Article Details

Research Database: Article Details

Citation:  Resnick, S. G., Neale, M. S., & Rosenheck, R. A. (2003). Impact of public support payments, intensive psychiatric community care, and program fidelity on employment outcomes for people with severe mental illness. The Journal of Nervous and Mental Disease, 191 (3), 139-144.
Title:  Impact of public support payments, intensive psychiatric community care, and program fidelity on employment outcomes for people with severe mental illness
Authors:  Resnick, S. G., Neale, M. S., & Rosenheck, R. A.
Year:  2003
Journal/Publication:  The Journal of Nervous and Mental Disease
Publisher:  Lippincott, Williams and Wilkens
Full text:   
Peer-reviewed?  Yes
NIDILRR-funded?  Not reported
Research design:  Randomized controlled trial

Structured abstract:

Background:  Supported employment is an evidenced based practice that assists individuals with mental illness with gaining and maintaining employment. One of the major barriers to work are disability payments offered by the Social Security Administration and the Veterans Administration. A few studies have shown that the amount of public income is negatively associated with employment, involvement with vocational rehabilitation services and income received from employment. There are no studies related to to the impact of disability benefits on employment of those individuals who receive intensive case management services.
Purpose:  The purpose of this study was to explore the relationship between income from public support, participation in Intensive Psychiatric Community Care and employment among veterans with severe mental illness.
Study sample:  The sample included 520 veterans with severe mental illness who were randomly assigned to either IPCC or standard care. Prior to entering the study the majority or 87.5% were receiving at least one form of public payment. The average amount was nine hundred and fifty five dollars. At the 12 month follow up interview, most of the sample 91.2%) were classified as non workers. There were few differences on baseline and demographic and mental health status. There was a significant difference between workers and non-workers on the amount of public income received in the month prior to baseline assessment, with non workers receiving more money.
Intervention:  The intervention was Intensive Psychiatric Community Care(IPCC).
Control or comparison condition:  The control condition was standard care.
Data collection and analysis:  Demographic and mental health status were obtained through participant interviews at baseline and one year out. Symptom severity was measured using the Brief Psychiatric Rating Scale. Alcohol and drug use were examined using scores from the Addiction Severity Index. Functional status was assessed using the Global Assessment Scale. Fidelity to the IPCC Model was measured using the Dartmouth Assertive Community Treatment scale. A liberal measure was used to determine employment. In the data analysis, only composite scores were examined. Bivariate analyses were used to examine differences between demographic and mental health status variables. Multivariate logistic regression was used to look at the contribution of the independent variable.
Findings:  Public support levels were inversely related to employment. Symptom severity did not appear to be an independent barrier to work.
Conclusions:  Previous analyses of this study did not look at infrequent outcomes like employment. However, there is value in doing so as the results revealed the impact of assertive case management on employment outcomes.

Disabilities served:  Anxiety disorder
Personality disorders
Populations served:  Gender: Female and Male
Race: Black / African American
Race: White / Caucasian
Interventions:  Other
Outcomes:  Employment acquisition