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The impact of employment on recovery among individuals who are homeless with severe mental illness in the Vancouver At Home/Chez Soi trial

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Abstract

Objective

To assess impact of employment on recovery in a sample of adults from Vancouver At Home (VAH) study, who were homeless and were diagnosed with severe mental disorders.

Methods

The VAH included two randomized controlled trials investigating the effect of housing first with support intervention in vulnerable population. Employment was assessed at baseline and during the follow-up using Demographics, Housing, Vocational, and Service Use History (DSHH), and Vocational Timeline Follow-Back (VTLFB) self-report questionnaires, respectively. Recovery was examined using Recovery Assessment Scale (RAS) at baseline and at 24-month follow-up visit. Multivariable regression models were built to examine: (1) the effect of current employment at baseline on RAS score at baseline, and RAS score at 24-month follow-up visit; and (2) and to examine the cumulative effect of recent employment over 8 follow-up visits on RAS score at 24-month visit. Cumulative effect of employment over the follow-up visits was weighted by recency using a pre-specified weighting function.

Results

Employment at baseline was associated with an increase in recovery score at baseline [8.06 (95% CI 1.21, 14.91); p = 0.02], but not with recovery score at 24-month follow-up visit [3.78 (−4.67, 12.24); p = 0.37]. Weighted cumulative effect of employment over 8 follow-up visits was associated with increase in RAS score at 24-month follow-up visit [8.33 (1.68, 14.99) p = 0.01].

Conclusion

Employment is associated with an increase in recovery. Our result suggests a dual effect of employment on recovery, an immediate effect through current employment, and a long-term effect of cumulative employment.

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Data availability

Data are available upon reasonable request to the corresponding author.

Code availability

Statistical codes for this manuscript using SAS analytical software are available upon request to the corresponding author.

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Acknowledgements

Initial findings of this work was presented at the “14th World Congress of Biological Psychiatry”, meeting 2019.

Funding

Vancouver At Home Study was supported by the Mental Health Commission of Canada (Grant: #:2009s0231). Mohammadali Nikoo is supported by Frederick Banting and Charles Best Canada Graduate Scholarships (CGS‐D: Code: 201710GSD‐402441‐275191).

Author information

Authors and Affiliations

  1. Addiction and Concurrent Disorders Group, Department of Psychiatry, Faculty of Medicine, Institute of Mental Health, University of British Columbia, Vancouver, Canada

    Kiana Yazdani

  2. Addiction and Concurrent Disorders Group, Centre for Health Evaluation Outcome Sciences, Department of Psychiatry, Faculty of Medicine, Institute of Mental Health, University of British Columbia, Vancouver, Canada

    Mohammadali Nikoo, Fiona Choi & Reinhard Michael Krausz

  3. Arthritis Research Canada, Richmond, BC, Canada

    Kiana Yazdani & Eric C. Sayre

  4. Department of Psychiatry, Faculty of Medicine, Institute of Mental Health, University of British Columbia, Vancouver, Canada

    Kerry Jang

  5. Experimental Medicine Program, Department of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada

    Kiana Yazdani

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  1. Kiana Yazdani
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  2. Mohammadali Nikoo
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  3. Eric C. Sayre
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Correspondence to Kiana Yazdani.

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Yazdani, K., Nikoo, M., Sayre, E.C. et al. The impact of employment on recovery among individuals who are homeless with severe mental illness in the Vancouver At Home/Chez Soi trial. Soc Psychiatry Psychiatr Epidemiol 55, 1619–1627 (2020). https://doi.org/10.1007/s00127-020-01887-9

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