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• W176708002 abstract "The psychiatric rehabilitation literature has documented difficulties that persons with severe and persistent mental disorders such as schizophrenia face in retaining employment in competitive jobs (Blankertz & Keller, 1997; Peckham & Muller 1999; Rutman, 1992; Scheid & Anderson, 1995). Risk of job loss is high for these individuals because of problems maintaining steady work schedules, episodic and unpredictable symptom manifestations, medication side effects, and difficulty in handling workplace stress (Peckham & Muller; Scheid & Anderson). Vocational programs that provide long-term support to promote job retention have been implemented, and a substantial literature evaluating these programs has been produced (Salkever, 2003). A large fraction (probably more than half) of employed persons with schizophrenia, however, are not served by these programs, and are instead working without formal vocational supports. Our own unpublished tabulations show that this is true for two-thirds of employed client interview respondents in the Schizophrenia Patient Outcomes Research Team (PORT) study (Lehman, Steinwachs & the Survey Co-Investigators of the PORT Project, 1998). To date, there has been little quantitative analysis of factors that promote or hinder continued employment of these individuals. Analysis of the employment retention experience for this study population may advance understanding of important issues relating to provision of rehabilitation and treatment services. In particular, examining the risk of employment loss for persons not currently receiving vocational support services, and identifying the groups for which this risk is highest, can be informative about unmet need for vocational services, and help in targeting service expansions. It may also be the case that, in the absence of formal vocational supports, clinical and treatment factors are particularly important determinants of employment retention. In this study, data from a large observational study of persons under treatment for schizophrenia in six different geographic areas of the U.S. is used to examine employment stability of persons working at study enrollment in jobs where they did not receive formal vocational supports. Using baseline and six-month follow-up data on these individuals, the significance of selected indicators of social, demographic, functional, and treatment status as predictors of employment status at six months after study enrollment was evaluated. Methods Data from the Schizophrenia Care and Assessment Program (SCAP), which is an ongoing longitudinal study of adults with schizophrenia recruited from systems of behavioral health care in six regions of the U.S. was analyzed (Mark, Dirani, Russo, & Slade, 200l). The regions are: Baltimore, New Haven, San Diego, selected counties in Florida, selected counties in Colorado, and selected counties in North Carolina. The behavioral health care systems include community mental health centers, public psychiatric hospitals, Veterans Administration mental health providers, and university outpatient clinics. Recruitment began in July 1997 and was completed in January 2001. All participants were over age 18 and had a schizophrenia, schizophreniform, or schizoaffective diagnosis prior to recruitment. Data were obtained from interviews, clinical assessments, and medical records reviews. The SCAP is designed to examine the impacts of medical treatment on clinical, functional, and economic outcomes for persons with schizophrenia (Mark et al.). The subjects for this study were SCAP participants who were classified, based on their interview responses, as employed in non-assisted jobs at baseline. Participants were defined as employed if they reported paid employment at some time in the four weeks preceding the baseline interview. This parallels the standard U.S. Census Bureau definition of employment used in the Current Population Survey and the Survey of Income and Program Participation (Westat & Mathematica Policy Research, 2001). …" @default.
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• W176708002 date "2003-10-01" @default.
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• W176708002 title "Employment Retention by Persons with Schizophrenia Employed in Non-assisted Jobs" @default.
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