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What predicts supported employment program outcomes?

Deborah R Becker¹, Haiyi Xie, Gregory J McHugo

¹Dartmouth Medical School, Hanover, NH, USA. deborah.r.becker@dartmouth.edu

Community Mental Health Journal

|March 15, 2006

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Supported employment programs for individuals with serious mental illness show varied access and success rates. Improving funding and evidence-based implementation are key to enhancing competitive employment outcomes.

Area of Science:

Psychiatry
Rehabilitation Medicine
Health Services Research

Background:

Supported employment (SE) is a key intervention for vocational rehabilitation of individuals with serious mental illness (SMI).
Implementation of SE varies across state and local mental health and vocational rehabilitation programs.
Understanding factors influencing SE access and competitive employment rates is crucial for program improvement.

Purpose of the Study:

To survey mental health agencies and federal-state vocational rehabilitation partnerships to identify differences in SE service access.
To determine rates of competitive employment (efficiency) among individuals with SMI participating in SE programs.
To identify predictors of both access to and efficiency of SE services.

Main Methods:

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A cross-sectional survey was conducted with 26 mental health agencies.

Data collected included access to SE services, competitive employment rates, and agency characteristics.

Statistical analysis explored relationships between agency funding, SE specialist staffing, evidence-based SE component implementation, local unemployment rates, and SE outcomes.

Main Results:

Access to SE services varied significantly (2% to 100%) and was associated with the proportion of SE specialists relative to consumers with SMI (funding).
Competitive employment efficiency ranged from 7% to 75% and was linked to the implementation of critical evidence-based SE components and local unemployment rates.
Agency funding and the quality of SE implementation emerged as significant predictors of program success.

Conclusions:

Consolidating resources within SE programs can improve client access to services.
Enhancing the quality of SE implementation, particularly adherence to evidence-based practices, is vital for increasing competitive employment outcomes for individuals with SMI.
Addressing both resource allocation and implementation fidelity is recommended for state systems and local programs aiming to support employment for mental health clients.