PMID- 16177278
OWN - NLM
STAT- MEDLINE
DCOM- 20060921
LR  - 20181113
IS  - 0586-7614 (Print)
IS  - 0586-7614 (Linking)
VI  - 32
IP  - 2
DP  - 2006 Apr
TI  - Randomized trial of supported employment integrated with assertive community 
      treatment for rural adults with severe mental illness.
PG  - 378-95
AB  - Urban-based randomized clinical trials of integrated supported employment (SE) 
      and mental health services in the United States on average have doubled the 
      employment rates of adults with severe mental illness (SMI) compared to 
      traditional vocational rehabilitation. However, studies have not yet explored if 
      the service integrative functions of SE will be effective in coordinating 
      rural-based services that are limited, loosely linked, and geographically 
      dispersed. In addition, SE's ability to replicate the work outcomes of urban 
      programs in rural economies with scarce and less diverse job opportunities 
      remains unknown. In a rural South Carolina county, we designed and implemented a 
      program blending Assertive Community Treatment (ACT) with an SE model, Individual 
      Placement and Support (IPS). The ACT-IPS program operated with ACT and IPS 
      subteams that tightly integrated vocational with mental health services within 
      each self-contained team. In a 24-month randomized clinical trial, we compared 
      ACT-IPS to a traditional program providing parallel vocational and mental health 
      services on competitive work outcomes for adults with SMI (N = 143; 69% 
      schizophrenia, 77% African American). More ACT-IPS participants held competitive 
      jobs (64 versus 26%; p < .001, effect size [ES] = 0.38) and earned more income 
      (median [Mdn] = 549 US dollars, interquartile range [IQR] = 0-5,145 US dollars, 
      versus Mdn = 0 US dollars, IQR = 0-40 US dollars; p < .001, ES = 0.70) than 
      comparison participants. The competitive work outcomes of this rural ACT-IPS 
      program closely resemble those of urban SE programs. However, achieving economic 
      self-sufficiently and developing careers probably require increasing access to 
      higher education and jobs imparting marketable technical skills.
FAU - Gold, Paul B
AU  - Gold PB
AD  - Department of Psychiatry and Behavioral Sciences, Medical University of South 
      Carolina, 67 President Street, IOP 4 South, Charleston, SC 29425, USA. 
      goldpb@musc.edu
FAU - Meisler, Neil
AU  - Meisler N
FAU - Santos, Alberto B
AU  - Santos AB
FAU - Carnemolla, Mark A
AU  - Carnemolla MA
FAU - Williams, Olivia H
AU  - Williams OH
FAU - Keleher, Jennie
AU  - Keleher J
LA  - eng
GR  - K23 MH001903-05/MH/NIMH NIH HHS/United States
GR  - SM53542/SM/CMHS SAMHSA HHS/United States
GR  - SM51823/SM/CMHS SAMHSA HHS/United States
GR  - K23 MH001903/MH/NIMH NIH HHS/United States
GR  - MH01903/MH/NIMH NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20050921
PL  - United States
TA  - Schizophr Bull
JT  - Schizophrenia bulletin
JID - 0236760
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Community Mental Health Services/*organization & administration
MH  - Employment, Supported/*statistics & numerical data
MH  - Female
MH  - Humans
MH  - Interview, Psychological
MH  - Male
MH  - *Mental Disorders/epidemiology/psychology/therapy
MH  - Middle Aged
MH  - Quality of Life
MH  - Rural Health Services/*organization & administration
MH  - Severity of Illness Index
PMC - PMC1435374
MID - NIHMS6510
EDAT- 2005/09/24 09:00
MHDA- 2006/09/22 09:00
PMCR- 2007/04/01
CRDT- 2005/09/24 09:00
PHST- 2005/09/24 09:00 [pubmed]
PHST- 2006/09/22 09:00 [medline]
PHST- 2005/09/24 09:00 [entrez]
PHST- 2007/04/01 00:00 [pmc-release]
AID - sbi056 [pii]
AID - 10.1093/schbul/sbi056 [doi]
PST - ppublish
SO  - Schizophr Bull. 2006 Apr;32(2):378-95. doi: 10.1093/schbul/sbi056. Epub 2005 Sep 
      21.