Clinical and Socio-demographic Variables Associated with the Outcome of Vocational Rehabilitation Programs: A Community-
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ORIGINAL PAPER
Clinical and Socio‑demographic Variables Associated with the Outcome of Vocational Rehabilitation Programs: A Community‑Based Italian Study G. Mattei1,2,3 · G. Venturi1 · S. Alfieri4 · N. Colombini4 · S. Ferrari1,4 · M. Rigatelli1 · F. Starace4 · G. M. Galeazzi1,4 Received: 29 March 2019 / Accepted: 11 February 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract This study aims to identify clinical and socio-demographic variables associated with the outcome of vocational rehabilitation programs (VRPs). All users of an Italian Community Mental Health Centre (CMHC) included in VRPs delivered according to the model of Supported Employment in years 2011–2016 were retrospectively enrolled. Fifty users who ended the program with employment were compared with fifty users who dropped out, with respect to clinical and socio-demographic variables. VRPs lasting less than 6 months and oriented toward the competitive labor market had a higher probability of employment. Among users who successfully ended the VRP, the median of health interventions significantly decreased after employment. In the same group of users, less non-health interventions strictly linked to the VRP were required, when compared with users who dropped out. We conclude that employment is associated with improvement of users’ clinical conditions and reduced workload for the CMHC. Keywords Vocational rehabilitation programs · Supported employment · Community mental health care · Italy · Recovery
Introduction Unemployment has long been recognized as one of the socio-economic determinants that contribute to poor mental health (Priebe 2015). It is also considered an environmental factor associated with increased risk of psychosis (Reininghaus et al. 2008). Yet, the employment rate for individuals with severe psychiatric disorders (SPDs) is dramatically and consistently low in all countries (between 10 and 25%),
much lower than for the general population (Mueser et al. 2001; Marwaha and Johnson 2004; Marwaha et al. 2007; Waghorn et al. 2012). Moreover, it was pointed out that during the years of the recent economic crisis, people with SPDs had higher risk of losing their jobs and being unemployed (Sharac et al. 2010; Starace et al. 2017). People with SPDs face much greater challenges gaining and maintaining employment due to the combination of social factors, economic pressures, and working conditions (Koletsi
* G. Mattei [email protected]
G. M. Galeazzi [email protected]
G. Venturi [email protected]
1
Department of Biomedical, Metabolic and Neural Sciences, Section of Clinical Neurosciences, University of Modena and Reggio Emilia, Modena, Italy
2
S. Ferrari [email protected]
Ph.D. School in Labor, Development and Innovation, “Marco Biagi” Department of Economics & Marco Biagi Foundation, University of Modena and Reggio Emilia, Modena, Italy
3
M. Rigatelli [email protected]
Association for Research in Psychiatry, Castelnuovo Rangone, Modena, Ital
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