The effects of a stigma awareness intervention on finding and retaining paid employment a cluster randomized controlled trial among unemployed people with mental illness

Introduction:
Stigma is one of the barriers to paid employment for people with mental illness. Deliberate (non-)disclosure decisions may prevent this, but the effects of stigma awareness interventions are mostly unknown. This study aims to examine the effectiveness of a stigma awareness intervention for employment specialists and a decision aid and two infographics about disclosure of mental illness on finding and retaining employment for unemployed people with mental illness, compared to usual guidance.

Material and methods:
A clustered RCT was conducted. Participants were unemployed people with mental illness who receive social benefits (N=153) and were recruited at eight locations. The control group received guidance as usual and the experimental group received guidance as usual combined with the stigma awareness intervention. Health, wellbeing, job seeking activities and disclosure were measured at baseline and 3, 6 and 12 months. Multilevel analyses were conducted to analyze the effects of the intervention on finding and retaining employment, controlled for other factors.

Results:
In the experimental group, after six (T2) and twelve months (T3) almost twice as many participants had found paid employment (T2: CG=26.1% vs EG=50.7%, p=0.003; T3: CG=34.4% vs EG=53.8%, p=0.026), and retained paid employment after twelve months (CG=23.4% vs EG=49.2%, p=0.002), compared to the control group.

Conclusions:
A stigma awareness intervention contributes to more often finding and retaining paid employment for people with mental illness.