Randomised controlled trials (RCTs), controlled clinical trials, pre-post studies with longitudinal follow-up and case series in unemployed adults aged between 18 and 65 years with mental distress complaints or distress were eligible for inclusion. Eligible studies were required to assess interventions aimed at return to work, resuming work, job application and/or improved functioning (excluding trials using drugs as the primary intervention) and to measure distress pre- and post-intervention.
Included studies were conducted in Australia, USA and Finland. Participants were unemployed for 4.11 weeks up to one year. Where reported, mean age ranged from 33 to 37 years. Some patients were categorised as low or high risk respondents (high risk was defined as higher depression score and financial strain and lower assertiveness score). All studies were of group interventions. Some studies used similar interventions, which included training courses or workshops to increase motivation and enhance job-search skills and self-efficacy for re-employment; some included subsidised employment. Study durations ranged from one week to six months. Controls were added to a training course waiting list, received booklets or literature packs on job-search methods or received no intervention, or were non-study participants. Primary outcomes were employment status and functioning (role and emotional). Secondary outcomes included psychological distress (mostly measured using the 12- or 20-item General Health Questionnaire). Post-intervention measurements ranged from three months to two years.
Two reviewers independently selected studies for inclusion. Disagreements were referred to a third reviewer.