Skip to main content

Advertisement

Log in

Cognitive and Social Functioning Correlates of Employment Among People with Severe Mental Illness

  • Brief Communication
  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

We assess how social and cognitive functioning is associated to gaining employment for 213 people diagnosed with severe mental illness taking part in employment programs in Andalusia (Spain). We used the Repeatable Battery for the Assessment of Neuropsychological Status and the Social Functioning Scale and conducted two binary logistical regression analyses. Response variables were: having a job or not, in ordinary companies (OCs) and social enterprises, and working in an OC or not. There were two variables with significant adjusted odds ratios for having a job: “attention” and “Educational level”. There were five variables with significant odds ratios for having a job in an OC: “Sex”, “Educational level”, “Attention”, “Communication”, and “Independence-competence”. The study looks at the possible benefits of combining employment with support and social enterprises in employment programs for these people and underlines how both social and cognitive functioning are central to developing employment models.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  • Addington, J., & Addington, D. (1999). Neurocognitive and Social Functioning in Schizophrenia. Schizophrenia Bulletin, 25(1), 173–182.

    Article  CAS  PubMed  Google Scholar 

  • Alonso, J., Olivares, J. M., Ciudad, A., Manresa, J. M., Casado, A., & Gilaberte, I. (2008). Desarrollo y validación de la versión corta de la Escala de Funcionamiento Social en esquizofrenia para su uso en la práctica clínica. Actas Españolas de Psiquiatría, 36, 102–110.

    CAS  PubMed  Google Scholar 

  • August, S. M., Kiwanuka, J. N., McMahon, R. P., & Gold, J. M. (2012). The MATRICS Consensus Cognitive Battery (MCCB): clinical and cognitive correlates. Schizophrenia Research, 134, 76–82.

    Article  PubMed  Google Scholar 

  • Becker, D., Bond, G., Mueser, K., & Torrey, W. (Eds.). (2007). Supported Employment Workbook. SAMHSA, 2003. Versiónespañolaen FAISEM. Guía para el desarrollo de programas de empleo con apoyo para personas con trastorno mental grave. Sevilla: FAISEM.

    Google Scholar 

  • Bell, M. D., & Bryson, Q. (2001). Work rehabilitation in schizophrenia: Does cognitive impairment limit improvement? Schizophrenia Bulletin, 27, 269–279.

    Article  CAS  PubMed  Google Scholar 

  • Birchwood, M., Smith, J., Cochrane, R., Wetton, S., & Copestake, S. (1990). The Social Functioning Scale. The development and validation of a new scale of social adjustment for use in family intervention programmes with schizophrenic patients. The British Journal of Psychiatry, 157, 853–859.

    Article  CAS  PubMed  Google Scholar 

  • Boardman, J., Grove, B., Perkins, R., & Shepherd, G. (2003). Work and employment for people with psychiatric disabilities. The British Journal of Psychiatry, 182, 467–468.

    Article  PubMed  Google Scholar 

  • Bond, G. R., Drake, R. E., & Becker, D. R. (2008). An update on randomized controlled trials of evidence-based supported employment. Psychiatric Rehabilitation Journal, 31, 280–290.

    Article  PubMed  Google Scholar 

  • Burke-Miller, J. K., Cook, J. A., Grey, D. D., Razzano, L. A., Blyler, C. R., Leff, H. S., et al. (2006). demographic characteristics and employment among people with severe mental illness in a multisite study. Community Mental Health Journal, 42(2), 143–159.

    Article  PubMed  Google Scholar 

  • Burns, T., Catty, J., Becker, T., Drake, R. R., Fioritti, A., Knapp, M., et al. (2007). The effectiveness of supported employment for people with severe mental illness: a randomized controlled trial. The Lancet, 370, 1146–1152.

    Article  Google Scholar 

  • Burns, T., Catty, J., White, S., Becker, T., Koletsi, M., Fioritti, A., et al. (2009). The impact of supported employment working on clinical and social functioning: results of an international study of individual placement and support. Schizophrenia Bulletin, 35, 949–959.

    Article  PubMed  Google Scholar 

  • Butler, G., Howard, L., Choi, S., & Thornicroft, G. (2010). Characteristics of people with severe mental illness who obtain employment. The Psychiatrist, 34, 47–50.

