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

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).


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.


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


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.


There was no control or comparison condition.


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.

URL http://www.ncbi.nlm.nih.gov/pubmed/16532378
Disabilities Emotional disturbance
Populations Male & Female
Outcomes Employment acquisition
Research Design Observational
Peer Reviewed Yes