A 10-year study of steady employment and non-vocational outcomes among people with serious mental illness and co-occurring substance use disorders

• Published in: Schizophrenia research 2012-07, Vol.138 (2), p.233-239
• Main Authors: McHugo, Gregory J, Drake, Robert E, Xie, Haiyi, Bond, Gary R
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Bipolar Disorder - psychology; Bipolar Disorder - rehabilitation; Co-occurring disorders; Diagnosis, Dual (Psychiatry); Employment, Supported - statistics & numerical data; Female; Humans; Independent Living - statistics & numerical data; Interpersonal Relations; Longitudinal outcomes; Longitudinal Studies; Male; Medical sciences; Personal Satisfaction; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotic Disorders - psychology; Psychotic Disorders - rehabilitation; Reeducation. Readaptation. Sociotherapy; Schizophrenia - rehabilitation; Substance-Related Disorders - psychology; Substance-Related Disorders - rehabilitation; Supported employment; Treatments
• ISSN: 0920-9964; 1573-2509
• DOI: 10.1016/j.schres.2012.04.007

Abstract Objective Employment promotes recovery for persons with serious mental illness by providing extra income and a valued social role, but the impact of employment on other psychosocial and clinical outcomes remains unclear. This study examined non-vocational outcomes in relation to steady employment over 10 years among people with serious mental illness and co-occurring substance use disorders. Methods Researchers interviewed people with co-occurring disorders at baseline and yearly for 10 years and tracked employment in relation to five non-vocational outcomes: independent living, psychiatric symptoms, substance use disorder, healthy (non-substance-abusing) relationships, and life satisfaction. Latent class trajectory analysis identified steady workers, and mixed-effects regression models compared steady workers with non-workers. Results Both steady workers (n = 51) and non-workers (n = 79) improved substantially; for example, a majority of each group achieved independent housing and stable remission of substance use disorders. Steady workers achieved independent housing and higher quality of life during the first 5 years of follow-up, but the two groups achieved similar outcomes by 10 years. Conclusions People with co-occurring disorders can improve markedly. Those with steady employment may improve faster, but those without employment may achieve similar long-term outcomes at a slower pace.