Tsang 2010.

Methods	Allocation: randomised Design: multi‐arm, multicentre Duration: 39 months for both intervention groups, 15 months for the control group Country: Hong Kong, China
Participants	N = 189 Diagnosis: severe mental illness (operationally defined as schizophrenia, schizoaffective disorder, bipolar disorder, recurrent major depression, or borderline personality disorder); at least 2 years of major role dysfunction; medium–high functioning and free from serious role dysfunction for the past 3 months Included: 77% schizophrenia Setting: 2 non‐government organisations and 3 day hospitals in Hong Kong Age: mean 34.9 years Gender: 49% male Ethnicity: ‐ Substance abuse: ‐ Living situation: ‐ Marital status: ‐ Employment status: unemployed Working history: 91% employment history Motivation: desire to work Education: 77% secondary education Disability benefit: ‐ Excluded: memory impairment, learning disorder, and neurological or medical illness that would preclude their working or participation in assessments
Interventions	IPS (N = 65) A single‐minded focus on competitive employment; eligibility for services based solely on client choice, with no exclusion on the basis of work readiness, substance use problems, lack of motivation, treatment non‐compliance and so on; rapid job search upon programme admission using the ‘place then train’ approach; attention to client preferences in the job search, rather than dependence on job availability; close integration between the employment services and the mental health treatment team; ongoing, individualised support and job training after clients obtained employment; systematic benefits counselling; and consultation with employer or job supervisor including advocacy accommodations. IPS fidelity scores ranged from 66‐68 out of 75 (88%–91%) Integrated SE (N = 58) The integrated SE programme combined IPS and WSST. The main difference with IPS is that it was enhanced by 10‐session WSST. The social skill training was provided to integrated SE participants before obtaining employment. A problem‐solving approach was used to help participants handle interpersonal conflicts throughout the follow‐up period. The IPS fidelity scores ranged from 65‐68 out of 75 (87%–91%). TVR (N = 66) TVR participants received comprehensive vocational assessments and pre‐vocational training conducted in the VR centres. Vocational assessments included work samples, vocational interest exploration, and situational vocational assessments. After the establishment of participants’ baseline work performance, pre‐vocational training on entry‐level job tasks were provided in order to help them develop specific job skills and work habits. The participants were placed in a sheltered environment in various work groups such as clerical training, computer training, and cleaning training. The aim of the workshop‐based training was to promote the participants to sheltered workshop or competitive employment.
Outcomes	Percentage of participants who obtained competitive employment Weeks in competitive employment Quality of life (PWI) Dropouts
Notes	Success in competitive employment was defined as having continuously worked in the job for at least 2 months for at least 20 h/week Data for the TVR group were available up to 15 months. They did not collect further follow‐up data due to the limited improvement in vocational and/or non‐vocational outcomes.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	The participants were randomly assigned using SPSS
Allocation concealment (selection bias)	Unclear risk	No details
Blinding of participants and personnel (performance bias) All outcomes	High risk	"The employment specialists were not blind to the treatment assignment of the participants." Participants could identify the given intervention by contents of the programme
Blinding of outcome assessment (detection bias) All outcomes	Low risk	"Assessments were conducted by an independent, trained, and blind assessor who was a registered occupational therapist"
Incomplete outcome data (attrition bias) All outcomes	High risk	N = 85 (69%) completed the follow‐up assessment at 39 months N = 44/58 integrated SE participants and N =41/65 IPS participants. 54 TVR participants (81.8%) completed the 15‐month follow‐up assessment. ITT analyses were conducted on the entire randomised sample (N = 189)
Selective reporting (reporting bias)	Low risk	All listed outcomes are reported
Other bias	Low risk	This study was funded by a grant from the Health Services Research Committee (HHSRF Project No. 03040031) of the Hong Kong Government