Public Mental, Health Research Unit, University Hospital of Psychiatry, Murtenstrasse 46, Bern, Switzerland.
Acta Psychiatr Scand. 2012 Feb;125(2):157-67. doi: 10.1111/j.1600-0447.2011.01780.x. Epub 2011 Nov 12.
Although numerous randomised controlled trials indicated the superiority of supported employment (SE), we still have too little evidence that SE is more effective than traditional vocational rehabilitation programmes (TVR) in Western European countries with highly developed social security and welfare systems, sophisticated rehabilitation programmes and high thresholds to the open labour market. The aim of this study is to prove the efficacy of SE in Switzerland.
Following a 2-week intake assessment, 100 unemployed persons with stabilised severe mental illness (SMI) were randomly assigned to either the SE programme (n=46) or to the most viable locally available TVR (n=54). Follow-up lasted 24 months.
After the first year, the rate of competitive employment reached a mean level of 48.2% in the SE group and of 18.5% in the TVR group. 58.7% of the SE group were ever competitively employed as opposed to 25.9% of the TVR group. In the second year, SE group participants were competitively employed for 24.5 weeks as compared with 10.2 in the TVR group. The groups showed no significant differences in the non-vocational outcome criteria.
The SE programme in Switzerland also proved more effective than TVR and seems to be applicable to the socio-economic context of Western European countries.
尽管大量随机对照试验表明支持性就业（SE）具有优越性，但在社会保障和福利制度高度发达、康复计划复杂、对开放劳动力市场准入门槛较高的西欧国家，我们仍缺乏足够的证据表明 SE 比传统的职业康复计划（TVR）更有效。本研究旨在证明 SE 在瑞士的疗效。
100 名病情稳定的严重精神疾病（SMI）失业者接受为期 2 周的入组评估后，随机分配至 SE 方案组（n=46）或当地最可行的 TVR 组（n=54）。随访时间为 24 个月。
在第一年结束时，SE 组的竞争性就业率达到了 48.2%的平均水平，而 TVR 组仅为 18.5%。58.7%的 SE 组曾有过竞争性就业，而 TVR 组为 25.9%。第二年，SE 组参与者的竞争性就业时间为 24.5 周，而 TVR 组为 10.2 周。两组在非职业结果标准上没有显著差异。
瑞士的 SE 方案也被证明比 TVR 更有效，并且似乎适用于西欧国家的社会经济环境。
