Individual Placement And Support Services Boost Employment For People With Serious Mental Illnesses, But Funding Is Lacking

Abstract

The majority of people with serious mental illnesses want to work. Individual placement and support services, an evidence-based supported employment intervention, enables about 60 percent of people with serious mental illnesses who receive the services to gain competitive employment and improve their lives, but the approach does not lead to fewer people on government-funded disability rolls. Yet individual placement and support employment services are still unavailable to a large majority of people with serious mental illnesses in the United States. Disability policies and lack of a simple funding mechanism remain the chief barriers. A recent federal emphasis on early-intervention programs may increase access to employment services for people with early psychosis, but whether these interventions will prevent disability over time is unknown.

Simulations Test Impact Of Education, Employment, And Income Improvements On Minority Patients With Mental Illness

“…Our findings regarding employment are consistent with the results of numerous randomized controlled trials showing that supported employment helps people with severe mental illness not only work but also manage symptoms and improve quality of life. 17,43 Our findings regarding racial/ethnic minority groups show that their members typically benefited as much from employment as did non-Latino whites. Latinos and Asians with common mental disorders were an exception.…”

“…Our simulation research, along with randomized controlled trials of supported employment, 17 suggests that improving employment among disadvantaged groups with mental disorders is correlated with improved mental health outcomes. Because service agencies and organizations protect their funding silos, government action to combine health care and social services in ways that benefit patients and society will be necessary.…”

“…We simulated the effect of employment by giving employment to 60 percent of the unemployed, which is a typical gain for unemployed clients with mental illness who enter supported employment programs in the United States. 17 For income, we added $10,000 to annual household income (similar to federal disability income) for all people with common mental disorders—and as a test of sensitivity, we added $20,000 instead (for the results of the sensitivity analysis, see Appendix Exhibits A3 and A4). 34 …”

“…54 A specific evidence-based model of supported employment has been developed and validated for people with severe mental disorders such as schizophrenia and bipolar disorder, but such services are poorly funded. 17 No comparable model of integrated mental health care and vocational services has emerged for adults with common mental disorders such as anxiety and depression, which are more prevalent; however, research is developing in this area. 44 Research on integrated employment and mental health interventions for people with nonsevere mental health problems, particularly for members of racial/ethnic minority groups, should continue.…”

“…Some combine mental health treatments with supported education, 16 supported employment, 17 housing supported by case management, 18 family assistance, 19 or income supports. 20 In all of these models, integration ensures that the message, approach, and goals are consistent with treating the whole person rather than solely the illness.…”