| Methods |
Allocation: by day of application ‐ patients referred on every fourth day allocated to control group.
Follow up: every 3 months for two years.*
Lost to follow‐up: 14%, hard to verify from data.
Objectivity of rating of outcome: raters not independent. |
| Participants |
Inclusion criteria: i. discharged from in‐patient psychiatric care in last 4 months; ii. in‐patient >2 months; iii. no primary diagnosis of substance abuse, "overt homosexuality", epilepsy, "criminal behaviour"; iv. local resident.
Diagnosis: schizophrenia, schizophrenia‐like disorders (82%).
N=352.
Age: 68% under 35.
Sex: 40% women.
Race: 12% non‐white.
History: ever married 23%, ever employed U/K, time since last employment U/K, previous admissions >1.
Setting: urban psychiatric rehabilitation centre, New York, USA. |
| Interventions |
1. Clubhouse group: i. social activities; ii. "work‐ordered day" on work‐crews; iii. transitional employment for 3‐4 months after completing phases i. + ii.; iv. real job placement with outreach and supported accommodation (mean daily attendance ˜75, 10 F/t staff, mainly psychiatric social workers, emergency psychiatric consultation provided by P/t psychiatrist. N=274.
2. Control: continued to receive community care from other services (not specified). N=78. |
| Outcomes |
In competitive employment.*
In any form of employment.
Not participating in program.
Rehospitalised. |
| Notes |
* Not all patients followed up for a full two years ‐ patients continued to enter the study until the last 3 months. Thus numbers followed up are different at different time points. |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Allocation concealment? |
High risk |
C ‐ Inadequate |
