Longitudinal outcomes of a work inclusion program in mental health departments in the city of Milan

Background: Work functioning impairment is a key diagnostic and prognostic criterion in patients with psychiatric disorders and work inclusion is a major goal of their therapeutic pathway. Since 2009, the Regional Innovative Program (PIR) TR106, promoted by ASST Fatebenefratelli-Sacco of Milan in co...

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Veröffentlicht in:International journal of social psychiatry 2024-05, Vol.70 (3), p.507-517
Hauptverfasser: Vanzetto, Simone, Quarenghi, Andrea, Varinelli, Alberto, Dragoni, Chiara, Conti, Dario, Boscacci, Maria, Carrà, Giuseppe, Percudani, Mauro, Morganti, Carla, Gambini, Orsola, Barbieri, Valentina, Brambilla, Paolo, Lazzaretti, Matteo, Rubelli, Paola, Mencacci, Claudio, Fusi, Antonio, Viganò, Caterina, Dell’Osso, Bernardo
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container_issue 3
container_start_page 507
container_title International journal of social psychiatry
container_volume 70
creator Vanzetto, Simone
Quarenghi, Andrea
Varinelli, Alberto
Dragoni, Chiara
Conti, Dario
Boscacci, Maria
Carrà, Giuseppe
Percudani, Mauro
Morganti, Carla
Gambini, Orsola
Barbieri, Valentina
Brambilla, Paolo
Lazzaretti, Matteo
Rubelli, Paola
Mencacci, Claudio
Fusi, Antonio
Viganò, Caterina
Dell’Osso, Bernardo
description Background: Work functioning impairment is a key diagnostic and prognostic criterion in patients with psychiatric disorders and work inclusion is a major goal of their therapeutic pathway. Since 2009, the Regional Innovative Program (PIR) TR106, promoted by ASST Fatebenefratelli-Sacco of Milan in collaboration with other Departments of Mental Health and Addictions (DSMDs) in the town of Milan (Italy), has been developing the employment inclusion of psychiatric patients. Aims: The objective of this study is to evaluate its outcomes over 8 years of observation. Method: We reported the results of a retrospective epidemiologic analysis on 2,142 interventions on 1,066 patients recruited, investigating PIR TR106 outcomes per year focusing on different subgroups. We focused on ‘positive’, ‘negative’, and ‘other’ outcomes. Results: We preliminary calculated job maintenance interventions (5%, 107) and excluded these interventions from the overall. We observed 29 job firing (1.4%) and 15 job resignations (0.7%) as negative results (equal to 2.2% of the total) and 388 job hiring (16.6%), 647 traineeships (31.8%), and 413 work formation (20.3%) as positive outcomes (equal to 68.75%). In other outcomes (29.1%) we found 305 dismissals from PIR TR 106 (15%) and transitory outcomes (14.1%). Job hiring increased from 8.9% in 2012 to 23.8 % in 2019 (p 
doi_str_mv 10.1177/00207640231217177
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Since 2009, the Regional Innovative Program (PIR) TR106, promoted by ASST Fatebenefratelli-Sacco of Milan in collaboration with other Departments of Mental Health and Addictions (DSMDs) in the town of Milan (Italy), has been developing the employment inclusion of psychiatric patients. Aims: The objective of this study is to evaluate its outcomes over 8 years of observation. Method: We reported the results of a retrospective epidemiologic analysis on 2,142 interventions on 1,066 patients recruited, investigating PIR TR106 outcomes per year focusing on different subgroups. We focused on ‘positive’, ‘negative’, and ‘other’ outcomes. Results: We preliminary calculated job maintenance interventions (5%, 107) and excluded these interventions from the overall. We observed 29 job firing (1.4%) and 15 job resignations (0.7%) as negative results (equal to 2.2% of the total) and 388 job hiring (16.6%), 647 traineeships (31.8%), and 413 work formation (20.3%) as positive outcomes (equal to 68.75%). In other outcomes (29.1%) we found 305 dismissals from PIR TR 106 (15%) and transitory outcomes (14.1%). Job hiring increased from 8.9% in 2012 to 23.8 % in 2019 (p &lt; .001), while the dismissals diminished from 26.7% to 13.3% (p &lt; .001). The effectiveness of traineeships in terms of job hiring increased in the ratio of annual job hiring versus job traineeship (+48.8%). The majority of hired patients (15.1%) were affected by a psychotic disorder. A significant hiring increase was observed in patients with psychotic disorders and personality disorders (p &lt; .005). Conclusions: PIR-TR106 represents a territorial employment inclusion program with progressively increasing effectiveness and specificity, as suggested by changes in outcomes during the 8-year observation. The adaptive capacity and sustainability of the intervention are worth further investigation.