    Article  Google Scholar 

  • Fioritti, A., D’Alema, M., Barone, R., & Bruschetta, S. (2014). Social enterprises, vocational rehabilitation, supported employment. The Journal of Nervous and Mental Disease, 202, 498–500.

    Article  PubMed  Google Scholar 

  • Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198.

    Article  CAS  PubMed  Google Scholar 

  • Gilbert, E., Marwaha, S., Milton, A., Johnson, S., Morant, N., Parsons, N., et al. (2013). Social firms as a means of vocational recovery for people with mental illness: A UK survey. BMC Health Services Research, 13, 270–279.

    Article  PubMed  PubMed Central  Google Scholar 

  • Giugiario, M., Crivelli, B., Mingrone, C., Montemagni, C., Scalese, M., Sigaudo, M., et al. (2012). Cognitive function and competitive employment in schizophrenia: Relative contribution of insight and psychopathology. Social Psychiatry and Psychiatric Epidemiology, 47, 553–561.

    Article  PubMed  Google Scholar 

  • Gogos, A., Joshua, N., & Rossell, S. (2010). Use of the repeatable Battery for the Assessment of Neuropsychological Status (RBANS) to investigate group and gender differences in schizophrenia and bipolar disorder. Australian and New Zealand Journal of Psychiatry, 44, 220–229.

    Article  PubMed  Google Scholar 

  • Gold, J. M., Queern, C., Iannone, V. N., & Buchanan, R. W. (1999). Repeatable Battery for the Assessment of Neuropsychological Status as screening test in Schizophrenia, I: Sensitivity, reliability and validity. American Journal of Psychiatry, 156, 1944–1950.

    CAS  PubMed  Google Scholar 

  • Green, M. F. (2006). Cognitive impairment and functional outcome in schizophrenia and bipolar disorder. Journal of Clinical Psychiatry, 67(suppl.), 3–8.

    PubMed  Google Scholar 

  • Green, M. F., Kern, R. S., Braff, D. L., & Mintz, J. (2000). Neurocognitive deficits and functional outcome in schizophrenia: Are we measuring the “right stuff”? Schizophrenia Bulletin, 26, 119–136.

    Article  CAS  PubMed  Google Scholar 

  • Grove, B., Freudenberg, M., & Harding, A. (1997). The social firm handbook. Brighton: Pavilion.

    Google Scholar 

  • Han, M., Huang, X. F., Chen, D. C., Xiu, M. H., Hui, L., Liu, H., et al. (2012). Gender differences in cognitive function of patients with chronic schizophrenia. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 39, 358–363.

    Article  PubMed  Google Scholar 

  • Hobart, M. P., Goldberg, R., Bartko, J. J., & Gold, J. M. (1999). Repeatable Battery for the Assessment of Neuropsychological Status as screening test in Schizophrenia, II: Convergent/discriminant validity and diagnostic group comparisons. American Journal of Psychiatry, 156, 1951–1957.

    CAS  PubMed  Google Scholar 

  • Kaneda, Y., Jayathilak, K., & Meltzer, H. Y. (2009). Determinants of work outcome in schizophrenia and schizoaffective disorder: Role of cognitive function. Psychiatric Research, 169, 178–179.

    Article  Google Scholar 

  • Kilian, R., Lauber, C., Kalkan, R., Dorn, W., Rössler, W., Wiersma, D., et al. (2012). The relationships between employment, clinical status, and psychiatric hospitalization in patients with schizophrenia receiving either IPS or a conventional vocational rehabilitation program. Social Psychiatry and Psychiatric Epidemiology, 47, 1381–1389.

    Article  PubMed  Google Scholar 

  • Lobo, A., Saz, P., Marcos, G., Día, J. L., de la Cámara, C., Ventura, T., et al. (1999). Revalidación y normalización del Mini-Examen cognoscitivo (primera versión en castellano del Mini-Mental Status Examination) en la población general geriátrica. Revista de Medicina Clínica de la Universidad de Barcelona, 112, 767–774.

    CAS  Google Scholar 

  • López, M. (2010). El empleo y la recuperación de personas con trastornos mentales graves. La experiencia de Andalucía. Revista Norte de Salud Mental, 36, 11–23.

    Google Scholar 

  • Loughland, C. M., Lewin, T. J., Carr, J., Sheedy, J., & Harris, A. W. (2007). RBANS neuropsychological profiles within schizophrenia samples recruited from non-clinical settings. Schizophrenia Research, 89, 232–242.

