'Placement Budgets’ for Supported Employment – Improving Competitive Employment for People with Mental Illness

The study is based on the assumption that exclusion from the labor market intensifies the social discrimination of people with severe mental disorders. The study's questions are guided by the ethical principle of equality. According to this, people with severe mental disorders should also have access to the labor market in order to improve their chances of social and professional integration. At present, the most successful approach in the field of professional integration is "Supported Employment”. In the so-called “Individual Placement and Support“ model, a job coach finds a job as quickly as possible on the labor market for the person concerned, corresponding to the wishes of the person, and continues to supervise him or her, so that the job can be held down as long as possible. Various studies have shown that every second person with a severe mental disorder was able to be found a job on the labor market within 1 ½ years. However, the goal of taking up employment within 2 months was rarely achieved.

The main question of this study is, therefore, whether limiting the "Placement-Budget “ leads to a quicker placement on the labor market, resulting in a better utilization of the overall resources of a job coach. In addition, factors connected with finding a job on the labor market quickly and holding that job down in the long term are being examined (motivation, expectations of stigmatization, influence of social environment, financial incentives). Over a period of 3 years, the study will examine whether employment in the free market economy leads in the long term to a diminishing of the mental disorder, to a transfer of the psychiatric support system to private networks and networks at work, whether financial independence is increased, whether stigmatization by society is reduced, whether the patient is more content with life and with work.

Job coaches are being trained at a total of 6 out-patient departments of psychiatric clinics in the Canton of Zurich, so that Supported Employment can be implemented strictly according to the "Individual Placement and Support“ model. Patients who are interested in the model are provided with verbal and written information about the subject-matter of the study and the criteria for participation. After they have signed the declaration of consent, they will be allocated one of 3 set "Placement-Budgets“ (25, 40 or 55 hours with the job coach). In April 2010 recruitment begins of 100 patients who will be supervised by a job coach for a maximum of 2 years. As part of this process an interview lasting approximately one hour will take place upon entering the study (Baseline, t0) and every six months thereafter (t1-t6), regardless of whether the client is still being supervised by the job coach or not. For each interview the test person will receive a remuneration of 45 CHF. The questioning of the test persons will therefore stretch over a period of 3 years. The final interviews will be completed by 31 May 2014. The following year will be dedicated to analyzing, publishing and circulating the results of the study.