How sustainable is supported employment? A follow-up investigation

The largest European multicenter randomized controlled trial to date on the effectiveness of supported employment (EQOLISE) was conducted in six European centres until 2005. It revealed that the intervention "individual placement and support" was more effective than conventional prevocational training services. The aim of this investigation was to assess the Zurich sample (individuals with schizophrenic, schizoaffective or bipolar disorders) 24 months after termination of the EQOLISE trial in terms of working situation, income, and hospital admissions. More favorable outcomes concerning these parameters were assumed for the intervention group. Assessment of the working situation and psychiatric hospitalizations since the end as well as the development of salaries since the start of EQOLISE. Comparisons between groups and illustration of incomes using a random coefficient model were conducted. 50% of the original sample could be assessed. All subjects who worked in competitive workplaces at the end of EQOLISE were met in a different situation. No differences were found concerning hospital admissions. The mean monthly income considerably increased during EQOLISE and decreased during the third year. At the time of follow-up it was approximately at the same level as the slightly increased control group. This investigation points at limited sustainability of supported employment among individuals with severe mental disorders in terms of maintenance of employment and income if the job coaching is not continued.