Abstract
Supported employment (SE) is an evidence-based practice that helps people with severe mental disorders obtain competitive employment. The implementation of SE programs in different social contexts has led to adaptations of the SE components, therefore impacting the fidelity/quality of these services. The objective of this study was to assess the implementation of SE services in three Canadian provinces by assessing the fidelity and describing components of SE services using the Quality of Supported Employment Implementation Scale. About 23 SE programs participated in this study. Cluster analyses revealed six profiles of SE programs that varied from high to low level of fidelity with a stronger focus on a particular component, and reflected the reality of service delivery settings. Future investigations are warranted to evaluate relationships between the levels of implementation of SE components and work outcomes while considering individual characteristics of people registered in SE programs.
Similar content being viewed by others
References
Anthony, W. A., & Blanch, A. (1989). Research on community support services: What have we learned? Psychosocial Rehabilitation Journal, 12, 55–81.
Becker, D. R., & Drake, R. E. (1994). Individual placement and support: A community mental health center approach to vocational rehabilitation. Community Mental Health Journal, 30(2), 193–206.
Becker, D. R., & Drake, R. E. (2003). A working life for people with severe mental illness. New York: Oxford University Press.
Becker, D. R., & Drake, R. E. (2004). Integration communautaire et soutien à l’emploi. In T. Lecomte & C. Leclerc (Eds.), Manuel de réadaptation psychiatrique (Handbook of psychiatric rehabilitation). Quebec: Presses de l’Universite du Quebec.
Bond, G. R. (2004). Supported employment: Evidence for an evidence-based practice. Psychiatric Rehabilitation Journal, 27(4), 345–359.
Bond, G. R., Becker, D. R., Drake, R. E., Rapp, C. A., Meisler, N., Lehman, A. F., et al. (2001). Implementing supported employment as an evidence-based practice. Psychiatric Services, 52(3), 313–322.
Bond, G. R., Becker, D. R., Drake, R. E., & Vogler, K. M. (1997a). A fidelity scale for the individual placement and support model of supported employment. Rehabilitation Counselling Bulletin, 40(4), 265–284.
Bond, G. R., Campbell, K., Evans, L. J., Gervey, R., Pascaris, A., Tice, S., et al. (2002). A scale to measure quality of supported employment for persons with severe mental illness. Journal of Vocational Rehabilitation, 17, 239–250.
Bond, G. R., Drake, R. E., Mueser, K. T., & Becker, D. R. (1997b). An update on supported employment for people with severe mental illness. Psychiatric Services, 48(3), 335–346.
Bond, G. R., McHugo, G. J., Becker, D. R., Rapp, C. A., & Whitley, R. (2008). Fidelity of supported employment: Lessons learned from the National Evidence-Based Practice Project. Psychiatric Rehabilitation Journal, 31(4), 300–305.
Bond, G. R., Picone, J., Mauer, B., Fishbein, S., & Stout, R. (2000). The quality of supported employment implementation scale. Journal of Vocational Rehabilitation, 14, 201–212.
Burns, T., Catty, J., Becker, T., Drake, R. E., Fioritti, A., Knapp, M., et al. (2007). The effectiveness of supported employment for people with severe mental illness: A randomised controlled trial. The Lancet, 370(9593), 1146–1152.
Campbell, K., Bond, G. R., Gervey, R., Pascaris, A., Tice, S., & Revell, G. (2007). Does type of provider organization affect fidelity to evidence-based supported employment? Journal of Vocational Rehabilitation, 27, 3–11.
Catty, J., Lissouba, P., White, S., Becker, T., Drake, R. E., Fioritti, A., et al. (2008). Predictors of employment for people with severe mental illness: Results of an international six-centre randomised controlled trial. The British Journal of Psychiatry, 192, 224–231.
Cochrane, J. J., Goering, P., & Rogers, J. M. (1991). Vocational programs and services in Canada. Canadian Journal of Community Mental Health, 10(1), 51–63.
Cook, J. A., Leff, H. S., Blyler, C., Gold, P. B., Goldberg, R. W., Mueser, K. T., et al. (2005). Results of a multisite randomized trial of supported employment interventions for individuals with severe mental illness. Archives of General Psychiatry, 62(5), 505–512.
Cook, J. A., & Razzano, L. (2000). Vocational rehabilitation for persons with schizophrenia: Recent research and implications for practice. Schizophrenia Bulletin, 26(1), 87–103.
Corbière, M., & Amundson, N. (2007). Perceptions of the ways of mattering by people with mental illness. Career Development Quaterly, 56(2), 141–149.
Corbière, M., Bond, G. R., Goldner, E. M., & Ptasinski, T. (2005a). The fidelity of supported employment implementation in Canada and the United States. Psychiatric Services, 56(11), 1444–1447.
Corbière, M., & Lecomte, T. (2009). Vocational services offered to people with severe mental illness. Journal of Mental Health, 18(1), 38–50.
Corbière, M., Lesage, A., Villeneuve, K., & Mercier, C. (2006a). Le maintien en emploi des personnes souffrant d’une maladie mentale. Santé Mentale au Québec, XXXI(1), 9–36.
