Objective: To investigate predictors for competitive employment in a three-year follow-up study of discharged schizophrenia patients.
Methods: The nationally representative sample comprised 2168 schizophrenia patients aged 15-64 years, who had been discharged from psychiatric hospitals in 1986, 1990, and 1994 in Finland. Comprehensive data were collected from psychiatric case records on the patients' sociodemographic and clinical characteristics at discharge and use of services during the follow-up period. The patients were interviewed 3 years after discharge using a structured interview schedule, which included questions on employment.
Results: At follow-up, the competitive employment rate declined among the three cohorts (1989: 7.4%, 1993: 2.6% and 1997: 1.5%), whereas the rate of non-competitive employment remained at the same level (8.4%, 7.2% and 9.6%). The probability of competitive employment was higher for those who, at the time of discharge, were not on disability pension and had a current or past history of marriage, and had been discharged in the late 1980s. The probability of being competitively employed was lower for those who had no occupation at discharge and for those who had spent more time in hospital care during the three years after discharge.
Conclusions: The high unemployment rate and continuous changes in work life, which characterized Finland in the 1990s may have negatively affected the employment prospects of schizophrenia patients. Work rehabilitation should be more commonly offered, to increase their opportunities for obtaining competitive employment and for improving their quality of life.