Influence of an Interdisciplinary Re-employment Programme Among Unemployed Persons with Mental Health Problems on Health, Social Participation and Paid Employment.
Bouwine E Carlier, Merel Schuring, Alex Burdorf
PMID 28397017WHAT IT FOUND
The interdisciplinary re-employment programme did not significantly improve paid employment, voluntary work or health after 2 years compared with usual programmes.
People who did get jobs had better physical health and fewer anxiety and depressive symptoms.
Key findings
01After 2 years, fulltime paid employment was 10% in the intervention programme and 4% in the usual programmes. Any paid employment was 26% and 22%, but the difference in increase was not statistically significant.
02Physical health and mental health did not change during the 2-year period, and there was no significant difference between programmes in physical health or anxiety and depressive symptoms.
03Among people who entered paid employment, physical health improved by +16% and anxiety and depressive symptoms decreased by -15%; these improvements were not found among people who remained unemployed.
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What it does not show
Only 181 of 380 intervention participants and 253 of 489 usual participants answered the baseline questionnaire, and follow-up response was 51 of 181 in the intervention group and 107 of 253 in the usual group. The groups were not randomly allocated, and the intervention group had worse mental health, lower mastery and lower self-esteem at baseline. The propensity score can only adjust for observed characteristics, so unobserved differences may have biased the results. The study may have lacked power to detect the small observed differences in employment. The intervention was not standardized, and rapid job placement was not implemented as intended. The study took place during a strong recession, which reduced job opportunities.
Declared interests
Funding came from ZonMW. No other conflicts of interest are reported in the supplied text.
The easy way to misread this
Do not conclude that the interdisciplinary programme improves health because people who entered paid employment had better physical health and fewer anxiety and depressive symptoms. The programme did not significantly improve paid employment, voluntary work, physical health, mental health or anxiety and depressive symptoms compared with usual programmes, and the health changes were observed among people who got jobs regardless of programme.