Skip to main content

Advertisement

Log in

Limitations of System Integration in Providing Employment Services for Persons with Mental Illness

  • Published:
Administration and Policy in Mental Health and Mental Health Services Research Aims and scope Submit manuscript

Abstract

This study assessed the influence of service systems integration on employment outcomes for persons with mental illness. A survey was sent to all 125 key program staff that worked for community mental health treatment agencies or vocational rehabilitation agencies. The survey found that referral and employment rates were low; but that these rates were related to characteristics of the interagency systems integration. Community mental health staff referred 448 individuals for employment services. Staff from vocational rehabilitation agencies accepted only 26% of these referrals and found work for just 11%; 7% were employed six months later. Also, 39% of respondents reported that the linkage agreement between their agencies was never established. This study suggests the need for more effective strategies for integrating mental health treatment and vocational rehabilitation systems.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1.

Similar content being viewed by others

References

  • Attkisson, C., Cook, J., Karno, M., Lehman, A., McGlashan, T.H., Meltzer, H.Y., O’Connor, M., Richardson, D., Rosenblatt, A., Wells, K., Williams, J., & Hohmann A.A. (1992). Clinical services research. Schizophrenia Bulletin, 18, 561–626.

    PubMed  CAS  Google Scholar 

  • Becker, D.R., Torrey, W.C., Toscano, R., Wyzik, P.F., & Fox, T.S. (1998). Building recovery-oriented services: Lessons from implementing Individual Placement and Support (IPS) in community mental health centers. Psychiatric Rehabilitation Journal, 22(1), 51–54.

    Google Scholar 

  • Black, B.J.(1988). Work and Mental Illness: Transitions to Employment. Baltimore: Johns Hopkins Press.

    Google Scholar 

  • Bond, G.R., Becker, D.R., Drake, R.E., Rapp, C.A., Meisler, N., Lehman, A.F., Bell, M.D., & Blyler, C.R. (2001). Implementing supported employment as an evidence-based practice. Psychiatric Services, 52(3), 313–322.

    Article  PubMed  CAS  Google Scholar 

  • 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(3), 335–346.

    PubMed  CAS  Google Scholar 

  • Bond, G.R., & Mcdonel. (1991). Vocational rehabilitation outcomes for persons with psychiatric disabilities: An update. Journal of Vocational Rehabilitation, 1, 9–20.

    Google Scholar 

  • Cook, J.A., Lehman, A.E., Drake, R., et al. (2005). Integration of psychiatric and vocational services: A multisite randomized, controlled trial of supported employment. American Journal of Psychiatry, 162(10), 1946–1948.

    Article  Google Scholar 

  • Cook, J.A., Pickett-Schenk, S.A., Grey, D., Banghart, M., Rosenheck, R.A., & Randolph, F. (2001.) Vocational outcomes among formerly homeless persons with severe mental illness in the ACCESS program. Psychiatric Services, 52, 1075 – 1080.

    Article  PubMed  CAS  Google Scholar 

  • Dellario, D.J. (1985). The relationship between mental health, vocational rehabilitation interagency functioning, and outcome of psychiatrically disabled patients. Rehabilitation Counseling Bulletin, 28, 167–170.

    Google Scholar 

  • Federal Register (1992, June 24). Vocational Rehabilitation Act Amendments of 1992 (29 United States Code 706 (18)). Washington, D.C.: U.S. Government Printing Office.

    Google Scholar 

  • Hursh, N.C., Rogers, E.S., & Anthony, W.A. (1988). Vocational evaluation with people who are psychiatrically disabled: Results of a national survey. Vocational Evaluation and Work Adjustment Bulletin, 21, 149–155.

    Google Scholar 

  • Kasper, J.A., Steinwachs, D.M., & Skinner, E.A. (1992). Family perspectives in 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 

  • Katz, L.J., & Geckle, M. (1990). A survey of perceptions and practice: Interagency collaboration and rehabilitation of persons with long-term mental illness. Rehabilitation Counseling June Bulletin, 33(4), 290–301.

    Google Scholar 

  • Lehman, A. (1983). The well-being of chronic mental patients. Archives of General Psychiatry, 40, 373–396

    Google Scholar 

  • Lehman, A.F., & Steinwachs, D.M. (1998). Patterns of usual care for schizophrenia: Initial results from the Schizophrenia Patient Outcomes Research Team (PORT) Client Survey. Schizophrenia Bulletin, 24(1), 11–20.

    PubMed  CAS  Google Scholar 

  • Mathews, J.W. (1979). Effects of Work Activity Program on Self-concept of Chronic Schizophrenics. Dissertation Abstracts International, 41, 358B (University Microfilms N. 816281–816298).

  • Mechanic, D. (2003). Policy challenges in improving mental health services: Some lessons from the past. Psychiatric Services, 54, 1227–1232.

    Article  PubMed  Google Scholar 

  • New Freedom Commission on Mental Health (2003). Achieving the Promise: Transforming Mental Health in America. (Final Report). DHHS Pub. No. SMA-03-3832. Rockville, Maryland.

  • O’Brien, A., Price, C., Burns, T., & Perkins, R. (2003) Improving the vocational status of patients with long-term mental illness: A randomized controlled trial of staff training. Community Mental Health Journal, 39(4), 333–347.

    Article  PubMed  Google Scholar 

  • Randolph, F., Goldman, H.H., Blasinsky, M., et al. (2002.) Overview of the ACCESS program. Psychiatric Services, 53(8), 967–969.

    Article  PubMed  Google Scholar 

  • Rogers, E.S., Walsh, D., Masotta, L., & Danely, K. (1991). Massachusetts Survey of Client Preferences for Community Support Services (Final Report). Boston: Center for Psychiatric Rehabilitation.

    Google Scholar 

  • Rosenheck, R.A., Lam, J., Morrissey, J.P., Calloway, M.S., Stolar, M., & Randolph, R. (2002.) Service systems integration and outcomes for mentally ill homeless persons in the ACCESS program. Psychiatric Services, 53(8), 958–966.

    Article  PubMed  Google Scholar 

  • United States Public Health Service. Office of the Surgeon General (1999). Mental Health: A Report of the Surgeon General. DHHS. U.S. Public Health Service. Rockville Maryland.

    Google Scholar 

Download references

Acknowledgments

The National Institute of Mental Health provided funding for this study to Dr. Patrick Corrigan (PI), and to Drs.Patricia Hanrahan and Daniel J. Luchins (Co-Investigators). We also wish to acknowledge Drs. Patrick Corrigan, Gary Bond and Kenneth Rasinski for their thoughtful review and comments on the survey questionnaire.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Patricia Hanrahan Ph.D..

Additional information

A version of this paper was presented at the Academy/Health annual conference in San Diego, June 8, 2004.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hanrahan, P., Heiser, W., Cooper, A.E. et al. Limitations of System Integration in Providing Employment Services for Persons with Mental Illness. Adm Policy Ment Health 33, 244–252 (2006). https://doi.org/10.1007/s10488-005-0026-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10488-005-0026-y

KEYWORDS

Navigation