History: 

Supported employment was first introduced into the mental health settings in the 1980's, and has continued to be an important factor for the recovery for people with severe mental illnesses. Researcher Wehman first developed the supported employment model in 1986.  Throughout the years, different models have evolved to serve the severely and persistently mentally ill, such as work crews, sheltered workshops, clubhouse and enclave (Barker, 1994).  Numerous ranomized controlled trials have indicated that the supported employment model, specifically the manual-based Individual Placement and Support (IPS) model are efficacious (Twamley, 2003).   

The following are the basic components the evidence-based model Individual Placement and Support (IPS) Model:      

Basic Components for IPS Model (Bond, 2001):

• The agency is "committed to competitive employment as an attainable goal for its clients with severe mental illness", and thus allocates the resources to competitive employment rather than to day treatment or sheltered workshops (pp. 315).
• SE programs rapidly search to get clients work quickly, opposed to prevocational training, assessments and counseling.
• Job placements are found to complement the client's strengths, previous work history and his or her preference.  SE placements are non-coercive.  
• Follow up/supports are indefinite

Possible Areas of Barriers Include:

• Culture and Language
• Clients often leave their work or limit their hours in order to avoid jeopardizing Social Security and Medicaid benefits

Research:

• Employment for persons who are diagnosed with Schizophrenia has been identified as an "unmet need" where only one in five people diagnosed with Schizophrenia have successfully worked in "full-time competitive employment and fewer than 50% have worked at all" (Giola & Brekke, 2003, pp. 59). 
• For any person, holding a job fulfills developmental, clinical and economic needs.  Yet, people with schizophrenia may have functional limiations (i.e., cognitive, social, physical and emotional), which make being employed more difficult.
• Persons diagnosed with schizophrenia have been cited as the number one reason why people leave their jobs because of interpersonable and emotional problems relating to their mental illness. 

• The American Disabilties Act of 1990 prohibits discrimination based upon a disability and this includes schizophrenia.  People with schizophrenia may not be aware of their rights, and they may be afraid of their employer's reaction if they found out about the mental illness.  Unfortunately, this fear is based on some reality;  A published year-2000 study found that pre-interview application materials influenced employer's perceptions of who would make the best candidate for an administration job.  Most employers favored a non-disabled person over the vignettes offered, including someone who had schizophrenia (Bricout & Bentley, 2000)! 
• Advocates, clients, families and others need to digest this form of discrimination and work towards justice.