Compared to the general ex-offender population, individuals with SMI have higher rates of homelessness, unemployment, and greater reliance on public assistance. Given the additional challenges and needs of this subpopulation, it is critical that consumers have access to services found to be effective.
This research aims to provide further understanding of the influence of severe mental illness (SMI) and criminal justice involvement (CJI) on access to Supported Employment (SE) services. The authors investigate differences between consumers with and without CJI regarding access to SE and explore reasons for group differences. This study employs a mixed-methods design. The quantitative portion compares employment service utilization of consumers with CJI to consumers without CJI to examine hypothesized differences in frequency of access and time to receipt of SE services. The qualitative portion includes in-depth, individual interviews with consumers with CJI and service providers to gain various perspectives on consumers' with CJI entry to SE.
This study examined access to SE among individuals with SMI and CJI receiving services at a community mental health agency.
A total of 1,191 individuals with SMI admitted to Thresholds between December 2007 and December 2008 were included in the quantitative portion of the study. A criterion for entry into Thresholds is an individual having a primary psychiatric diagnosis of a SMI such as schizophrenia, bipolar disorder, or schizoaffective disorder. A total of 12 individuals were recruited for the qualitative portion of the study, four employment specialists, four mental health treatment team leaders, and four consumers with past or current CJI.
Descriptive statistics and chi-square analyses were used to compare group (CJI vs. without CJI) frequencies on demographics and SE service utilization variables.
Thresholds provides a comprehensive array of treatment and rehabilitation services, including medication management, residential services, case management, and day programming. Currently, Thresholds has 22 employment specialists that assist consumers in obtaining and keeping jobs.
There was not control or comparison condition.
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.
Consumers with CJI do receive SE services at the same rate as those without CJI, but it takes them substantially longer to engage in SE services. Both programmatic and policy level interventions and modifications may ameliorate this problem.