate the effectiveness of supported employment in achieving competitive employment for individuals with severe mental illnesses.
• To assess the impact of supported employment on vocational and nonvocational outcomes.
• To review the evidence supporting core principles of supported employment.

Main Methods:

• Synthesizing findings from 4 studies on day treatment conversion.
• Analyzing data from 9 randomized controlled trials comparing supported employment to alternative approaches.
• Reviewing evidence for 7 core principles of supported employment.

Main Results:

• Supported employment participants achieve competitive employment at rates of 40-60%, compared to less than 20% for non-participants.
• Sustained competitive employment is associated with improved self-esteem and symptom control.
• Supported employment enrollment did not systematically impact nonvocational outcomes like rehospitalization or quality of life.

Conclusions:

• Supported employment is a highly effective intervention for improving vocational outcomes in severe mental illness.
• Evidence strongly supports 4 of the 7 core principles of supported employment; further research is needed for the remaining 3.
• Continued innovation and research into supported employment principles are recommended for enhancing services.