What Predicts Supported Employment Program Outcomes?

Abstract

Numerous state systems and local mental health and vocational rehabilitation programs are currently attempting to implement supported employment. This cross-sectional survey of 26 mental health agencies, partnering with federal-state vocational rehabilitation, identified differences in access to supported employment services and rates of competitive employment (efficiency) as well as predictors of access and efficiency. Access varied from 2 to 100% and was related to the percentage of supported employment specialists per consumers with serious mental illness served by the mental health agency (funding). Efficiency varied from 7 to 75% and was related to implementation of the critical components of evidence-based supported employment and to the local unemployment rate. To help mental health clients achieve their employment goals, state systems and local programs should address consolidation of resources in supported employment and the quality of implementation of supported employment.

The 2009 Schizophrenia PORT Psychosocial Treatment Recommendations and Summary Statements

“…There is clear evidence that employment outcomes are better when there is greater fidelity to the supported employment model (ie, more of these components are in place), eg, Becker et al, 57 Becker et al, 58 Catty et al, 59 and Mcgrew et al 60 While greater integration of mental health services and vocational services is associated with better outcomes, 54 the individual effectiveness of the other elements of supported employment has not been demonstrated. Thus, it is recommended that supported employment programs make every effort to incorporate all aspects of this treatment model.…”

Service users' perceptions of the effective ingredients in supported employment

“…They found distinctive differences between high performing and low performing programmes, such as staff in high performing programmes holding positive views about the value of work and about clients' ability to work. However, most studies examining the factors of supported employment have compared client outcomes with characteristics of the service (Becker et al, 2006;Jones et al, 2001), rather than gaining stakeholders' views.…”

Methods of a multisite randomized clinical trial of supported employment among veterans with spinal cord injury

“…The primary outcome measure is the rate of CE among study participants. CE is defined as "community jobs that pay at least minimum wage (paid directly by the employer to the employee) that any person can apply for, including full-time and part-time jobs" [23]. Employment data are collected every 3 months and include weekly documentation of employment status, job title, wages, hours actually worked, hours missed, type of leave used (reflecting benefits such as paid vacation or sick time), and reasons for missing any work (medical or nonmedical).…”

“…During site visits, consultant trainers gather data on program fidelity through semistructured interviews with consumers, employers, clinicians, program managers, healthcare team members, administrative management and leadership; chart reviews; and observation of team meetings. The scale has been widely used and is consistently linked with employment outcomes among programs that serve persons with mental illness [23,[48][49]. To our knowledge, this is the first time fidelity assessments have been performed with a population with physical disabilities.…”