Assessing the underutilization of supported employment services

Area of Science:

• Psychiatry
• Rehabilitation Medicine
• Health Services Research

Background:

• Supported Employment Services (SES) are evidence-based interventions for individuals with psychiatric disabilities.
• Despite demonstrated effectiveness, SES are often underutilized in clinical practice.

Purpose of the Study:

• To evaluate the extent of SES underutilization in urban and suburban agencies serving individuals with psychiatric disabilities.
• To examine the concordance between consumer intentions to accept SES referrals and practitioner intentions to provide them.

Main Methods:

• A study involving 269 unemployed consumers with psychiatric disabilities and 54 practitioners.
• Data collection focused on intentions to accept or provide SES referrals within a 6-month period.
• Analysis of concordance rates and contributing factors to referral intentions.

Main Results:

• A 55% concordance rate was observed between consumer and practitioner intentions regarding SES referrals.
• An overall underutilization rate of 28% was identified across combined urban and suburban agencies.
• Consumer intentions to accept referrals (49%) significantly differed from practitioner intentions to refer (21%).

Conclusions:

• Significant underutilization of SES exists, stemming from a discordance between consumer needs and practitioner referrals.
• Differing perspectives on the importance of an individual's felt need to work may contribute to low concordance rates.
• Interventions to improve SES utilization should address these differing perspectives to enhance service access for psychiatric disability populations.