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The effects of supported employment interventions in populations of people with conditions other than severe mental health: a systematic review

The effects of supported employment interventions in populations of people with conditions other than severe mental health: a systematic review
The effects of supported employment interventions in populations of people with conditions other than severe mental health: a systematic review
Aim: To assess the effectiveness of supported employment interventions for improving competitive employment in populations of people with conditions other than only severe mental illness.
Background: Supported employment interventions have been extensively tested in severe mental illness populations. These approaches may be beneficial outside of these populations.
Methods: We searched PubMed, Embase, CINAHL, PsycInfo, Web of Science, Scopus, JSTOR, PEDro, OTSeeker, and NIOSHTIC for trials including unemployed people with any condition and including severe mental illness if combined with other co-morbidities or other specific circumstances (e.g., homelessness). We excluded trials where inclusion was based on severe mental illness alone. Two reviewers independently assessed risk of bias (RoB v2.0) and four reviewers extracted data. We assessed rates of competitive employment as compared to traditional vocational rehabilitation or waiting list/services as usual.
Findings: Ten randomised controlled trials (913 participants) were included. Supported employment was more effective than control interventions for improving competitive employment in seven trials: in people with affective disorders [risk ratio (RR) 10.61 (1.49, 75.38)]; mental disorders and justice involvement [RR 4.44 (1.36,14.46)]; veterans with posttraumatic stress disorder (PTSD) [RR 2.73 (1.64, 4.54)]; formerly incarcerated veterans [RR 2.17 (1.09, 4.33)]; people receiving methadone treatment [RR 11.5 (1.62, 81.8)]; veterans with spinal cord injury at 12 months [RR 2.46 (1.16, 5.22)] and at 24 months [RR 2.81 (1.98, 7.37)]; and young people not in employment, education, or training [RR 5.90 (1.91-18.19)]. Three trials did not show significant benefits from supported employment: populations of workers with musculoskeletal injuries [RR 1.38 (1.00, 1.89)]; substance abuse [RR 1.85 (0.65, 5.41)]; and formerly homeless people with mental illness [RR 1.55 (0.76, 3.15)]. Supported employment interventions may be beneficial to people from more diverse populations than those with severe mental illness alone. Defining competitive employment and increasing (and standardising) measurement of non-vocational outcomes may help to improve research in this area.
Adolescent, Employment, Supported, Homeless Persons, Humans, Mental Disorders, Mental Health, Rehabilitation, Vocational, Stress Disorders, Post-Traumatic
1463-4236
e79
Probyn, Katrin
2604caf4-b2bf-4f9e-a19f-16046cb6e4e4
Engedahl, Martin Stav
e5a1a7b6-de91-4017-bfdf-259b59366e69
Rajendran, Dévan
6d4ee340-f483-4c9c-8cab-a835ae08eb7d
Pincus, Tamar
55388347-5d71-4fc0-9fd2-66fbba080e0c
Naeem, Khadija
cf0cfde8-c90d-4794-a06a-d95b89c9bee6
Mistry, Dipesh
a8bdb6a9-78fd-429e-b7c5-7a4aa3fd5ab6
Underwood, Martin
239a8609-e7b5-4acb-aaf9-9e7f717f0d62
Froud, Robert
303169a8-8486-4e37-98f8-494c4be01dfd
et al.
Probyn, Katrin
2604caf4-b2bf-4f9e-a19f-16046cb6e4e4
Engedahl, Martin Stav
e5a1a7b6-de91-4017-bfdf-259b59366e69
Rajendran, Dévan
6d4ee340-f483-4c9c-8cab-a835ae08eb7d
Pincus, Tamar
55388347-5d71-4fc0-9fd2-66fbba080e0c
Naeem, Khadija
cf0cfde8-c90d-4794-a06a-d95b89c9bee6
Mistry, Dipesh
a8bdb6a9-78fd-429e-b7c5-7a4aa3fd5ab6
Underwood, Martin
239a8609-e7b5-4acb-aaf9-9e7f717f0d62
Froud, Robert
303169a8-8486-4e37-98f8-494c4be01dfd

Probyn, Katrin, Engedahl, Martin Stav, Rajendran, Dévan and Pincus, Tamar , et al. (2021) The effects of supported employment interventions in populations of people with conditions other than severe mental health: a systematic review. Primary Health Care Research & Development, 22, e79. (doi:10.1017/S1463423621000827).

Record type: Article

Abstract

Aim: To assess the effectiveness of supported employment interventions for improving competitive employment in populations of people with conditions other than only severe mental illness.
Background: Supported employment interventions have been extensively tested in severe mental illness populations. These approaches may be beneficial outside of these populations.
Methods: We searched PubMed, Embase, CINAHL, PsycInfo, Web of Science, Scopus, JSTOR, PEDro, OTSeeker, and NIOSHTIC for trials including unemployed people with any condition and including severe mental illness if combined with other co-morbidities or other specific circumstances (e.g., homelessness). We excluded trials where inclusion was based on severe mental illness alone. Two reviewers independently assessed risk of bias (RoB v2.0) and four reviewers extracted data. We assessed rates of competitive employment as compared to traditional vocational rehabilitation or waiting list/services as usual.
Findings: Ten randomised controlled trials (913 participants) were included. Supported employment was more effective than control interventions for improving competitive employment in seven trials: in people with affective disorders [risk ratio (RR) 10.61 (1.49, 75.38)]; mental disorders and justice involvement [RR 4.44 (1.36,14.46)]; veterans with posttraumatic stress disorder (PTSD) [RR 2.73 (1.64, 4.54)]; formerly incarcerated veterans [RR 2.17 (1.09, 4.33)]; people receiving methadone treatment [RR 11.5 (1.62, 81.8)]; veterans with spinal cord injury at 12 months [RR 2.46 (1.16, 5.22)] and at 24 months [RR 2.81 (1.98, 7.37)]; and young people not in employment, education, or training [RR 5.90 (1.91-18.19)]. Three trials did not show significant benefits from supported employment: populations of workers with musculoskeletal injuries [RR 1.38 (1.00, 1.89)]; substance abuse [RR 1.85 (0.65, 5.41)]; and formerly homeless people with mental illness [RR 1.55 (0.76, 3.15)]. Supported employment interventions may be beneficial to people from more diverse populations than those with severe mental illness alone. Defining competitive employment and increasing (and standardising) measurement of non-vocational outcomes may help to improve research in this area.

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More information

Accepted/In Press date: 15 November 2021
Published date: 9 December 2021
Keywords: Adolescent, Employment, Supported, Homeless Persons, Humans, Mental Disorders, Mental Health, Rehabilitation, Vocational, Stress Disorders, Post-Traumatic

Identifiers

Local EPrints ID: 475568
URI: http://eprints.soton.ac.uk/id/eprint/475568
ISSN: 1463-4236
PURE UUID: d9902ddb-f8b4-4cb3-9b7f-d7fa36eb403b
ORCID for Tamar Pincus: ORCID iD orcid.org/0000-0002-3172-5624

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Date deposited: 21 Mar 2023 17:47
Last modified: 17 Mar 2024 04:11

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Contributors

Author: Katrin Probyn
Author: Martin Stav Engedahl
Author: Dévan Rajendran
Author: Tamar Pincus ORCID iD
Author: Khadija Naeem
Author: Dipesh Mistry
Author: Martin Underwood
Author: Robert Froud
Corporate Author: et al.

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