# Functional improvement is a better predictor of steady work than medical improvement for individuals with mental health conditions

**Authors:** Joshua C. Chang, Julia Porcino, Elizabeth Marfeo, Larry Tang, Howard Goldman, Elizabeth Rasch, David Onchonga, David Onchonga, David Onchonga

PMC · DOI: 10.1371/journal.pmen.0000384 · 2025-08-05

## TL;DR

Functional improvement, not medical improvement, better predicts steady work for people with mental health conditions.

## Contribution

Shows functional improvement is a more reliable predictor of employment success than medical improvement in mental health.

## Key findings

- Functional improvement better predicts steady work than medical improvement.
- Bayesian and neural network models confirmed the stronger predictive power of functional improvement.
- Supported Employment Demonstration showed benefits of functional assessments in vocational outcomes.

## Abstract

The Supported Employment Demonstration (SED) offered vocational and mental health services to recently denied disability benefit applicants with mental health conditions, along with other multiple co-morbidities, to evaluate the impact of evidence-based interventions on fostering employment and downstream benefits such as self-sufficiency, improved quality of life, and improved mental health. Using the SED public use file, we analyzed work outcomes for the study participants in relation to functional improvement, as measured by the Work Disability Functional Assessment Battery, vs. medical improvement. Using both Bayesian logistic regression models and neural networks, we found that functional improvement is a better predictor of steady work than medical improvement.

## Figures

9 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12798178/full.md

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Source: https://tomesphere.com/paper/PMC12798178