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Supported Employment: A Best Practice for People with Psychiatric Disabilities

Abstract

Over the past several decades, research from a variety of fields has presented powerful evidence of the importance of employment to people with psychiatric disabilities. Many of these people want to work and can successfully participate in the labor market in a variety of competitive jobs. Researchers have also shown how employment can alleviate poverty, reduce hospitalization, and improve quality of life. Society also benefits through taxes paid by workers, goods and services they purchase, and reductions in entitlements and the overall cost of care. However, the 1997 National Health Interview Survey (NHIS) reports employment rates for people with a wide range of mental disorders to be 37.1 percent (Harris et al., 2005; New Freedom Commission on Mental Health, 2003). Employment rates for people with schizophrenia and related disorders are 22 percent (Jans, et al., 2004). Recently, funding agencies and practitioners have begun to move towards evidence-based practice in serving people with psychiatric disabilities. A number of reviews and meta-analyses of single-site, randomized controlled trials of supported employment for this group have found it to be more effective at establishing competitive employment outcomes than prevocational training or non-vocational community care (Crowther et al., 2001; Twamley et al., 2003; Wewiorski & Fabian, 2004). Still in question at the time of this study\u27s funding, however, was the effectiveness of different models of supported employment, operating in a variety of organizational settings, for consumers with diverse demographic characteristics, in different regions of the country. Therefore, the Employment Intervention Demonstration Program (EIDP) was designed as a multi-site randomized controlled trial of the effectiveness of supported employment (SE) for people with psychiatric disabilities in eight locations across the U.S. SE programs use a rapid job search approach to help clients obtain jobs directly (rather than providing lengthy assessment, training, and counseling), and provide them with ongoing support to maintain and improve their earnings after they start work. This policy brief describes the EIDP, presents study findings, and suggests some policy and research implications

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