Are financial burdens compromising the recovery goals of EIP programs?

In brief

One of the goals of early intervention for psychosis (EIP) services is to enable clients to make a full recovery. This includes finding and holding a job after being diagnosed with a psychotic disorder, facilitating a return to school, or promoting long-term career planning.

When people receiving EIP services experience financial insecurity, they may rely on government disability income: financial support for those who can’t get or hold jobs due to their mental illness. But while this income can help individuals deal with the financial burdens of their mental illness, it can also discourage them from seeking or keeping a job and other career development activities.

Researchers from Ontario tracked 558 people served by EIP programs over the first five years of their involvement with EIP services. To find out the results of this research read EENet's Research Snapshot of the article, “Early Intervention Services for Psychosis and Time Until Application for Disability Income Support: A Survival Analysis,” by Terry Krupa and colleagues. The article was published in the Community Mental Health Journal, vol. 348, no. 5.

Research Snapshots are brief, clear language summaries of research articles, presented in a user-friendly format.

Read it below or download the PDF.

What you need to know

30% of people using early intervention for psychosis (EIP) services apply for government disability income within 1 year. While financial security is very important, government disability income can have negative effects on a person’s likelihood of looking for or holding a job and on their long-term career prospects.

What is this research about?

One of the goals of early intervention for psychosis (EIP) services is to enable the full social and occupational recovery of clients. This can include helping clients to find and hold a job after being diagnosed with a psychotic disorder, facilitating a return to school, or promoting long-term career planning. When people receiving EIP services experience financial insecurity they may rely on government disability income: financial support for those who can’t get or hold jobs due to their mental illness. But while this income can help deal with the financial burdens of mental illness, it can also discourage a person from seeking or keeping a job and other career development activities.

What did the researchers do?

Researchers from Ontario looked at 558 people served by EIP programs. The patients were 16-40 years old, and from either a large metropolitan area, a large city, a medium sized city, or a small city in Ontario. The researchers tracked these people over the first 5 years of their involvement with EIP services to see whether they applied to government disability income.

What did the researchers find?

After the 1st year of entering EIP services, 30% of people had already applied for disability income. It is estimated that more than 60% of patients will make an application for this government support within 5 years of entering EIP services.

Hospitalization and financial dependence on others were major factors that predicted if a person would apply for government income. Whether a person was engaged in some form of productivity activity (such as work, school, parenting) at the time of entry to the service also predicted their application for government support.

How can you use this research?

This study may interest service providers of EIP. The researchers recommend that EIP programs develop best practice guidelines related to the occupational recovery and financial security of people served. EIP programs should:

  • Provide intensive family support, psycho-education and financial counselling at the outset of entry to EIP;
  • Provide targeted vocational assessment, counselling and support as early as possible;
  • Advocate for time-limited government financial support; and
  • Provide pharmacotherapy to enable a safe and meaningful life in the community.

Potential limitations

This study analyzes data of disability income application and not receipt, which may have offered different results. Some info, like social or occupational supports and cost of medications, was excluded. Finally, the findings are specific to Ontario and need to be interpreted in other contexts. 

About the researchers

Terry Krupa is a Professor in the School of Rehabilitation Therapy at Queen’s University in Kingston, ON. Kola Oyewumi is a Professor in Psychiatry, Pharmacology & Toxicology at Queen’s University in Kingston, ON. Suzanne Archie is an Associate Professor with the Department of Psychiatry and Behavioural Neurosciences at McMaster University in Hamilton, ON. J. Stuart Lawson is an Emeritus Professor in Providence Care and Mental Health Services at Queen’s University, Kingston, ON. Joan Nandlal is the Director of the John Howard Society of Waterloo-Wellington in Kitchener, ON and an Associate Professor in Psychiatry at the University of Toronto. Gretchen Conrad is a Clinical Psychologist at the Ottawa Hospital in Ottawa, ON.

This Research Snapshot is based on, “Early Intervention Services for Psychosis and Time Until Application for Disability Income Support: A Survival Analysis,” which was published in the Community Mental Health Journal, online (2012).

Keywords

First episode psychosis, recovery, socio-economic status, early intervention

This Research Snapshot is based on an article that has been critically appraised for quality and susceptibility to bias.

EENet has partnered with the Knowledge Mobilization Unit at York University to produce Research Snapshots in the field of mental health and addictions in Ontario. This summary was written by Maia Miller.

 

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