Recent Research on Vocational Rehabilitation for Persons With Severe Mental Illness

Robert E Drake, Deborah R Becker, Gary R Bond


Curr Opin Psychiatry. 2003;16(4) 

In This Article

Abstract and Introduction

Purpose of review: This review examines the 2002 literature on vocational services for people with psychiatric disabilities.
Recent findings: Vocational rehabilitation has emerged as a mainstream intervention in community mental health, and supported employment has become an evidence-based practice. In addition to clarifying and confirming the effectiveness and principles of supported employment, the literature describes clients' needs, innovative modifications of supported employment for special groups, the subjective experiences and non-vocational outcomes of clients related to employment, impacts of the Americans with Disabilities Act, costs of vocational services, cultural disparities, and the development of vocational services in other countries.
Summary: Increasing demands for employment services and for empirical outcomes influence clinical practice. Supported employment has by far the strongest evidence base of any vocational intervention for people with psychiatric disabilities and continues to be disseminated rapidly. Further research is needed to clarify the principles, impacts, and modifications of supported employment.

In the fields of vocational rehabilitation and community mental health for persons with psychiatric disabilities, supported employment has rapidly emerged as a recommended practice because of its strong evidence base.[1,2,3,4,5] The recent literature clarifies many aspects of supported employment and points toward several new developments.

This review examines the 2002 literature on vocational services for persons with severe mental illness in order to identify trends, to clarify current research and emerging ideas, and to anticipate clinical implications and research directions. We searched for articles that addressed vocational services for people with severe mental illness in the 2002 issues of several major journals of mental health (American Journal of Psychiatry, Archives of General Psychiatry, Journal of Nervous and Mental Disease, Schizophrenia Bulletin), psychiatric rehabilitation (Community Mental Health Journal, Psychiatric Rehabilitation Journal, Psychiatric Services), and general rehabilitation (Journal of Vocational Rehabilitation, Rehabilitation Counseling Bulletin, Rehabilitation Psychology). Because experimental studies produce robust and reproducible findings, we emphasize randomized controlled trials. We also note quasi-experimental and ethnographic studies, again because the findings tend to be more reproducible than those from studies using descriptive and open clinical trial methods.


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