Corbière, M., Mercier, C., Lesage, A., & Villeneuve, K. (2005b). Professional integration of individuals with a mental illness: An analysis of individual characteristics. Canadian Journal of Psychiatry, 50(11), 722–733.
Corbière, M., Reinharz, D., Latimer, E., Kirsh, B., Lecomte, T., Goering, P., et al. (2006). A pan-Canadian analysis of programmatic, organizational, and individual aspects of supported employment programs implementation. Canadian Institute of Health Research—Operating Grant MOP-79314.
Corrigan, P. W., Mueser, K. T., Bond, G. R., Drake, R. E., & Solomon, P. (2008). Principles and pratice of psychiatric rehabilitation: An empirical approach. New York, NY: The Guilford Press.
Corrigan, P. W., & Wassel, A. (2008). Understanding and influencing the stigma of mental illness. Journal of Psychosocial Nursing and Mental Health Services, 46(1), 42–48.
Crowther, R. E., Marshall, M., Bond, G. R., & Huxley, P. (2001). Helping people with severe mental illness to obtain work: Systematic review. BMJ, 322(7280), 204–208.
Danley, K. S., Sciarappa, K., & MacDonald-Wilson, K. (1992). Choose-get-keep: A psychiatric rehabilitation approach to supported employment. New Directions for Mental Health Services, 53, 87–96.
Donnel, C. M., Lustig, D. C., & Strauser, D. R. (2002). The working alliance rehabilitation outcomes for persons with severe mental illness (abstract). Rehabilitation Psychology, 47, 367.
Drake, R. E. (1998). A brief history of the individual placement and support model. Psychiatric Rehabilitation Journal, 22(1), 3–7.
Drake, R. E., & Becker, D. (1996). The individual placement and support model of supported employment. Psychiatric Services, 47, 473–475.
Drake, R. E., Becker, D. R., & Bond, G. R. (2003a). Recent research on vocational rehabilitation for persons with severe mental illness. Current Opinion in Psychiatry, 16, 451–455.
Drake, R. E., Becker, D. R., Bond, G. R., & Mueser, K. T. (2003b). A process analysis of integrated and non-integrated approaches to supported employment. Journal of Vocational Rehabilitation, 18, 51–58.
Drake, R. E., Becker, D. R., Clark, R. E., & Mueser, K. T. (1999). Research on the individual placement and support model of supported employment. Psychiatric Quarterly, 70(4), 289–301.
Drake, R. E., Becker, D. R., Goldman, H. H., & Martinez, R. A. (2006). The Johnson & Johnson-Dartmouth Community Mental Health Program: Disseminating evidence-based practice. Psychiatric Services, 57(3), 302–304.
Drake, R. E., & Bond, G. R. (2008). Supported employment: 1998 to 2008. Psychiatric Rehabilitation Journal, 31(4), 274–276.
Drake, R. E., Fox, T. S., Leather, P. K., Becker, D. R., Musumeci, J. S., Ingram, W. F., et al. (1998). Regional variation in competitive employment for persons with severe mental illness. Administration and Policy In Mental Health, 25(5), 493–504.
Gehrs, M., & Goering, P. (1994). The relationship between the working alliance and rehabilitation outcomes of schizophrenia. Psychosocial Rehabilitation Journal, 18, 43–54.
Gold, P. B., & Waghorn, G. (2007). Supported employment for people with severe mental illness. The Lancet, 370, 1108–1109.
Goldman, H. H., Ganju, V., Drake, R. E., Gorman, P., Hogan, M., Hyde, P. S., et al. (2001). Policy implications for implementing eveidence-based practices. Psychiatric Services, 52(12), 1591–1597.
Hair, J. F., Anderson, R. E., Tatham, R. L., & Black, W. C. (1998). Multivariate data analysis with readings (5th ed.). Englewood Cliffs, NJ: Prentice Hall.
Handler, J., Doel, K., Henry, A., & Lucca, A. (2003). Implementing supported employment services in a real-world setting. Psychiatric Services, 54(7), 960–962.
Harnois, G., & Gabriel, P. (2000). Mental health and work: Impact, issues and good practices. Geneva: World Health Organization.
Hoekstra, E. J., Sanders, K., van den Heuvel, W. J., Post, D., & Groothoff, J. W. (2004). Supported employment in The Netherlands for people with an intellectual disability, a psychiatric disability and a chronic disease. Journal of Vocational Rehabilitation, 21, 39–48.
Killackey, E., Jackson, H., & McGorry, P. (2008). Vocational intervention in first-episode psychosis: Individual placement and support versus treatment as usual. British Journal of Psychiatry, 193(2), 114–120.
King, R., Waghorn, G., Lloyd, C., McLoed, P., McMah, T., & Leong, C. (2006). Enhancing employment services for people with severe mental illness: The challenge of the Australian service environment. Australian and New Zealand Journal of Psychiatry, 40, 471–477.
