Article Details

Research Database: Article Details

Citation:  Biegel DE; Beimers D; Stevenson LD; Ronis R; & Boyle P. (2009). Predictors of referral to supported employment among consumers with co-occurring mental and substance us disorders. Community Mental Health Journal, 45 427-438.
Title:  Predictors of referral to supported employment among consumers with co-occurring mental and substance us disorders
Authors:  Biegel DE; Beimers D; Stevenson LD; Ronis R; & Boyle P.
Year:  2009
Journal/Publication:  Community Mental Health Journal
Publisher:  American Association of Community Psychiatrists
DOI:  https://doi.org/10.1007/s10597-009-9242-3
Full text:  http://proxy.library.vcu.edu/login?url=http://link.springer.com/art...    |   PDF   
Peer-reviewed?  Yes
NIDILRR-funded?  No
Research design:  Quasi-experimental

Structured abstract:

Background:  Clinical trials demonstrate that Supported Employment is effective in assisting persons with severe mental illness in obtaining competitive employment. However, little is known about the factors related to consumers’ decisions to pursue employment, especially for consumers with co-occurring substance and mental disorders.
Purpose:  This study examines the demographic, socioeconomic and illness characteristics of consumers referred for Supported Employment services. Study examines the following research question: What are the effects of consumers’ demographic and socioeconomic characteristics, mental health and substance use status, functioning and life status, work history and work interest, and agency organizational characteristics on referral of consumers for Supported Employment services?
Setting:  Consumers were drawn from Integrated Dual Diagnosis Treatment programs in four community mental health agencies.
Study sample:  Study participants included 113 consumers referred for Supported Employment services and 78 randomly selected non-referred consumers as the comparison group. The criteria for consumers in the intervention group were that: (1) they had been diagnosed with co-occurring substance use and mental illness disorders and were receiving IDDT services; (2) they expressed a desire to engage in competitive employment; (3) they were being referred for Supported Employment services; and (4) they had not previously received Supported Employment services. The sampling criteria for the consumers in the comparison group were that: (1) they had been diagnosed with co-occurring substance use and mental illness disorders; (2) they had not received Supported Employment services in the past; and (3) they did not express an interest in competitive employment.
Intervention:  Individual Placement and Support (IPS) is a systematic approach to helping people with severe mental illness achieve competitive employment. It is based on eight principles: eligibility based on client choice, focus on competitive employment, integration of mental health and employment services, attention to client preferences, work incentives planning, rapid job search, systematic job development, and individualized job supports. Systematic reviews have concluded that IPS is an evidence-based practice
Control or comparison condition:  The comparison was Integrated Dual Diagnosis Treatment programs in four community mental health agencies.
Data collection and analysis:  Data for the study was generated through four sources: consumer and provider questionnaires already in use by the study agencies, data collection forms designed specifically for this research project which were completed by case managers and Supported Employment staff at the study agencies, data from agency administrative records, and IDDT and supported employment (SE) fidelity scores from a state-funded training and consultation center. Prior to the beginning of data collection, approval of data collection procedures and consent forms was received from the Case Western Reserve University IRB.
Findings:  Results suggest that consumers who have past work experience are more likely to be referred to Supported Employment, while consumers who perceive themselves as disabled or who are diagnosed as substance dependent are less likely to be referred to Supported Employment.
Conclusions:  Future research is needed to obtain a fuller understanding of consumer and agency level barriers to referral to Supported Employment suggested by the current study. First, future studies should use larger sample sizes and include a larger number of agency sites. In order to more fully examine the role of fidelity in impacting referrals to supported employment, future studies should include a larger number of agencies representing a fuller range of fidelity scores, including agencies that have reached and maintained high SE fidelity, than was realized in the present study.

Disabilities served:  Alcohol and drug abuse
Chronic mental illness
Populations served:  Gender: Female and Male
Race: Black / African American
Race: White / Caucasian
Interventions:  Individual Placement and Support (IPS) model of supported employment
Psychological counseling
Outcomes:  Employment acquisition