Helping people with severe mental illness to obtain work: systematic review

被引:290
作者
Crowther, RE
Marshall, M
Bond, GR
Huxley, P
机构
[1] Univ Manchester, Sch Psychiat & Behav Sci, Manchester PR2 9HT, Lancs, England
[2] Indiana Univ Purdue Univ, Dept Psychol, Indianapolis, IN 46202 USA
[3] Kings Coll London, Inst Psychiat, Hlth Serv Res, London SE5 8AF, England
来源
BMJ-BRITISH MEDICAL JOURNAL | 2001年 / 322卷 / 7280期
关键词
D O I
10.1136/bmj.322.7280.204
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective To determine the most effective way of helping people with severe mental illness to obtain competitive employment-that is, a job paid at the market rate, and for which any one can apply. Design Systematic review: Participants Eligible studies were randomised controlled trials comparing prevocational training or supported employment (for people with severe mental illness) with each other or with standard community care. Outcome measures The primary outcome was number of subjects in competitive employment outcomes, clinical outcomes, and costs. Results Eleven trials met the inclusion criteria. Five (1204 subjects) compared prevocational training with standard community care, one (256 subjects) compared supported employment with standard community care, and five (484 subjects) compared supported employment wit prevocational training. Subjects in supported employment were more likely to be in competitive employment than those who received prevocational training at 4, 6, 9, 12, 15, and 18 months (for example, 34% v 12% at 12 months; number needed to treat 4.45, 95% confidence interval 3.37 to 6.59). This effect was still present, although at a reduced level, after a sensitivity analysis that retained only the highest quality trials (31% v 12%; 5.3, 3.6 to 10.4). People in supported employment earned more and worked more hours per month than those who had had prevocational training. Conclusion Supported employment is more effective than prevocational training at helping people with severe mental illness obtain competitive employment.
引用
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页码:204 / 208
页数:5
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