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The employment of people with severe mental illness / by Alison E. Luciano.

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Author	Luciano, Alison E.
Title	The employment of people with severe mental illness / by Alison E. Luciano.
Date	2014
Abstract	Study 1 This systematic review aimed to synthesize the emerging body of work on the impact of employment, with a focus on prospective cohort studies. Researchers identified relevant studies for review via PubMed, expert referral, and reference review. Two levels of screening were applied to 1,484 citations. A total of 12 studies, representing eight cohorts (N = 6 ,844 participants), were included. No prospective evidence indicated that employment is detrimental to the course and outcome of schizophrenia and other major mental disorders. Limited longitudinal data with inconsistent exposure and outcome criteria hindered the effort to understand if, when, and how employment acts to improve prognosis. Study 2 This epidemiological analysis compared employment rate and income by mental illness severity. Researchers estimated logistic regression models of employment status controlling for demographic characteristics and substance use disorders among all working-age participants from the 2009 and 2010 National Survey on Drug Use and Health (N = 77,326). Employment rates decreased linearly with increasing mental illness severity (none = 75.9% to serious = 54.5 %, p<0.001). Over a third of people with serious mental illness, 39%, had incomes below $10,000 compared to 23% among people without mental illness p<0.001. Study 3 This qualitative study examined career expectations among twelve young adult men (18-35) with co-occurring disorders from an integrated treatment center. Participants completed a series of three semi-structured in-depth interviews. Data were transcribed verbatim and analyzed using content analysis. Young adults with co-occurring disorders described positions that did not align with future goals as frustrating and disempowering, rather than confidence building. In treatment, they explored career options and pursued future-oriented work and school opportunities. Study 4 This multilevel modeling study assessed the size and direction of associations between employment and psychiatric hospitalization using data from a two-year, prospective cohort study of adults with severe psychiatric disorder (analytic N = 2,055). Employment was associated with lower subsequent three-month risk of psychiatric hospitalization (adjusted OR,.73;95% CI,.43 to.83). Regardless of hospitalization history or access to outpatient services, jobless outpatients with severe psychiatric disorder were less likely to be hospitalized for psychiatric reasons after gaining employment.
Description	viii, 141 leaves : ill.
Format	application/pdf
College	Dartmouth Institute for Health Policy and Clinical Practice.
Issuing Body	Dartmouth Dissertations are made available through the Dartmouth Digital Library.
Degree	Thesis (Ph.D.)--Dartmouth College.
Copyright	All rights reserved. No part of this book may be reproduced in any form by any electronic or mechanical means without permission in writing from the author.
DOI	http://dx.doi.org/10.1349/ddlp.1261

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