The stability of correlates of labour force activity
ABSTRACT To investigate the stability of correlates of labour force activity among people with affective and anxiety disorders, compared with healthy adults, between 1998 and 2003.
Secondary analyses of multi-stage probability samples of community residents (n(1998)=37,580 and n(2003)=36,088) obtained from repeat administrations of an Australian population survey.
Proportionally, fewer people with affective or anxiety disorders were employed compared with well controls. Extent of employment restrictions, sex, age left school, country of birth, age and educational attainment were strong correlates of labour force participation and current employment. These effects were stable despite improved labour market conditions in 2003.
These results can inform decisions about access to substantial forms of employment assistance. Subgroups of people with anxiety and depression, with severe employment restrictions, low education, low language proficiency, aged 15-24 years, or aged 55 years or more, may require greater access to substantial employment assistance.
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ABSTRACT: OBJECTIVE Studies of the demographic and clinical correlates of employment activity have proven useful for identifying employment assistance needs among people with severe and persistent mental illness. However, the results of prior studies remain unclear, and most reviews of prior studies have not differentiated competitive from noncompetitive employment. This study attempted to clarify the relative strength and consistency of correlates of competitive versus noncompetitive employment. METHODS Data were drawn from a population-based survey of Australian adults with psychotic disorders between March and December 2010. Demographic, clinical, and employment assistance correlates of competitive and noncompetitive employment were compared. The sample comprised 1,825 participants who agreed to face-to-face interviews. RESULTS A total of 408 (22.3%) participants were employed in the previous four weeks, 330 (18.1%) in competitive employment and 78 (4.3%) in noncompetitive employment. Those in competitive employment were more likely to be female and aged 18-34, to have a partner, to have received formal vocational training or education after high school, and to have no literacy difficulties. Better global functioning, shorter illness duration, less severe course of illness, and affective versus nonaffective psychosis were associated with a greater likelihood of competitive employment. Those using Australian government employment services were less likely to be in competitive employment, suggesting a service provider preference for noncompetitive employment. CONCLUSIONS Four times as many employees were in competitive employment than in noncompetitive employment. The negative relationship between employment assistance and competitive employment highlights the urgent need to improve the effectiveness of Australian employment services for people with severe mental illnesses.Psychiatric services (Washington, D.C.) 12/2013; 65(4). DOI:10.1176/appi.ps.201300096 · 1.99 Impact Factor
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ABSTRACT: The peak years of offending in the general population and among those with serious mental health conditions (SMHC) are during emerging adulthood. There currently are no evidence-based interventions for reducing offending behavior among 18-21 year olds, with or without SMHC. This open trial examined outcomes from an adaptation of Multisystemic Therapy (MST), an effective juvenile recidivism reduction intervention, modified for use with emerging adults with SMHC and recent justice system involvement. MST for emerging adults (MST-EA) targets MH symptoms, recidivism, problem substance use, and young adult functional capacities. All study participants (n = 41) were aged 17-20 and had a MH diagnosis and recent arrest or incarceration. Implementation outcomes indicated that MST-EA was delivered with strong fidelity, client satisfaction was high, and the majority of participants successfully completed the intervention. Research retention rates also were high. Pre-post-analyses revealed significant reductions in participants' MH symptoms, justice system involvement, and associations with antisocial peers.The Journal of Behavioral Health Services & Research 07/2014; DOI:10.1007/s11414-014-9425-8 · 1.03 Impact Factor
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ABSTRACT: Objective:Innovative models of care for people with a severe mental illness have been developed across Australia to more effectively address comorbidity and disability by enhancing the collaboration between clinical and non-clinical services. In particular, this review paper focuses on collaboration that has occurred to address comorbidities affecting the following domains: homelessness; substance addiction; physical ill-health; unemployment; and forensic issues.Method:The identification of relevant collaborative care models was facilitated by carrying out a review of the published peer-reviewed literature and policy or other published reports available on the Internet. Contact was also made with representatives of the mental health branches of each Australian state and territory health department to assist in identifying examples of innovative collaborative care models established within their jurisdiction.Results:A number of nationally implemented and local examples of collaborative care models were identified that have successfully delivered enhanced integration of care between clinical and non-clinical services. Several key principles for effective collaboration were also identified. Governmental and organisational promotion of and incentives for cross-sector collaboration is needed along with education for staff about comorbidity and the capacity of cross-sector agencies to work in collaboration to support shared clients. Enhanced communication has been achieved through mechanisms such as the co-location of staff from different agencies to enhance sharing of expertise and interagency continuity of care, shared treatment plans and client records, and shared case review meetings. Promoting a 'housing first approach' with cross-sector services collaborating to stabilise housing as the basis for sustained clinical engagement has also been successful.Conclusions:Cross-sector collaboration is achievable and can result in significant benefits for mental health consumers and staff of collaborating services. Expanding the availability of collaborative care across Australia is therefore a priority for achieving a more holistic, socially inclusive, and effective mental health care system.Australian and New Zealand Journal of Psychiatry 10/2012; 47(4). DOI:10.1177/0004867412463975 · 3.77 Impact Factor