Department of Public Health, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000, Rotterdam, CA, The Netherlands.
Int Arch Occup Environ Health. 2024 Apr;97(3):253-262. doi: 10.1007/s00420-023-02039-7. Epub 2024 Jan 11.
This study evaluates the effects of the interdisciplinary employment program 'Work As Best Care (WABC)' on employment participation and mental health of persons with severe mental disorders.
WABC is a 'work first' employment program for unemployed persons with severe mental disorders in which employment professionals work closely together with mental health professionals. In a longitudinal non-randomized controlled study, participants of WABC (n = 35) are compared with participants of the control group (n = 37), who received regular employment support. Participants were followed for 1 year and filled out questionnaires on individual characteristics and health at baseline, after 6 and 12 months. This information was enriched with monthly register data on employment status from 2015 until 2020. Difference-in-differences analyses were performed to investigate changes in employment participation among participants of WABC and the control group. A generalized linear mixed-effects model was used to compare changes in mental health (measured on 0-100 scale) between the two groups.
Before WABC, employment participation was 22.0%points lower among participants of WABC compared to the control group. After starting WABC, employment participation increased with 15.3%points per year among participants of WABC, compared to 5.6%points in the control group. Among all participants of WABC, no change in mental health was found (β 1.0, 95% CI - 3.4; 5.5). Only female participants of WABC showed a significant change in mental health (β 8.0, 95% CI 2.6; 13.4).
To enhance employment participation of persons with severe mental disorders, an interdisciplinary 'work-first' approach in which professionals of employment services and mental health services work in close collaboration, is of paramount importance.
本研究评估跨学科就业计划“Work As Best Care（WABC）”对严重精神障碍患者就业参与和心理健康的影响。
WABC 是一项针对失业严重精神障碍患者的“以工作为先”的就业计划，就业专业人员与精神健康专业人员密切合作。在一项纵向非随机对照研究中，将 WABC 组（n=35）的参与者与对照组（n=37）的参与者进行比较，对照组参与者接受常规就业支持。参与者随访 1 年，在基线、6 个月和 12 个月时填写个人特征和健康问卷。这些信息通过 2015 年至 2020 年每月登记的就业状况数据进行补充。采用差异-差异分析来研究 WABC 组和对照组参与者就业参与率的变化。使用广义线性混合效应模型比较两组之间心理健康（0-100 分制）的变化。
在 WABC 之前，与对照组相比，WABC 组参与者的就业参与率低 22.0 个百分点。在开始 WABC 后，WABC 组参与者的就业参与率每年增加 15.3 个百分点，而对照组参与者增加 5.6 个百分点。在所有 WABC 组参与者中，心理健康没有变化（β 1.0，95%CI-3.4；5.5）。只有 WABC 的女性参与者心理健康有显著变化（β 8.0，95%CI 2.6；13.4）。
为了提高严重精神障碍患者的就业参与率，至关重要的是采用跨学科的“以工作为先”方法，使就业服务和精神健康服务的专业人员密切合作。
