Case management-integrated supported employment for individuals with schizophrenia: a 3-year longitudinal study in China

Background Although case management (CM) and supported employment (SE) have each demonstrated effectiveness for individuals with schizophrenia, evidence on their long-term combined effects remains limited, particularly in real-world settings. Methods This 3-year longitudinal randomized study enrolled 60 patients with schizophrenia. Participants were randomly assigned in a 1:1 ratio to a CM-integrated SE (CM-SE) group (n = 30) or an independent employment (IE) group (n = 30). Employment stability, psychiatric symptoms (PANSS), and perceived social support (PSSS) were assessed at baseline, 12, 24, and 36 months. Results The CM-SE group demonstrated significantly longer cumulative employment duration (median 25.0 vs 15.0 months, P<0.001), greater improvements in PANSS scores (time×group interaction, P<0.001), and progressively enhanced PSSS scores (time×group interaction, P<0.001) compared to the IE group. Conclusions The CM-SE model significantly improves long-term employment stability, psychiatric symptoms, and social support in individuals with schizophrenia, supporting its implementation as an integrated psychosocial rehabilitation strategy.