</description><identifier>ISSN: 0020-7640</identifier><identifier>EISSN: 1741-2854</identifier><identifier>DOI: 10.1177/00207640231217177</identifier><identifier>PMID: 38312065</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Addictions ; Adult ; Dismissal ; Employment ; Female ; Hiring ; Humans ; Intervention ; Italy ; Job performance ; Longitudinal Studies ; Male ; Mental disorders ; Mental Disorders - therapy ; Mental health ; Mental Health Services - organization &amp; administration ; Middle Aged ; Personality disorders ; Personnel Selection - methods ; Psychosis ; Resignations ; Retrospective Studies</subject><ispartof>International journal of social psychiatry, 2024-05, Vol.70 (3), p.507-517</ispartof><rights>The Author(s) 2024</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c320t-69a2e8db7faa49c32f54ad0a05aa2294ffa194010818bb90ea890e3c521b6a2f3</cites><orcidid>0000-0001-7937-1266 ; 0000-0003-2262-8811 ; 0000-0001-7544-8318 ; 0000-0003-0427-110X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/00207640231217177$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/00207640231217177$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,30976,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38312065$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vanzetto, Simone</creatorcontrib><creatorcontrib>Quarenghi, Andrea</creatorcontrib><creatorcontrib>Varinelli, Alberto</creatorcontrib><creatorcontrib>Dragoni, Chiara</creatorcontrib><creatorcontrib>Conti, Dario</creatorcontrib><creatorcontrib>Boscacci, Maria</creatorcontrib><creatorcontrib>Carrà, Giuseppe</creatorcontrib><creatorcontrib>Percudani, Mauro</creatorcontrib><creatorcontrib>Morganti, Carla</creatorcontrib><creatorcontrib>Gambini, Orsola</creatorcontrib><creatorcontrib>Barbieri, Valentina</creatorcontrib><creatorcontrib>Brambilla, Paolo</creatorcontrib><creatorcontrib>Lazzaretti, Matteo</creatorcontrib><creatorcontrib>Rubelli, Paola</creatorcontrib><creatorcontrib>Mencacci, Claudio</creatorcontrib><creatorcontrib>Fusi, Antonio</creatorcontrib><creatorcontrib>Viganò, Caterina</creatorcontrib><creatorcontrib>Dell’Osso, Bernardo</creatorcontrib><title>Longitudinal outcomes of a work inclusion program in mental health departments in the city of Milan</title><title>International journal of social psychiatry</title><addtitle>Int J Soc Psychiatry</addtitle><description>Background: Work functioning impairment is a key diagnostic and prognostic criterion in patients with psychiatric disorders and work inclusion is a major goal of their therapeutic pathway. Since 2009, the Regional Innovative Program (PIR) TR106, promoted by ASST Fatebenefratelli-Sacco of Milan in collaboration with other Departments of Mental Health and Addictions (DSMDs) in the town of Milan (Italy), has been developing the employment inclusion of psychiatric patients. Aims: The objective of this study is to evaluate its outcomes over 8 years of observation. Method: We reported the results of a retrospective epidemiologic analysis on 2,142 interventions on 1,066 patients recruited, investigating PIR TR106 outcomes per year focusing on different subgroups. We focused on ‘positive’, ‘negative’, and ‘other’ outcomes. Results: We preliminary calculated job maintenance interventions (5%, 107) and excluded these interventions from the overall. We observed 29 job firing (1.4%) and 15 job resignations (0.7%) as negative results (equal to 2.2% of the total) and 388 job hiring (16.6%), 647 traineeships (31.8%), and 413 work formation (20.3%) as positive outcomes (equal to 68.75%). In other outcomes (29.1%) we found 305 dismissals from PIR TR 106 (15%) and transitory outcomes (14.1%). Job hiring increased from 8.9% in 2012 to 23.8 % in 2019 (p &lt; .001), while the dismissals diminished from 26.7% to 13.3% (p &lt; .001). The effectiveness of traineeships in terms of job hiring increased in the ratio of annual job hiring versus job traineeship (+48.8%). The majority of hired patients (15.1%) were affected by a psychotic disorder. A significant hiring increase was observed in patients with psychotic disorders and personality disorders (p &lt; .005). 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Since 2009, the Regional Innovative Program (PIR) TR106, promoted by ASST Fatebenefratelli-Sacco of Milan in collaboration with other Departments of Mental Health and Addictions (DSMDs) in the town of Milan (Italy), has been developing the employment inclusion of psychiatric patients. Aims: The objective of this study is to evaluate its outcomes over 8 years of observation. Method: We reported the results of a retrospective epidemiologic analysis on 2,142 interventions on 1,066 patients recruited, investigating PIR TR106 outcomes per year focusing on different subgroups. We focused on ‘positive’, ‘negative’, and ‘other’ outcomes. Results: We preliminary calculated job maintenance interventions (5%, 107) and excluded these interventions from the overall. We observed 29 job firing (1.4%) and 15 job resignations (0.7%) as negative results (equal to 2.2% of the total) and 388 job hiring (16.6%), 647 traineeships (31.8%), and 413 work formation (20.3%) as positive outcomes (equal to 68.75%). In other outcomes (29.1%) we found 305 dismissals from PIR TR 106 (15%) and transitory outcomes (14.1%). Job hiring increased from 8.9% in 2012 to 23.8 % in 2019 (p &lt; .001), while the dismissals diminished from 26.7% to 13.3% (p &lt; .001). The effectiveness of traineeships in terms of job hiring increased in the ratio of annual job hiring versus job traineeship (+48.8%). The majority of hired patients (15.1%) were affected by a psychotic disorder. A significant hiring increase was observed in patients with psychotic disorders and personality disorders (p &lt; .005). 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subjects Addictions
Adult
Dismissal
Employment
Female
Hiring
Humans
Intervention
Italy
Job performance
Longitudinal Studies
Male
Mental disorders
Mental Disorders - therapy
Mental health
Mental Health Services - organization & administration
Middle Aged
Personality disorders
Personnel Selection - methods
Psychosis
Resignations
Retrospective Studies
title Longitudinal outcomes of a work inclusion program in mental health departments in the city of Milan
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