Converting day treatment centers to supported employment programs in Rhode Island

Authors: 
Becker, D. R., Bond, G. R., McCarthy, D., Thompson, D., Xie, H., McHugo, G. J., & Drake, R. E.
Year Published: 
2001
Publication: 
Psychiatric Services
Volume: 
52
Number: 
3
Pages: 
351-357
Publisher: 
American Psychiatric Association
Background: 

Day treatment centers were originally designed to provide "partial hospitalization" for patients with serious mental disorders who required intensive, comprehensive, and multidisciplinary treatment that was unavailable in an outpatient setting. These programs began to develop rehabilitative services, rather than "hospital diversion". However, research indicates that these centers do not assist clients in obtaining jobs in the community. Because of the expense involved in maintaining these centers, they are coming under closer scrutiny. As such, several day treatment centers were successfully converted to supported employment programs.

Purpose: 

The intent of the study was to determine if phasing out day treatment centers in support of supported employment and other activities can be implemented statewide.

Setting: 

Three community day care treatment centers in Rhode Island participated in the study. Two were converted to supported employment programs, while the third remained a day treatment center until after the study was complete, for comparison purposes.

Sample: 

The study sample include 28 day treatment clients with severe mental illness in three community mental health centers.

Data Collection: 

"Participants were assessed at baseline and again at follow-up 30 to 36 months later; follow-up for clients in the converted programs took place 18 months after the conversion was completed. An independent research team conducted the interviews and evaluation." (p. 352)

Intervention: 

The intervention related to conversion of two day treatment centers to ones offering supported employment services.

Control: 

One of the centers remained as a rehabilitative day center.

Findings: 

"Former day treatment clients in the converted centers attained higher rates of competitive employment than those in the comparison group (44.2 percent and 56.7 percent versus 19.5 percent). Other employment outcomes also improved, and hospitalization rates and overall social functioning were unchanged." (p. 351)

Conclusions: 

"This study supports findings of previous studies suggesting that replacing rehabilitative day treatment programs with supported employment programs yields improvements in employment outcomes without adverse effects." (p. 351)

URL: 
http://www.worksupport.com/kter/documents/pdf/ConvertingDayCenters.pdf
Disabilities: 
Emotional disturbance
Populations: 
Male & Female
Asian
Black / African American
White / Caucasian
Outcomes: 
Employment acquisition
Return to work
NIDILRR Funded: 
Yes
Research Design: 
Quasi-experimental
Peer Reviewed: 
Yes

Long-term employment trajectories among participants with severe mental illness in supported employment

Authors: 
Bejarano, V., Quinn, M., Conaghan, P. G., Reece, R., Keenan, A.-M., Walker, D., Gough, A., Green, M., McGonagle, D., Adebajo, A., Jarrett, S., Doherty, S., Hordon, L., Melsom, R., Unnebrink, K., Kupper, H., & Emery, P.
Year Published: 
2007
Publication: 
Psychiatric Services
Volume: 
58
Number: 
7
Pages: 
922-928
Publisher: 
American Psychiatric Association
Background: 

The article describes the evidence in support of supported employment for people with psychiatric disabilities. However, most of the studies are limited to a maximum of a 2-year follow-up period.

Purpose: 

The purpose of the study was to evaluate individual work trajectories and generic work patterns over an eight- to 12-year period through a quantitative analysis. Perceived influences by participants of their work-related behaviors were also examined through a qualitative analysis.

Setting: 

A community mental health center in New England was the setting for two studies. One began in 1990. The second began in 1995.

Sample: 

The sample included 38 with severe mental illness eight to 12 years after they enrolled in supported employment studies.

Data Collection: 

Participants in the two original studies who received IPS services were invited to participate in one follow-up interview in 2004.

A modified version of a semi-structured interview developed of a previous study was used. Participants were asked about of all their work activities, including competitive employment, sheltered work, and volunteer work. The pattern of work was coded by the percentage of months worked, excluding recent work history.

Most questions were closed; however, several open-ended questions were included. The analysis was developed using the grounded theory approach developed by Glaser and Strauss.

Intervention: 

The intervention was supported employment services.

Control: 

There was a matched sample of participants who did not receive supported employment services.

Findings: 

During the follow up period, all participants had worked at least one job. Most jobs were competitive, and most participants worked at competitive jobs. Most people worked less than 20 hours per week for any job they held during the follow up period.

Twenty-seven participants had worked more than half of the follow-up period. 71% of the 38 participants were working at the time of the re-interview. The majority of the jobs were in clerical, service, or sales categories.

The majority of participants received some type of benefits at long-term follow-up.

Conclusions: 

The long-term trajectories of participants in supported employment programs, both vocational and non-vocational, appear to be positive.

URL: 
http://www.worksupport.com/kter/documents/pdf/LongtermEmploymentTrajectories.pdf
Disabilities: 
Emotional disturbance
Populations: 
Hispanic or Latino
Black / African American
White / Caucasian
Male & Female
Outcomes: 
Full-time employment
Increase in tenure
Part-time employment
NIDILRR Funded: 
No
Research Design: 
Mixed methods
Peer Reviewed: 
Yes

What predicts supported employment program outcomes?

