Helping people with severe mental illness to obtain work: systematic review
Supported employment is more effective than prevocational training at helping people with severe mental illness to obtain and keep competitive employment (a job paid at the market rate, and for which anyone can apply), finds a study in this week's BMJ.
Crowther and colleagues analysed 11 trials comparing prevocational training (a period of preparation before entering competitive employment) or supported employment (placement in competitive employment while offering on the job support) with each other, or with standard community care, for people with severe mental illness. They found that supported employment was more effective than prevocational training at helping people to obtain competitive employment. This effect was still present, although at a reduced level, when all but the two highest quality trials were excluded from the analysis.
There are compelling ethical, social and clinical reasons for helping people with mental illness to work, say the authors. In light of the UK government's commitment to helping disabled people return to the workplace, it should encourage agencies concerned with vocational rehabilitation to develop and evaluate supported employment schemes similar to those in the United States, they conclude.
Ruth Crowther, Research Fellow, School of Psychiatry and Behavioural Sciences, University of Manchester, UK