Campbell Kikuko, Bond Gary R, Drake Robert E, McHugo Gregory J, Xie Haiyi
Department of Psychology, Indiana University-Purdue University Indianapolis, 402 N, Blackford St, LD-124, Indianapolis, IN 46202-3275, USA.
J Nerv Ment Dis. 2010 Aug;198(8):556-63. doi: 10.1097/NMD.0b013e3181ea1e53.
Research on vocational rehabilitation for clients with severe mental illness over the past 2 decades has yielded inconsistent findings regarding client factors statistically related to employment. The present study aimed to elucidate the relationship between baseline client characteristics and competitive employment outcomes-job acquisition and total weeks worked during an 18-month follow-up-in Individual Placement and Support (IPS). Data from 4 recent randomized controlled trials of IPS were aggregated for within-group regression analyses. In the IPS sample (N = 307), work history was the only significant predictor for job acquisition, but receiving Supplemental Security Income-with or without Social Security Disability Insurance-was associated with fewer total weeks worked (2.0%-2.8% of the variance). In the comparison sample (N = 374), clients with a diagnosis of mood disorder or with less severe thought disorder symptoms were more likely to obtain competitive employment. The findings confirm that clients with severe mental illness interested in competitive work best benefit from high-fidelity supported employment regardless of their work history and sociodemographic and clinical background, and highlight the needs for changes in federal policies for disability income support and insurance regulations.
过去20年来，针对重症精神疾病患者职业康复的研究，在与就业存在统计学关联的患者因素方面，得出了不一致的结果。本研究旨在阐明个体安置与支持（IPS）模式下，患者基线特征与竞争性就业结果（即就业获取情况以及18个月随访期内的总工作周数）之间的关系。对近期4项IPS随机对照试验的数据进行汇总，以进行组内回归分析。在IPS样本（N = 307）中，工作经历是就业获取的唯一显著预测因素，但领取补充保障收入（无论是否享有社会保障残疾保险）与总工作周数减少相关（方差的2.0%-2.8%）。在对照样本（N = 374）中，被诊断为情绪障碍或思维障碍症状较轻的患者更有可能获得竞争性就业。研究结果证实，对竞争性工作感兴趣的重症精神疾病患者，无论其工作经历、社会人口统计学和临床背景如何，都能从高保真支持性就业中最大程度获益，并突出了联邦残疾收入支持政策和保险法规变革的必要性。
