Richard R. Bebout

Does competitive employment improve nonvocational outcomes for people with severe mental illness

The authors examined the cumulative effects of work on symptoms, quality of life, and self-esteem for 149 unemployed clients with severe mental illness receiving vocational rehabilitation. Nonvocational measures were assessed at 6-month intervals throughout the 18-month study period, and vocational activity was tracked continuously. On the basis of their predominant work activity over the study period, participants were classified into 4 groups: competitive work, sheltered work, minimal work, and no work. The groups did not differ at baseline on any of the nonvocational measures. Using mixed effects regression analysis to examine rates of change over time, the authors found that the competitive work group showed higher rates of improvement in symptoms; in satisfaction with vocational services, leisure, and finances; and in self-esteem than did participants in a combined minimal work-no work group. The sheltered work group showed no such advantage.

Integrated Treatment for Dually Diagnosed Homeless Adults

This study examined the effects of integrating mental health, substance abuse, and housing interventions for homeless persons with co-occurring severe mental illness and substance use disorder. With the use of a quasi-experimental design, integrated treatment was compared with standard treatment for 217 homeless, dually diagnosed adults over an 18-month period. The integrated treatment group had fewer institutional days and more days in stable housing, made more progress toward recovery from substance abuse, and showed greater improvement of alcohol use disorders than the standard treatment group. Abuse of drugs other than alcohol (primarily cocaine) improved similarly for both groups. Secondary outcomes, such as psychiatric symptoms, functional status, and quality of life, also improved for both groups, with minimal group differences favoring integrated treatment.

A research induction group for clients entering a mental health research project : A replication study

Through education and discussion, the researchinduction group introduces mental health clients toparticipation in a research study. The purpose is tohelp clients to understand fully the clinical and research procedures involved in the study sothat they can make a truly informed decision aboutwhether or not to participate. This study replicated aprevious study in showing that the research induction group resulted in informed decision-making,high rates of participation in the clinical services andin the research, and high rates of satisfaction withboth vocational services and researchprocedures.