Work as treatment? The effectiveness of re-employment programmes for unemployed persons with severe mental health problems on health and quality of life: a systematic review and meta-analysis
Abstract
Given the importance of unemployment in health inequalities, re-employment of unemployed persons into paid employment may be a powerful intervention to increase population health. It is suggested that integrated programmes of vocational reintegration with health promotion may improve the likelihood of entering paid employment of long-term unemployed persons with severe mental health problems. However, the current evidence regarding whether entering paid employment of this population will contribute to a reduction in health problems remains unambiguous. This systematic review and meta-analysis aimed to assess the effects of re-employment programmes with regard to health and quality of life. Three electronic databases were searched (up to March 2015). Two reviewers independently selected articles and assessed the risk of bias on prespecified criteria. Measures of effects were pooled and random effect meta-analysis of randomised controlled trials was conducted, where possible. Sixteen studies were included. Nine studies described functioning as an outcome measure. Five studies with six comparisons provided enough information to calculate a pooled effect size of -0.01 (95% CI -0.13 to 0.11). Fifteen studies presented mental health as an outcome measure of which six with comparable psychiatric symptoms resulted in a pooled effect size of 0.20 (95% CI -0.23 to 0.62). Thirteen studies described quality of life as an outcome measure. Seven of these studies, describing eight comparisons, provided enough information to calculate a pooled effect size of 0.28 (95% CI 0.04 to 0.52). Re-employment programmes have a modest positive effect on the quality of life. No evidence was found for any effect of these re-employment programmes on functioning and mental health.
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A prior meta-analysis found no significant effect on mental health symptoms (d = -0.20, 95% CI [-0.62, 0.23]).
“or mental health symptoms (d = -0.20, 95%CI = [-0.62, 0.23]).”
From Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support (2019) · cites this paper as [53]
A prior meta-analysis found no significant effect on global functioning (d = -0.01, 95% CI [-0.13, -0.11]).
“but no significant effects on global functioning (d = -0.01, 95%CI = [-0.13, -0.11])”
From Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support (2019) · cites this paper as [53]
A prior meta-analysis found a significant effect on quality of life, with those in IPS having a higher level (d = 0.28, 95% CI [0.04, 0.52]).
“The researchers found a significant effect on quality of life with those in IPS having a higher level (d = 0.28, 95%CI = [0.04, 0.52])”
From Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support (2019) · cites this paper as [53]
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- Authors
- van Rijn, R. M., Carlier, B. E., Schuring, M., & Burdorf, A.
- Affiliations
- Erasmus MC (NL)
- Venue
- Occupational and Environmental Medicine
- Publisher
- BMJ
- Published
- 2016-01-06
- Volume
- 73
- Issue
- 4
- Pages
- 275-279
- ISSN
- 0007-1072 (ISSN-L)
- 1351-0711
- 1470-7926
- OpenAlex
- W2230236165
- Cited by
- 60
- References
- 48
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 8 · 2023: 6 · 2022: 6 · 2021: 4 · 2020: 13 · 2019: 8 · 2018: 5 · 2017: 4
- FWCI
- 1.08
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Occupational and Environmental Medicine (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Employment and Welfare Studies
- Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
- Social Sciences › Safety Research › Disability Education and Employment
- Keywords
- long-term unemployment, severe mental illness, vocational reintegration, health promotion, employment, quality of life, mental health, functioning, health disparities
- MeSH terms
- Mental Disorders, Humans, Mental Health, Quality of Life, Unemployment, Work
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