Authors: 
Becker, D., Whitley, R., Bailey, E., & Drake, R.
Year Published: 
2006
Publication: 
Community Mental Health Journal
Volume: 
42
Number: 
3
Pages: 
303-313
Publisher: 
Community Mental Health Journal
Background: 

Research studies have identified supported employment as an evidence-based approach to helping people with serious mental illness gain competitive employment. A dozen randomized controlled trials comparing supported employment to other vocational interventions such as prevocational training, sheltered work, and transitional employment show that supported employment produces better competitive employment outcomes (average 59% in supported employment vs. 21% in traditional programs) (Bond, 2004a,b; Twamley, Bartels,Becker, & Jeste, 2004; Latimer et al., 2005). Two meta-analyses have yielded similar findings (Crowther, Marshall, Bond, & Huxley, 2001; Twamley, Jeste, & Lehman, 2003).

Purpose: 

Although nearly all state mental health systems have endorsed supported employment services as part of their state mental health plan (Ganju, 2004), few studies address factors that affect access (percentage of eligible people receiving supported employment services) and efficiency (percentage of people receiving supported employment services who are working). The purpose of this study was to determine the extent of differences in access and efficiency and the factors that predict access and efficiency.

Setting: 

The setting included 26 mental health agencies that partner with federal-state vocational rehabilitation programs.

Sample: 

Cross sectional survey of 26 sites that participated in the Johnson & Johnson Dartmouth Community Mental Health Program during January to June 2004.

Data Collection: 

Supported employment supervisors submitted data on: the number of adults served in the mental health agency, case mix, number of full time equivalent staff positions in vocational services, staff turnover, referral rate from VR, timing of eligibility determination, number of clients served.

Intervention: 

The intervention was Supported Employment.

Control: 

There was no control or comparison condition.

Findings: 

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.

Conclusions: 

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.

URL: 
http://www.ncbi.nlm.nih.gov/pubmed/16532378
Disabilities: 
Emotional disturbance
Populations: 
Male & Female
Outcomes: 
Employment acquisition
NIDILRR Funded: 
No
Research Design: 
Observational
Peer Reviewed: 
Yes

Vocational rehabilitation service patterns and employment outcomes for Hispanics with spinal cord injuries

Authors: 
Arango-Lasprilla, J. C., da Silva Cardoso, Wilson, L. M., Romero, M. G., Chan, F., & Sung, C.
Year Published: 
2012
Publication: 
Rehabilitation Research Policy and Education
Volume: 
25
Number: 
3
Pages: 
149-162
Publisher: 
Elliott and Fitzpatrick Inc.
Background: 

Employment impacts the quality of life for individuals with spinal cord injury. Most studies that look at vocational service patterns for individuals with spinal cord injury focus on European Americans. Ethnic minority groups within the United State are growing. These changes also impact referrals to Model Spinal Cord Injury Systems. This presents new challenges to rehabilitation professionals.

Purpose: 

The purpose of this study was to identify demographic and service related patterns for Hispanics with spinal cord injury receiving services from state vocational rehabilitation agencies and examine similarities and differences in vocational rehabilitation services and employment outcomes between a group of European Americans and Hispanics with spinal cord injury.

Setting: 

This study included individuals with SCI served by multiple vocational rehabilitation agencies in various settings.

Sample: 

Data for this study came from the Rehabilitation Services Administration Case Service report (RSA-911) database. There were 4,392 spinal cord cases closed either rehabilitated or not in 2005. Among these 3,119 were European American and 395 Hispanics. There were significant differences in age, education, per-service employment status, employment status, significant disabilities and work disincentives between the two groups.

Data Collection: 

Logistical regression analysis were conducted.

Intervention: 

The intervention uses various types of vocational rehabilitation services. These included: assessment, diagnosis and treatment of impairments, vocational rehabilitation counseling and guidance, college or university training, occupational vocational training, on the job training, basic academic remedial or literacy training, job readiness training, disability related, augmentative skills training, miscellaneous training, job search assistance, job placement assistance, on the job supports, transportation services, maintenance services, rehabilitation technology, technical assistance services, information and referral services and other services.

Control: 

There was no control or comparison condition.

Findings: 

Minor differences in case dollar expenditures and service patterns were noted between the two groups. Vocational rehabilitation services that impacted successful work outcomes included: assistive technology services, basic support services and job placement services.

Conclusions: 

Hispanic status of vocational rehabilitation clients does not affect employment outcomes. Hispanics appear to have more risk factors than European American clients. Vocational rehabilitation counselors were able to support the needs of Hispanic clients.

URL: 
http://www.academia.edu/10786564/Vocational_Rehabilitation_Service_Patterns_and_Employment_Outcomes_for_Hispanics_with_Spinal_Cord_Injuries
Disabilities: 
Orthopedic impairments
Populations: 
Male & Female
Hispanic or Latino
NIDILRR Funded: 
Yes
Research Design: 
Observational
Peer Reviewed: 
Yes