Regional Variation in Competitive Employment for Persons with Severe Mental Illness

  • Robert E. Drake
  • Thomas S. Fox
  • Paul K. Leather
  • Deborah R. Becker
  • James S. Musumeci
  • William F. Ingram
  • Gregory J. McHugo
Article

Abstract

The supported employment approach offers the potential to increase rates of competitive employment for persons with severe mental illness, but implementation and outcomes vary considerably. The authors examined regional variation in rates of employment across one state to ascertain the factors that affect outcomes. Mental health centers that emphasized supported employment programs achieved higher rates of competitive employment than centers that continued to offer pre-employment programs, such as day treatment and sheltered workshops. Mental health centers that attained high rates of competitive employment spent a larger proportion of their total budget on vocational services than other centers. Rural centers were also more likely to attain high employment rates than urban centers.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

REFERENCES

  1. Anthony, W.A., & Blanch, A. (1987). Supported employment for persons who are psychiatrically disabled: An historical and conceptual perspective. Psychosocial Rehabilitation Journal, 11(2), 5–23.Google Scholar
  2. Baron, R.C., Rutman, I.D., & Hadley, T. (1996). Rehabilitation services for persons with long term mental illness in the managed care behavioral health care system: Stepchild again? Psychiatric Rehabilitation Journal, 20, 33–38.Google Scholar
  3. Becker, D.R., & Drake, R.E. (1994). Individual placement and support: A community mental health center approach to vocational rehabilitation. Community Mental Health Journal, 30, 193–206.Google Scholar
  4. Bell, M.D., Milstein, R.M., & Lysaker, P.H. (1993). Pay and participation in work activity: Clinical benefits for clients with schizophrenia. Psychosocial Rehabilitation Journal, 17, 173–177.Google Scholar
  5. Bond, G.R., Drake, R.E., Mueser, K.T., & Becker, D.R. (1997). An update on supported employment for people with severe mental illness. Psychiatric Services, 48, 335–346.Google Scholar
  6. Chandler, D., Meisel, J., Hu, T., McGowen, M., & Madison, K. (1997). A capitated model for a cross-section of severely mentally ill clients: Employment outcomes. Community Mental Health Journal, 33, 501–516.Google Scholar
  7. Clark, R.E., Bush, P.W., Becker, D.R., & Drake, R.E. (1996). A cost-effectiveness comparison of supported employment and rehabilitative day treatment. Administration and Policy in Mental Health, 24, 63–77.Google Scholar
  8. Dellario, D.J. (1985). The relationship between mental health, vocational rehabilitation interagency functioning, and outcome of psychiatrically disabled persons. Rehabilitation Counseling Bulletin, 28, 167–170.Google Scholar
  9. Drake, R.E., Becker, D.R., Biesanz, J.C., Torrey, W.C., McHugo, G.J., & Wyzik, P.F. (1994). Rehabilitative day treatment vs. supported employment: I. Vocational outcomes. Community Mental Health Journal, 30, 519–532.Google Scholar
  10. Drake, R.E., Becker, D.B., Biesanz, J.C., Wyzik, P.F., & Torrey, W.C. (1996). Day treatment versus supported employment for persons with severe mental illness: A replication study. Psychiatric Services, 47, 1125–1127.Google Scholar
  11. Drake, R.E., McHugo, G.J., Becker, D.R., Anthony, W.A., & Clark, R.E. (1996). The New Hampshire study of supported employment for people with severe mental illness. Journal of Consulting and Clinical Psychology, 64, 391–399.Google Scholar
  12. Drake, R.E., McHugo, G.J., Clark, R.E., Teague, G.B., Ackerson, T., Xie, H., & Miles, K.M. (1998). A clinical trial of assertive community treatment for patients with co-occurring severe mental illness and substance use disorder. American Journal of Orthopsychiatry, 68, 201–215.Google Scholar
