It Is Not Only Competitive Employment That Counts: Findings From a Longitudinal Panel of People With Severe Mental Illness

Objective: Being engaged in work and social activities is associated with a better quality of life. However, little evidence is available on the relationship between different categories of social participation and quality of life in people with severe mental illnesses. Furthermore, longitudinal studies considering this relationship in people with severe mental illnesses (SMI) are scarce. This study attempts to fill this gap by exploring whether and how different categories of social participation and quality of life were associated over a period of 4 years. Method: The association between social participation activities and quality of life was analyzed with linear mixed models, using data from a Dutch national panel of people with SMI. Four annual waves including self-reported measures were used. Three categories of participation were assessed: paid employment, voluntary work, outside social activities. Results: From 2015 to 2018, 1.682 panel members (18–75 years old) participated in the survey. All three participation variables show a unique significant positive association with quality of life. Controlling for covariates (age, sex, and mental health) comparable regression coefficients were found: paid employment,.208, 95% CI [.090–.326], voluntary work,.210, 95% CI [.120–.300], and outside social activities,.239, 95% CI [.154–.324]. Conclusions and Implications for Practice: The value of participation for people with SMI seems to be not restricted to competitive employment. Engagement in paid employment, voluntary work, and performing outside social activities each have a comparable and additional positive association with quality of life. Therefore, rehabilitation professionals should pay attention to social participation activities in a broad range.