Drake‐New Hampshire1.
Methods | Allocation: 'randomly assigned' ‐ information from trialists indicated that randomisation was by an off‐site co‐ordinator using computer‐generated random numbers. Follow up: monthly for 2 years (preceded by 4 once‐weekly "informational" meeting). Lost to follow‐up: 2%. Objectivity of rating of outcome: raters independent. | |
Participants | Inclusion criteria: i. major mental illness with major role dysfunction for past 2 years; ii. in community >1 month; iii. living locally; iv. age 20‐65 years; v. unemployed >1 month, wanting to work; vi. no substance dependence, physical disability, or memory impairment. Diagnosis: schizophrenia, schizophrenia‐like disorders (46.9%). N=143. Age: mean ˜37years. Sex: 52% women. Race: 5% non‐white. History: ever married 50%, ever employed ‐ "relatively good employment history", time since last employment U/K, previous admissions U/K but "many" hospitalised in last year. Setting: urban, New Hampshire, USA. | |
Interventions | 1. Individual placement and support program: i. integrated team working within mental health services; ii. employment specialists attached directly to clinical teams (helped clients find jobs immediately, provided on‐job training, supportive follow‐up); iii. 3 staff working directly with clients in all phases of supported employment (direct contact time with staff ˜62 hours). N=74. 2. Brokered model (GST) pre‐employment preparation group: i. discussions of skills needed to get and keep jobs; ii. practising these skills; ii. exploration of work‐related values; iii. exploration of clients' strengths and weaknesses as workers; iv. interview skills meetings; v. discussion of job leads and interviews (meetings 2/week); vi. once employed received on job support (liaison with mental health providers, follow‐along support); vii. 3 staff divided functions into job training, job development, and job support roles (direct contact time with staff=74 hours). N=69. | |
Outcomes | In competitive employment.
Time in competitive employment.
Monthly earnings.
Not participating in program.
Global functioning: GAS scores.
Self‐esteem: Rosenberg's scale
Mental state: BPRS expanded.
Costs: program costs, all heatlh care costs. Unable to use ‐ Quality of life: Lehman's scale (subscales only). |
|
Notes | Two centre trial but not possible to separate the data by site. | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment? | Low risk | A ‐ Adequate |