  13. Harding, C.M., Strauss, J.S., Hafez, H., & Liberman, P.B. (1987). Work and mental illness: I. Toward an integration of the rehabilitation process. Journal of Nervous and Mental Disease, 175, 317–326.Google Scholar
  14. Kasper, J.A., Steinwachs, D.M., & Skinner, E.A. (1992). Family perspectives on the service needs of people with serious and persistent mental illness: Part II: Needs for assistance and needs that go unmet. Innovations and Research, 1, 21–33.Google Scholar
  15. Malloy, M. (1995). Mental illness and managed care: A primer for families and consumers. Arlington, VA: National Alliance for the Mentally Ill.Google Scholar
  16. Mellen, V., & Danley, L. (1987). Supported employment for persons with severe mental illness. Psychosocial Rehabilitation Journal, 9(2), 3–4.Google Scholar
  17. Miles, M.B. (1990). New methods for qualitative data collection and analysis: Vignettes and pre-structured cases. Qualitative Studies in Education, 3, 37–51.Google Scholar
  18. Miles, M.B., & Huberman, A.M. (1994). Qualitative data analysis (2nd ed.). Thousand Oaks, CA: Sage.Google Scholar
  19. Rogers, E.S., Anthony, W.A., & Danley, K.S. (1989). The impact of interagency collaboration on system and client outcomes. Rehabilitation Counseling Bulletin, 33, 100–109.Google Scholar
  20. Rogers, E.S., Sciarappa, K., MacDonald-Wilson, K., & Danley, K. (1995). A benefit-cost analysis of a supported employment model for persons with psychiatric disabilities. Evaluation and Program Planning, 18, 105–115.Google Scholar
  21. Rogers, E.S., Walsh, D., Masotta, L. & Danley, K. (1991). Massachusetts survey of client preferences for community support services (Final Report). Boston, MA: Center for Psychiatric Rehabilitation.Google Scholar
  22. Strauss, J.S., Harding, C.M., Silverman, M., Eichler, A., & Lieberman, M. (1988). Work as treatment for psychiatric disorder: A puzzle in pieces. In J.A. Ciardiello & M.D. Bell (Eds.), Vocational rehabilitation of persons with prolonged psychiatric disorders (pp. 47–55). Baltimore, MD: Johns Hopkins University Press.Google Scholar
  23. Teague, G.B., Drake, R.E., McHugo, G.J., & Vowinkle, S. (1994). Alcohol and substance abuse, housing, and vocational status in a statewide survey of severely mentally ill clients (Final report to the National Institute on Alcohol Abuse and Alcoholism). Concord, NH: New Hampshire/Dartmouth Psychiatric Research Center.Google Scholar
  24. Torrey, W.C. (1993). Wyman Way Cooperative. Unpublished paper, Lebanon, NH: New Hampshire-Dartmouth Psychiatric Research Center.Google Scholar
  25. Torrey, W.C., Becker, D.R., & Drake, R.E. (1995). Rehabilitative day treatment vs. supported employment: II. Consumer, family and staff reactions. Psychosocial Rehabilitation Journal, 18(3), 67–75.Google Scholar
  26. Tukey, J.W. (1977). Exploratory data analysis. Reading, MA: Addison-Wesley.Google Scholar
  27. Wehman, P. (1986). Supported competitive employment for persons with severe disabilities. Journal of Applied Rehabilitation Counseling, 17, 24–29.Google Scholar
  28. Weinstock, P., & Toms-Barker, L. (1995). Mental health and vocational rehabilitation collaboration: Local strategies that work. Psychosocial Rehabilitation Journal, 18(4), 35–50.Google Scholar

Copyright information

© Human Sciences Press, Inc. 1998

Authors and Affiliations

  • Robert E. Drake
    • 1
  • Thomas S. Fox
    • 2
  • Paul K. Leather
    • 3
  • Deborah R. Becker
    • 1
  • James S. Musumeci
    • 4
  • William F. Ingram
    • 3
  • Gregory J. McHugo
    • 1
  1. 1.New Hampshire-Dartmouth Psychiatric Research CenterUSA
  2. 2.Mental Health Center of Greater ManchesterUSA
  3. 3.New Hampshire Division of Vocational RehabilitationUSA
  4. 4.New Hampshire Division of Mental Health and Developmental ServicesUSA

Personalised recommendations