| Methods |
Allocation: 'random assignment at intake' ‐ information from trialists indicates randomisation was by independent trial co‐ordinator using sealed envelopes.
Follow up: 9 months.
Lost to follow‐up: 37%.
Objectivity of rating of outcome: raters not independent. |
| Participants |
Inclusion criteria: i. severe mental disorder; ii. accepted by agency for rehabilitation; iii. no primary diagnosis of substance abuse or mental retardation; iv. age >19.
Diagnosis: schizophrenia, schizophrenia‐like disorders (86%).
N=132.
Age: mean ˜25 years.
Sex: 47% women.
Race: not reported.
History: ever married U/K, ever employed U/K, time since last employment U/K, previous admissions ˜3.
Setting: urban, privately operated VR centre, Chicago, USA. |
| Interventions |
1. Threshold rehabilitation program: i. individual case work; ii. work crews leading to transitional employment; iii. problem‐solving and activity groups; iv. linked residential facilities (where suitable); v. special education program; vi. medication and relapse discussion group; vii. staff:patient ratio 1:10. N=66.
2. Control: 6 hours/week supportive treatment "widely used by practitioners who treat severely disturbed clients"; i. referral to existing community services where appropriate; ii. discussion and peer‐support group; iii. visits fortnightly by consulting psychiatrist (prescribed and discussed medication); iv. in nearby church; v. staffed by 2 P/t workers and volunteers; vi. staff:patient ratio 1:20. N=66. |
| Outcomes |
In competitive employment.
Admitted to hospital.
Not participating in program.*
Costs of care. |
| Notes |
*15 people in each group excluded from further analysis after randomisation because they failed to participate in programs ‐ have been added to the denominator for number not participating. |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Allocation concealment? |
Low risk |
A ‐ Adequate |
