Susan A. Pickett-Schenk

Clinical factors associated with employment among people with severe mental illness: Findings from the employment intervention demonstration program

Research has shown that supported employment programs are effective in helping psychiatric outpatients achieve vocational outcomes, yet not all program participants are able to realize their employment goals. This study used 24 months of longitudinal data from a multisite study of supported employment interventions to examine the relationship of patient clinical factors to employment outcomes. Multivariate random regression analysis indicated that, even when controlling for an extensive series of demographic, study condition (experimental versus control), and work history covariates, clinical factors were associated with individuals’ ability to achieve competitive jobs and to work 40 or more hours per month. Poor self-rated functioning, negative psychiatric symptoms, and recent hospitalizations were most consistently associated with failure to achieve these employment outcomes. These findings suggest ways that providers can tailor supported employment programs to achieve success with a diverse array of clinical subpopulations.

The effect of support group participation on caregiver burden among parents of adult offspring with severe mental illness

The purpose of this study was to determine whether parents participating in 14 National Alliance for the Mentally Ill-affiliated support groups in Illinois had significantly lower caregiver burden than a comparison group of parents not participating in support groups. Respondents included 120 parents: 86 participants and 34 nonparticipants. Ordinary least squares regression analysis revealed that caregiver burden was significantly lower among support group participants, those with lower depression, and those whose offspring hadfewer unmet needs and days hospitalized.

Journey of hope program outcomes

Families of persons with mental illness often benefit from participating in interventions which provide education and support. The present study describes outcomes reported by 424 families who participated in one such intervention, the Journey of Hope (JOH) program. Hierarchical regression analyses found that program outcomes—increased knowledge of the causes and treatment of mental illness, increased understanding of the mental health service system, and improved morale—were predictive of one another. JOH therefore may provide families with the knowledge and support they need to strengthen their ability to cope with their relatives mental illness.

Employment histories of homeless persons with mental illness.

This study examined the work histories of 7,228 homeless persons with mental illness who were enrolled into the multi-site Access to Community Care and Effective Services and Supports (ACCESS) research demonstration program. Multiple logistic regression analyses suggest that use of vocational services is significantly associated with increased likelihood of paid employment. The role of vocational rehabilitation services in removing persons from homelessness and improving their quality of life is discussed.

Changes in caregiving satisfaction and information needs among relatives of adults with mental illness: Results of a randomized evaluation of a family-led education intervention

The authors examined changes in caregiving satisfaction and information needs among 462 relatives of individuals with mental illness who participated in a study of a family-led education course, the Journey of Hope (JOH). Participants were randomly assigned to receive JOH or to a control group waiting list and followed for 9 months. General linear model repeated measures analysis of variance found that, compared with the control group, the intervention group showed significant improvement in caregiving satisfaction and information needs following course completion and maintained these gains for another 6 months. Education and support from other family members in the form of a structured course is effective in meeting the caregiving needs of relatives of persons with mental illness.

Effectiveness of supported employment for individuals with schizophrenia: Results of a multi-site, randomized trial

Background: Prior studies of supported employment efficacy for individuals with schizophrenia have yielded mixed results, with some finding poorer outcomes for those with this diagnosis and others finding no differences.Aims: This multi-site effectiveness trial examined the relative impact of diagnosis with schizophrenia and evidence-based practice supported employment on the likelihood of competitive employment.Method: At seven U.S. sites, 1,273 outpatients with severe mental illness were randomly assigned to either an experimental supported employment program or to a comparison/services as usual condition and followed for two years. Data collection involved semi-annual, in-person interviews, and weekly recording of all paid employment by vocational and research staff. Mixed-effects random regression analysis was used to examine the effects of study condition, schizophrenia diagnosis, and their interaction, on the likelihood of competitive employment.Results: Subjects in experimental group programs and t...

Family Contact and Housing Stability in a National Multi-Site Cohort of Homeless Adults with Severe Mental Illness

This study examined associations between family contact and housing stability among 4,778 homeless persons with mental illness who received intensive outreach and case management services through the national multi-site ACCESS project. Ordinary-least squares regression analysis found that, at 12-months post-study entry, greater contact with relatives to whom participants feel close, more frequent telephone contact, and greater satisfaction with family relationships were associated with a greater number of nights in stable housing. Program and policy implications for strengthening family ties as a means to reduce homelessness among this population are discussed.

BUSINESS AS USUAL: WORK EXPERIENCES OF HOMELESS PERSONS WITH MENTAL ILLNESS

Employment has been identified as a significant goal for many homeless persons with mental illness. However, treatment plans for this population typically focus on housing and mental health needs, and neglect to assess individuals’ desires and abilities to achieve and maintain paid employment. This chapter describes the work experiences of the Chicago cohort of the Access to Community Care and Effective Services and Supports (ACCESS) project.