Pathways to vocational services: Factors affecting entry by veterans enrolled in Veterans Health Administration mental health services.

Abstract

The current study provides naturalistic data documenting the pathways-to-care to vocational services for 155 veterans who were receiving some form of mental health care from the Veterans Health Administration and had a vocational need but were not currently enrolled in vocational services. Of the participants, 94.2% had recognized their vocational need, 80.6% reported that they or someone else had sought help to alleviate the need, and 77.4% had previously received some form of vocational services. The median length of the participants' vocational need was more than 4.2 years. Delays associated with recognition, help-seeking, and treatment entry all contributed to the overall delay in entering appropriate care. Filtering factors associated with quicker recognition, seeking help, and receiving services included diagnosis, level of disability, type of vocational need, and support from primary providers, family, and friends. The results provide information for designing interventions to improve service entry by adults with mental health problems and vocational needs.

Receipt of employment services among Veterans Health Administration users with psychiatric diagnoses

“…Overall, findings suggest that only a small percentage of VHA users with psychiatric diagnoses access employment services in a given year-a finding that is consistent with a prior report [17][18][19]. In this representative sample, VHA users with psychiatric diagnoses of schizophrenia had higher odds of accessing any employment services relative to VHA users with other psychiatric diagnoses, including PTSD, depression, and other anxiety disorders, but did not differ in their odds of accessing employment services as compared with VHA users with bipolar disorder.…”

“…Prior analyses identified the number of Veterans who participated in employment services relative to the total number of VHA users with psychiatric diagnoses in fiscal year (FY) 2009 and found that only 3.5 percent of Veterans with a psychiatric diagnosis received employment services [17][18][19]. Although it cannot be assumed that all Veterans with psychiatric diagnoses who use the VHA have a need for employment services, a recent independent multimethod evaluation suggested a substantial unmet need for employment services among VHA users with psychiatric diagnoses.…”

Enhanced vocational rehabilitation for Veterans with mild traumatic brain injury and mental illness: Pilot study

“…Despite the promise and availability of vocational rehabilitation for Veterans, not all individuals benefit, with many dropping out or being unable to obtain and retain competitive employment over the course of a year [21,31,39]. These findings suggest that efforts to enhance the outcome of vocational services for Veterans are needed.…”

“…Unfortunately, despite the many benefits of employment, Veterans and civilians who experience mTBI and/ or have MI often have significant difficulty getting their vocational needs met [10,[21][22][23][24]. Work plays a significant role in how people identify themselves and how they are described by their families, communities, and society.…”

“…In TWE programs, temporary jobs are provided for the Veteran on a time-limited basis while staff assist the Veteran to address issues that hinder competitive employment (lack of job search skills, interpersonal skill development, etc.) and provide assistance with the competitive job search [21,38]. SE and TWE are national Department of Veterans Affairs (VA) vocational rehabilitation models that share the goal of helping Veterans overcome barriers to successful return to competitive employment.…”