Dirk Richter1,2, Holger Hoffmann3,4. 1. Center for Psychiatric Rehabilitation, University Bern Psychiatric Services, Murtenstrasse 46, 3008, Bern, Switzerland. dirk.richter@upd.unibe.ch. 2. Health Division, Bern University of Applied Sciences, Bern, Switzerland. dirk.richter@upd.unibe.ch. 3. Center for Psychiatric Rehabilitation, University Bern Psychiatric Services, Murtenstrasse 46, 3008, Bern, Switzerland. 4. Soteria, Bern, Switzerland.
Abstract
PURPOSE: While supported employment (SE) programs for people with mental illness have demonstrated their superiority in randomized controlled trials (RCTs) and meta-analyses, little is known about the effectiveness of non-trial routine programs. The primary objective of this study was to estimate a pooled competitive employment rate of non-trial SE programs by means of a meta-analysis. A secondary objective was to compare this result to competitive employment rates of SE programs in RCTs, prevocational training programs in RCTs and in routine implementation. METHODS: A systematic review and a random-effects meta-analysis of proportions were conducted. Quality assessment was provided. Moderator analyses by subgroup comparisons were conducted. RESULTS: Results from 28 samples were included in the meta-analysis. The pooled competitive employment rate for SE routine programs was 0.43 (95% CI 0.37-0.50). The pooled competitive employment rates for comparison conditions were: SE programs in RCTs: 0.50 (95% CI 0.43-0.56); prevocational programs in RCTs: 0.22 (95% CI 0.16-0.28); prevocational programs in routine programs: 0.17 (95% CI 0.11-0.23). SE routine studies conducted prior to 2008 showed a significantly higher competitive employment rate. CONCLUSION: SE routine programs lose only little effectiveness compared to SE programs from RCTs but are much more successful in reintegrating participants into the competitive labor market than prevocational programs. Labor market conditions have to be taken into account when evaluating SE programs.
PURPOSE: While supported employment (SE) programs for people with mental illness have demonstrated their superiority in randomized controlled trials (RCTs) and meta-analyses, little is known about the effectiveness of non-trial routine programs. The primary objective of this study was to estimate a pooled competitive employment rate of non-trial SE programs by means of a meta-analysis. A secondary objective was to compare this result to competitive employment rates of SE programs in RCTs, prevocational training programs in RCTs and in routine implementation. METHODS: A systematic review and a random-effects meta-analysis of proportions were conducted. Quality assessment was provided. Moderator analyses by subgroup comparisons were conducted. RESULTS: Results from 28 samples were included in the meta-analysis. The pooled competitive employment rate for SE routine programs was 0.43 (95% CI 0.37-0.50). The pooled competitive employment rates for comparison conditions were: SE programs in RCTs: 0.50 (95% CI 0.43-0.56); prevocational programs in RCTs: 0.22 (95% CI 0.16-0.28); prevocational programs in routine programs: 0.17 (95% CI 0.11-0.23). SE routine studies conducted prior to 2008 showed a significantly higher competitive employment rate. CONCLUSION: SE routine programs lose only little effectiveness compared to SE programs from RCTs but are much more successful in reintegrating participants into the competitive labor market than prevocational programs. Labor market conditions have to be taken into account when evaluating SE programs.
Entities:
Keywords:
Psychiatric rehabilitation; Routine implementation; Social psychiatry; Supported employment
Authors: Isabelle Weld-Blundell; Marissa Shields; Alexandra Devine; Helen Dickinson; Anne Kavanagh; Claudia Marck Journal: Int J Environ Res Public Health Date: 2021-11-17 Impact factor: 3.390