Black / African American

Clients with a co-occurring substance use disorder were 52% less likely to enroll in a supported employment program. However, of those that did enter the program, the competitive employment outcomes for both groups was similar.

Consumers with CJI take longer to access SE services. Consumers with CJI and service providers identify the following as barriers or facilitators to access to SE: competing challenges for consumers with CJI such as mental health probation, the adverse impact of CJI on consumers' psychosocial functioning, social networks, consumers' relationships with practitioners, and practitioners' relationship with SE.

Of 148 participants in the project, 114 (77%) were employed at some point during the project. They held a total of 278 jobs during the project, averaging 2.4 jobs per participant. Sixty-three percent of participants were employed for 90 days or longer during the project, Earnings ranged from $2.50 per hour to $44.23 per hour, with an average hourly wage of $8.49 (median $7.50/hour). Of the 278 jobs, only 4 paid less than minimum wage. The vast majority of all jobs obtained (87.4%) did not include any benefits at any time.

During the 18-month study period, participants receiving IPS were more likely than those in EVR to obtain competitive employment. IPS participants "also had superior outcomes in other dimensions of competitive employment" (p. 629). In addition, IPS participants were more satisfied than their EVR counterparts.

With regard to organization and financing of services, clinical and vocational services should be integrated at the client level, which would offer the client "single team of providers who provide a consistent message" (p. 368). Disability policies actually "socialize people into disability" rather than supporting them. Increasing the quality of vocational services will address several of the areas identified in the Intervention section, in addition to learning to implement, maintain, and update supported employment programs as research becomes available. Motivating people with psychiatric disabilities to work can be difficult, especially with the overwhelming issues they face, such as treatment itself, applying for benefits, obtaining insurance, or societal stigma. Job development is critical to supported employment; none of the approaches mentioned have been studied empirically. Individuals with greater symptoms are less likely to be employed unless vocational and psychiatric services are integrated.

Improving job supports would enhance the employability of the individual, such as increasing the use of natural supports and skills training. Career development implies a pattern of growth and increasing satisfaction in employment over time. And lastly, supported employment was proven as a successful technique in the field of developmental disabilities; it is being evaluated as a technique for use with populations other than those with psychiatric disabilities.

Substance use disorders were more prevalent in those who had not achieved return to work. Those who had returned to work were more likely to have received mental health assessment and treatment.

During the 12-month study, 76% of the IPS participants gained competitive employment, compared with 28% of the VRP participants (number needed to treat = 2.07; ?(2) = 19.84, df = 1, p<.001). Veterans assigned to IPS also worked substantially more weeks than those assigned to VRP (42% versus 16% of the eligible weeks, respectively; Mann-Whitney z test p<.001) and earned higher 12-month income (mean ± SD income of $9,264 ± $13,294 for IPS versus $2,601 ± $6,009 for VRP; Mann-Whitney z test p<.001) during the 12-month period.

The study revealed that there were no differences by condition in the level of motivation to secure employment and the number of job seeking activities. Whereas, the motivation to work and number of action steps did predict gaining employment for the entire sample.

The experimental groups achieved competitive employment (55%), worked 40 hours or more per month (51%), and had significantly higher earnings ($122/month) than the control groups (34%, 39%, and $99/month, respectively). These outcomes increased significantly over time.

Supported employment models were more effective than services as usual. In addition, Experimental condition subjects were
more likely to be competitively employed (55% of experimental versus 34% of control participants), work 40 or more hours per month (51% versus 39%), and have higher earnings ($i22/month vs. $99/month) despite controlling for demographic, clinical, and work history confounds. And, the advantage that the experimental group clients had over the comparison group increased over time.