Kirsh, B., Krupa, T., Cockburn, L., & Bickenbach, J. (2002). The social construction of work integration in Canada. Toronto: Social Sciences and Humanities Research Council.
Kirsh, B., Krupa, T., Cockburn, L., & Gewurtz, R. (2006). Work initiatives for persons with severe mental illnesses in Canada: A decade of development. Canadian Journal of Community Mental Health, 25(2), 173–191.
Latimer, E., Lecomte, T., Becker, D. R., Drake, R. E., Duclos, I., Piat, M., et al. (2006). Generalisability of the individual placement and support model of supported employment: Results of a Canadian randomised controlled trial. British Journal of Psychiatry, 189, 65–73.
Marrone, J., Gandolfo, C., Gold, M., & Hoff, D. (1998). Just doing it: Helping people with mental illness get good jobs. Journal of Applied Rehabilitation Counseling, 29(1), 37–48.
McGrew, J. H., & Griss, M. E. (2005). Concurrent and predictive validity of two scales to assess the fidelity of implementation of supported employment. Psychiatric Rehabilitation Journal, 29(1), 41–47.
Mowbray, C. T., Holter, M. C., Teague, G. B., & Bybee, D. (2003). Fidelity criteria: Development, measurement, and validation. American Journal of Evaluation, 24(3), 315–339.
Mueser, K. T., Torrey, W. C., Lynde, D., Singer, P., & Drake, R. E. (2003). Implementing evidence-based practices for people with severe mental illness. Behavior Modification, 27(3), 387–411.
Novak, J., Rogan, P., Mank, D., & DiLeo, D. (2003). Supported employment and systems change: Findings from a national survey of state vocational rehabilitation agencies. Journal of Vocational Rehabilitation, 19, 157–166.
O’Brien, A., Price, C., & Burns, T. (2003). Improving the vocational status of patients with long-term mental illness: A randomised controlled trial of staff training. Community Mental Health Journal, 39, 333–347.
Oldman, J., Thomson, L., Calsaferri, K., Luke, A., & Bond, G. R. (2005). A case report of the conversion of sheltered employment to evidence-based supported employment in Canada. Psychiatric Services, 56(11), 1436–1440.
Paulson, R. I., Post, R. L., Herinckx, H. A., & Risser, P. (2002). Beyond components: Using fidelity scales to measure and assure choice in program implementation and quality assurance. Community Mental Health Journal, 38(2), 119–128.
Rapkin, B., & Luke, D. A. (1993). Cluster analysis in community research: Epistemology and practice. American Journal of Community Psychology, 21, 247–277.
Rapp, C. A., Etzel-Wise, D., Marty, D., Coffman, M., Carlson, L., Asher, D., et al. (2008). Evidence-based practice implementation strategies: Results of a qualitative study. Community Mental Health Journal, 44(3), 213.
Thomson, L., & Oldman, J. (2003). Working towards wellness—An evaluation report from a two-year Supported Employment Redesign Project. British Columbia: Canadian Mental Health Association.
Trochim, W. M. K., Cook, J. A., & Setze, R. J. (1994). Using concept mapping to develop a conceptual framework of staff’s views of a supported employment program for individuals with sever mental illness. Journal of Consulting and Clinical Psychology, 62, 766–775.
Twamley, E. W., Jeste, D. V., & Lehman, A. F. (2003). Vocational rehabilitation in schizophrenia and other psychotic disorders: A literature review and meta-analysis of randomized controlled trials. The Journal of Nervous and Mental Disease, 191(8), 515–523.
van Erp, N. H. J., Giesen, F. B. M., van Weeghel, J., Kroon, H., Michon, H. W. C., Becker, D., et al. (2007). A multisite study of implementing supported employment in the Netherlands. Psychiatric Services, 58(11), 1421–1426.
Waghorn, G., & Lloyd, C. (2005). The employment of people with mental illness. Australian e-Journal for the Advancement of Mental Health, 4(2), 1–43.
Wewiorski, N. J., & Fabian, E. S. (2004). Association between demographic and diagnostic factors and employment outcomes for people with psychiatric disabilities: A synthesis of recent research. Mental Health Services Research, 6, 9–21.
Wong, K. K., Chiu, R., Tang, B., Mak, D., Liu, J., & Chiu, S. N. (2008). A randomized controlled trial of a supported employment program for persons with long-term mental illness in Hong Kong. Psychiatric Services, 59(1), 84–90.
Acknowledgments
We would like to acknowledge the contributions of the directors and employment specialists from supported employment services implemented in three Canadian provinces (i.e., British Columbia, Ontario and Quebec) for kindly taking part in this study. This study was supported by a research grant from the Canadian Institutes for Health Research (CIHR) received by Drs. Corbière, Reinharz and collaborators.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Corbière, M., Lanctôt, N., Lecomte, T. et al. A Pan-Canadian Evaluation of Supported Employment Programs Dedicated to People with Severe Mental Disorders. Community Ment Health J 46, 44–55 (2010). https://doi.org/10.1007/s10597-009-9207-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10597-009-9207-6