The efficacy of supported employment for middle-aged and older people with schizophrenia

Twamley, Elizabeth W.; Vella, Lea; Burton, Cynthia Z.; Becker, Deborah R.; Bell, Morris D.; Jeste, Dilip V.

doi:10.1016/j.schres.2011.11.036

« Previous Next »Schizophrenia Research
Volume 135, Issue 1 , Pages 100-104, March 2012

The efficacy of supported employment for middle-aged and older people with schizophrenia

Elizabeth W. Twamley
- Department of Psychiatry and Stein Institute for Research on Aging, University of California, San Diego, 9500 Gilman Drive (0851), La Jolla, CA, 92093, USA
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA
- Corresponding author at: Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive (0851), La Jolla, CA, 92093, USA. Tel.: +1 619 543 6684; fax: +1 619 543 6489.
Lea Vella
- SDSU/UCSD Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120, USA
Cynthia Z. Burton
- SDSU/UCSD Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120, USA
Deborah R. Becker
- Dartmouth Psychiatric Research Center, 85 Mechanic Street, Suite B4-1, Lebanon, NH, 03766, USA
Morris D. Bell
- Department of Psychiatry, Yale University, 300 George Street, Suite 901, New Haven, CT, 06511, USA
- VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA
Dilip V. Jeste
- Department of Psychiatry and Stein Institute for Research on Aging, University of California, San Diego, 9500 Gilman Drive (0851), La Jolla, CA, 92093, USA

Received 19 July 2011; received in revised form 29 November 2011; accepted 30 November 2011. published online 26 December 2011.

Abstract

Objective

Supported employment is the evidence-based treatment of choice for assisting individuals with severe mental illness to achieve competitive employment, but few supported employment programs specifically target older clients with psychiatric illness. The purpose of this study was to evaluate the efficacy of supported employment for middle-aged or older people with schizophrenia.

Method

Participants included 58 outpatients with schizophrenia or schizoaffective disorder aged 45 or older who were recruited from a community mental health clinic. Participants were randomly assigned to receive Individual Placement and Support (IPS; the manualized version of supported employment) or conventional vocational rehabilitation (CVR) for one year, and completed assessments at baseline, six months, and twelve months.

Results

IPS was superior to CVR on nearly all work outcome measures, including attainment of competitive employment, weeks worked, and wages earned. Fifty-seven percent of IPS participants worked competitively, compared with 29% of CVR participants; 70% of IPS participants obtained any paid work, compared with 36% of CVR participants. Within the IPS group, better baseline functional capacity (as measured by the UCSD Performance Based Skills Assessment) and more recent employment were modestly associated with better work outcomes.