Effectiveness of vocational rehabilitation programs carried out according to the Emilia-Romagna Regional Act 14/2015

The aim of this retrospective observational study was to measure the effectiveness of VRPs carried out in an Italian Community Mental Health Center (CMHC) according to the regional Act 14/2015. As far as clinical variables are concerned, we compared a group of patients included in vocational rehabilitation according to the Regional Act 14/2015 (exposed, group A and B) with a non-experimental group of patients of the same CMHC who were not included in such programs (not exposed, group C). Among the exposed, we distinguished between those who successfully ended the VRP with employment (group A) and those who dropped out (group B). Statistics were carried out by means of simple and multiple binary logistic regressions, and Student’s t-test. A total of 117 patients were enrolled in this study, divided into three groups: group A (N.=57), group B (N.=19), and group C (N.=41). It was noted that none of the users had organic comorbidities. We found that having a Social Services caseworker allocated was associated with higher odds of being included in group A (OR=11.49, 95% CI: 3.56-37.03), while receiving long-acting antipsychotic therapy was negatively associated with the same outcome (OR=0.19, 95% CI: 0.05-0.67). Notably, patients included in VRPs did not need compulsory admissions during the follow-up period. As far as group A is concerned, the number of visits at the CMHC decreased for 61% of the individuals, and drug prescription decreased or remained stable for 75% of the patients. Notably, in this group, the mean number of visits to the CMHC significantly reduced after the beginning of VRPs (t=2.32, P=0.03). Our data indicate that VRPs can promote clinical stabilization for CMHCs users, which has been confirmed by the international literature.