The effects of an interdisciplinary employment program on paid employment and mental health among persons with severe mental disorders

Abstract

Abstract Purpose This study evaluates the effects of the interdisciplinary employment program ‘Work As Best Care (WABC)’ on employment participation and mental health of persons with severe mental disorders. Methods WABC is a ‘work first’ employment program for unemployed persons with severe mental disorders in which employment professionals work closely together with mental health professionals. In a longitudinal non-randomized controlled study, participants of WABC (n = 35) are compared with participants of the control group (n = 37), who received regular employment support. Participants were followed for 1 year and filled out questionnaires on individual characteristics and health at baseline, after 6 and 12 months. This information was enriched with monthly register data on employment status from 2015 until 2020. Difference-in-differences analyses were performed to investigate changes in employment participation among participants of WABC and the control group. A generalized linear mixed-effects model was used to compare changes in mental health (measured on 0–100 scale) between the two groups. Results Before WABC, employment participation was 22.0%points lower among participants of WABC compared to the control group. After starting WABC, employment participation increased with 15.3%points per year among participants of WABC, compared to 5.6%points in the control group. Among all participants of WABC, no change in mental health was found (β 1.0, 95% CI − 3.4; 5.5). Only female participants of WABC showed a significant change in mental health (β 8.0, 95% CI 2.6; 13.4). Conclusion To enhance employment participation of persons with severe mental disorders, an interdisciplinary ‘work-first’ approach in which professionals of employment services and mental health services work in close collaboration, is of paramount importance.