The effects of an interdisciplinary employment program among persons with severe mental disorders

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 one 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 participants of WABC, no change in mental health was found (β 1.0, 95%CI -3.4;5.5). CONCLUSIONS: 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. KEY MESSAGES: • An interdisciplinary work-first approach where employment- and mental health services work in close collaboration, is of paramount importance for re-employment of persons with severe mental disorders. • Having a severe mental disorder should not be an exclusion criterion for receiving support towards paid employment.