    Article  PubMed  Google Scholar 

  • Lysaker, P. H., Davis, L. H., Bryson, G. J., & Bell, M. D. (2009). Effects of cognitive behavioral therapy on work outcomes in vocational rehabilitation for participants with schizophrenia spectrum disorders. Schizophrenia Research, 107, 186–191.

    Article  PubMed  Google Scholar 

  • McGurk, S. R., & Mueser, K. T. (2003). Cognitive functioning and employment in severe mental illness. The Journal of Nervous and Mental Disease, 191, 789–798.

    Article  PubMed  Google Scholar 

  • McGurk, S. R., & Mueser, K. T. (2004). Cognitive functioning, symptoms, and work in supported employment: a review and heuristic model. Schizophrenia Research, 70, 147–173.

    Article  PubMed  Google Scholar 

  • McGurk, S. R., Mueser, K. T., De Rosa, T. J., & Wolfe, R. (2009). Work, recovery, and comorbidity in schizophrenia: a randomized controlled trial of cognitive remediation. Schizophrenia Bulletin, 35, 319–335.

    Article  PubMed  PubMed Central  Google Scholar 

  • McGurk, S. R., & Wykes, T. (2008). Cognitive remediation and vocational rehabilitation. Psychiatric Rehabilitation Journal, 31, 350–359.

    Article  PubMed  Google Scholar 

  • Mueser, K. T., Salyers, M. P., & Mueser, P. R. (2001). A prospective analysis of work in schizophrenia. Schizophrenia Bulletin, 27, 281–296.

    Article  CAS  PubMed  Google Scholar 

  • Perkins, D. V., Raines, J. A., Tschopp, M. K., & Warner, T. C. (2009). Gainful employment reduces stigma toward people recovering from schizophrenia. Community Mental Health Journal, 45, 158–162.

    Article  PubMed  Google Scholar 

  • Provencher, H. P., Gegg, R., Mead, S., & Mueser, K. T. (2002). The role of work in recovery of persons with psychiatric disabilities. Psychiatric Rehabilitation Journal, 26, 132–144.

    Article  PubMed  Google Scholar 

  • Ramsay, C. E., Stewart, T., & Compton, M. T. (2012). Unemployment among patients with newly diagnosed first-episode psychosis: Prevalence and clinical correlates in a US sample. Social Psychiatry and Psychiatric Epidemiology, 47, 797–803.

    Article  PubMed  Google Scholar 

  • Randolph, C. (1998). Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): Test manual. San Antonio: Harcourt Brace and Company.

    Google Scholar 

  • Ruggieri, M., Leese, M., Thornicroft, G., Bisoffi, G., & Tansella, M. (2000). Definition and prevalence of severe and persistent mental illness. The British Journal of Psychiatry, 177, 149–155.

    Article  Google Scholar 

  • Waghorn, G., Saha, S., & McGrath, J. J. (2014). Correlates of competitive versus nomcompetitive employment among adults with psychotic disorders. Psychiatric Services, 65, 476–482.

    Article  PubMed  Google Scholar 

  • Warner, R., & Mandiberg, J. (2006). An update on affirmative businesses or social firms for people with mental illness. Psychiatric Services, 57, 1488–1492.

    Article  PubMed  Google Scholar 

  • WHO (2013) Comprehensive mental health action plan 2013–2020. Resolution WHA 66/8. http://apps.who.int/gb/ebwha/pdf_files/WHA66/A66_R8-en.pdf. Accessed 27 Dec 2013.

  • Wilk, C. M., Gold, J. M., Humber, K., Dickerson, F., Fenton, W. S., & Buchanan, R. W. (2004). Brief cognitive assessment in schizophrenia: normative data for the Repeatable Battery for the Assessment of Neuropsychological Status. Schizophrenia Research, 70, 175–186.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was conducted thanks to the financial backing of the European Social Fund of the European Union and the Andalusian Employment Service of the Regional Government of Andalusia.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Javier Saavedra.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Saavedra, J., López, M., González, S. et al. Cognitive and Social Functioning Correlates of Employment Among People with Severe Mental Illness. Community Ment Health J 52, 851–858 (2016). https://doi.org/10.1007/s10597-015-9874-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-015-9874-4

Keywords

Navigation