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Occupational Therapy Interventions for Employment and Education for Adults With
Serious Mental Illness
1. How can modification of work environment lead to successful employment in
people with mental health problems?
3. How can education of employers lead to successful employment of people with
mental health problems?
5. How does a supportive work environment lead to sustainability in people with
mental health problems?
10. How can individual placement and support lead to successful employment in
people with mental health problems?
In this research the researchers were evaluating the effectiveness of occupational
therapy interventions focusing on participation and performance in occupations
related to paid and unpaid employment and education for people with serious
mental illness. They were evaluating the interventions Supported Employment and
Individual Placement and Support and other occupation- activity based
interventions.
People with serious mental illness have the lowest employment rate, lower than
other people with disabilities. For people with serious mental illness developing
the skills and obtaining the supports necessary for productive living are of
particular importance to participating in the employment. Work is any productive
activity, whether paid or unpaid, that contributes to the maintenance or
advancement of society as well as to the individuals own survival or development.
Qualitative research by Honey (2004) in Australia reported that people with
mental illness weighed the benefits and drawbacks of employment on the basis of
contextual factors such as the perceived status of employment in society, type of
job available, support and expectation of the social network, individual factors of
mental illness, level of comfort with disclosing ones mental health status to a
potential employer, and perceived alternatives to employment.
The AOTA set up this systematic review. Three EKU graduate students, one faculty
advisor, and AOTA staff and consultant were involved. They developed a search
strategy and key search terms based on population, interventions and outcomes.
They operationalized the term serious mental illness. Other criteria were: Englishlanguage articles, participants between the age of 18-6 and interventions within
the scope of occupational therapy practice. They only used studies from level I
(SR, Meta-analyses) II (non-RCTS) and III (pretest-posttest). There were 37 Level I
studies, 5 Level II, and 4 were Level III.
Work Programs: SE and Vocational Rehabilitation
Evidence for the efficacy of SE and IPS is strong. Another review shows that SE
with prevocational training found that those in SE programs earned significantly
more and worked more hours per month than clients in prevocational training The
results indicate higher rates of employment, shorter length of time to find a job,
and longer job duration: Two-thirds of the study participants in the IPS condition
worked 20 Hr/week compared with 23% for those in the control conditions. SE is
more effective than Vocational Rehabilitation.
Supported Education Programs
The effective is good. The skills were increasing in enrollment in school or
vocational education.
SE Plus Cognitive or Social Skills Training
Neurocognitive enhancement therapy (NET) in combination with work therapy
(WT). At 2- to
3-yr follow-up, the results indicate that participants in SE and cognitive training
were more likely to work, to be employed for more hours, to be working over a
longer period of time, and to earn more than those in the SE-alone program.

Programs Related to Homemaking, Parenting, and Environmental Supports

Two Level I studies (Velligan et al., 2000, 2006) showed good evidence of the
efficacy of using environmental supports provided through cognitive adaptation
training, a manual-driven series of compensatory strategies based on
neuropsychological, occupational therapy, and behavioral principles.
Increasing evidence has shown that the results for the IPS model are stronger
when paired with social skills training or cognitive skills training.