Does cognitive remediation improve employment prospects for people with a mental illness returning to work?

INTERVENTION: Cognitive Remediation ‐ Internet delivered Cognitive Remediation aiming to improve deficits in attention, concentration, vigilance, memory, speed of processing, planning skills & facial emotion recognition. The treatment will be delivered twice weekly for 45‐60 minutes for at least 10 weeks. Treatment can continue for up to 16 weeks. The duration of treatment within that time frame is at the behest of the individual concerned. Supported Employment ‐ participants will be case managed by vocational employment officers at a ratio of no more than 20 cases per case manager and placed and supported in educational or employment opportunities as it becomes available. CONDITION: Bipolar 1 Disorder Delusional Disorder Major Depressive Disorder with Psychotic features Psychosis Not Otherwise Stated Schizoaffective disorder Schizophrenia Schizophreniform Disorder PRIMARY OUTCOME: Total number of hours worked ‐ assessed at 6 months by detailed log of work performed including paysheets of participants on the basis of figures reported to DEWR. Assessed at 12 months on the basis of a detailed log of work performed. SECONDARY OUTCOME: Change in cognition will be measured using web‐based neuropsychiatric testing. Each cognitive domain listed below will be tested and any improvement in cognition measured via web‐delivered neuropsychiatric testing will include the following:‐ ; Emotion Identification ‐ Explicit Emotion Identification ; Emotion Recognition ‐ Implicit Emotion Recognition ; Response Speed ‐ Motor Tapping ; Impulsivity ‐ Go‐NoGo ; Attention‐Concentration ‐ Continuous Performance Test ; Information Processing Efficiency ‐ Switching of Attention, Verbal Interference, Choice Reaction Time ; Memory ‐ Digit Span, Memory Recognition ; Executive Function ‐ Maze Number of contacts with Supported Employment service over 12 months ; On the basis of Contacts register and notes at Disability Employment Service Office Number of readmissions to hospital ‐ On the basis of participant report Role Functioning Scale score ‐ on the basis of supported employment officer reports Total number of days in work over 12 months. ; Measured on basis of participant log and report of Supported Employment case manager using all available data including payslips Total number of jobs over 12 months ; Measured on basis of participant log and report of Supported Employment case manager using all available data including payslips Total wages over 12 months ; Measured on basis of participant log and report of Supported Employment case manager using all available data including payslips INCLUSION CRITERIA: 1. Eligible for the employment program 2. Had given consent to take part in the program 3. a diagnosis of a severe mental illness as defined as schizophrenia, schizophreniform disorder, bipolar disorder, psychotic depression 4. age between 18 and 65 years 5. not developmentally delayed 6. no current substance dependence other than nicotine and caffeine