Supported employment, supported education, and career development.

Two articles in the current issue of the Psychiatric Rehabilitation Journal bring into focus the important question of the importance of work, and in particular meaningful employment, in people with a serious mental illness. Gewurtz, Cott, Rush, and Kirsh (see record 2012-34112-003) present findings from a change in policy in Canada for the funding of vocational services for people with a serious mental illness from a fee-for-service model to an outcomes-based model, with reimbursement based on successful competitive job placement and retention, irrespective of job type and consumer preference. The results indicated increased rates of competitive work, mainly in entry-level jobs, but they also raised questions as to whether the narrow focus on job attainment may have been at the cost of less career development and ultimately less meaningful work for the consumers. Baksheev, Allott, Jackson, McGorry, and Killackey (see record 2012-34112-002) found that a combined supported employment and education program for people with a first episode of psychosis led to higher rates of employment and class completion than usual services. The analysis presented in this report showed that no individual consumer characteristics other than program assignment (supported employment and education vs. usual services) predicted vocational or educational outcomes. The findings underscore the potency of supported employment, and suggest that combining it with educational services may be fruitful for people who have recently experienced an episode of psychosis. These findings raise several questions that will be touched on in this editorial, including: Why are career development and supported education important? What have we learned about supported education? What are the current gaps in our knowledge about supported education?