Quality of Life and Competitive Work Among Adults With Severe Mental Illness: Moderating Effects of Family Contact

Objective

Competitive employment may improve life quality for adults with severe mental illness, but it is not known for whom or under what circumstances. On the basis of previous research demonstrating benefits of family contact for African-American adults with severe mental illness, it was hypothesized that frequent family contact would moderate (enhance) a positive association between competitive employment and global quality of life for a rural sample of predominantly African-American adults.

Methods

In a secondary analysis of data collected from a randomized trial of supported employment, a series of nested random regression analyses was conducted to test the hypothesized moderating effect of face-to-face family contact on the association between competitive employment and global quality of life, controlling for severity of psychiatric symptoms and satisfaction with family relations.

Results

Most of the 143 study participants spent time with a family member at least once a month (80%)—and most at least weekly (60%). Participants who held a competitive job and had face-to-face contact with family members at least weekly reported higher global quality of life than all other study participants.

Conclusions

In this rural sample of African-American adults with severe mental illness, competitive work was associated with higher global quality of life only for those who frequently spent time with family members. Research is needed to test the generalizability of this finding to other geographic settings and cultures, as well as the feasibility and effectiveness of formal inclusion of family members in psychosocial rehabilitation interventions.