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Abstract

After 20 years of research, evidence of the effectiveness of supported employment for individuals with mental disorders is irrefutable. Across the country, this approach has replaced sheltered workshops for people who want the benefits and satisfaction of holding a job. Supported employment has consistently demonstrated positive outcomes, including higher rates of competitive employment, fewer days to the first competitive job, more hours and weeks worked, and higher wages. But how to expand the supported employment model to meet demand remains an open question, according to the authors of this review.

Abstract

Objective

Supported employment is a direct service with multiple components designed to help adults with mental disorders or co-occurring mental and substance use disorders choose, acquire, and maintain competitive employment. This article describes supported employment and assesses the evidence base for this service.

Methods

Authors reviewed meta-analyses, research reviews, and individual studies from 1995 through 2012. Databases surveyed were PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, Published International Literature on Traumatic Stress, the Educational Resources Information Center, and the Cumulative Index to Nursing and Allied Health Literature. Authors chose from three levels of evidence (high, moderate, and low) based on benchmarks for the number of studies and quality of their methodology. They also described the evidence for service effectiveness.

Results

The level of research evidence for supported employment was graded as high, based on 12 systematic reviews and 17 randomized controlled trials of the individual placement and support model. Supported employment consistently demonstrated positive outcomes for individuals with mental disorders, including higher rates of competitive employment, fewer days to the first competitive job, more hours and weeks worked, and higher wages. There was also strong evidence supporting the effectiveness of individual elements of the model.

Conclusions

Substantial evidence demonstrates the effectiveness of supported employment. Policy makers should consider including it as a covered service. Future research is needed for subgroups such as young adults, older adults, people with primary substance use disorders, and those from various cultural, racial, and ethnic backgrounds.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services

Cover: A ‘Bear’ Chance, by Philip Russell Goodwin, 1907. Oil on canvas. Minneapolis Institute of Arts, gift of the National Biscuit Company; the Bridgeman Art Library, New York.

Psychiatric Services
Pages: 16 - 23
PubMed: 24247197

History

Published in print: January 2014
Published online: 15 October 2014

Authors

Details

Tina Marshall, Ph.D.
Dr. Marshall, Dr. Daniels, Dr. Ghose, and Dr. George are with Westat, Rockville, Maryland. Dr. Goldberg is with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Capitol Health Care Network, Baltimore. Dr. Braude and Dr. Dougherty are with DMA Health Strategies, Lexington, Massachusetts. Dr. Delphin-Rittmon is with the Office of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville. Send correspondence to Dr. George (e-mail: [email protected]). This article is part of a series of literature reviews that will be published in Psychiatric Services over the next several months. The reviews were commissioned by SAMHSA through a contract with Truven Health Analytics and were conducted by experts in each topic area, who wrote the reviews along with authors from Truven Health Analytics, Westat, DMA Health Strategies, and SAMHSA. Each article in the series was peer reviewed by a special panel of Psychiatric Services reviewers.
Richard W. Goldberg, Ph.D.
Dr. Marshall, Dr. Daniels, Dr. Ghose, and Dr. George are with Westat, Rockville, Maryland. Dr. Goldberg is with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Capitol Health Care Network, Baltimore. Dr. Braude and Dr. Dougherty are with DMA Health Strategies, Lexington, Massachusetts. Dr. Delphin-Rittmon is with the Office of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville. Send correspondence to Dr. George (e-mail: [email protected]). This article is part of a series of literature reviews that will be published in Psychiatric Services over the next several months. The reviews were commissioned by SAMHSA through a contract with Truven Health Analytics and were conducted by experts in each topic area, who wrote the reviews along with authors from Truven Health Analytics, Westat, DMA Health Strategies, and SAMHSA. Each article in the series was peer reviewed by a special panel of Psychiatric Services reviewers.
Lisa Braude, Ph.D.
Dr. Marshall, Dr. Daniels, Dr. Ghose, and Dr. George are with Westat, Rockville, Maryland. Dr. Goldberg is with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Capitol Health Care Network, Baltimore. Dr. Braude and Dr. Dougherty are with DMA Health Strategies, Lexington, Massachusetts. Dr. Delphin-Rittmon is with the Office of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville. Send correspondence to Dr. George (e-mail: [email protected]). This article is part of a series of literature reviews that will be published in Psychiatric Services over the next several months. The reviews were commissioned by SAMHSA through a contract with Truven Health Analytics and were conducted by experts in each topic area, who wrote the reviews along with authors from Truven Health Analytics, Westat, DMA Health Strategies, and SAMHSA. Each article in the series was peer reviewed by a special panel of Psychiatric Services reviewers.
Richard H. Dougherty, Ph.D.
Dr. Marshall, Dr. Daniels, Dr. Ghose, and Dr. George are with Westat, Rockville, Maryland. Dr. Goldberg is with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Capitol Health Care Network, Baltimore. Dr. Braude and Dr. Dougherty are with DMA Health Strategies, Lexington, Massachusetts. Dr. Delphin-Rittmon is with the Office of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville. Send correspondence to Dr. George (e-mail: [email protected]). This article is part of a series of literature reviews that will be published in Psychiatric Services over the next several months. The reviews were commissioned by SAMHSA through a contract with Truven Health Analytics and were conducted by experts in each topic area, who wrote the reviews along with authors from Truven Health Analytics, Westat, DMA Health Strategies, and SAMHSA. Each article in the series was peer reviewed by a special panel of Psychiatric Services reviewers.
Allen S. Daniels, Ed.D.
Dr. Marshall, Dr. Daniels, Dr. Ghose, and Dr. George are with Westat, Rockville, Maryland. Dr. Goldberg is with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Capitol Health Care Network, Baltimore. Dr. Braude and Dr. Dougherty are with DMA Health Strategies, Lexington, Massachusetts. Dr. Delphin-Rittmon is with the Office of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville. Send correspondence to Dr. George (e-mail: [email protected]). This article is part of a series of literature reviews that will be published in Psychiatric Services over the next several months. The reviews were commissioned by SAMHSA through a contract with Truven Health Analytics and were conducted by experts in each topic area, who wrote the reviews along with authors from Truven Health Analytics, Westat, DMA Health Strategies, and SAMHSA. Each article in the series was peer reviewed by a special panel of Psychiatric Services reviewers.
Sushmita Shoma Ghose, Ph.D.
Dr. Marshall, Dr. Daniels, Dr. Ghose, and Dr. George are with Westat, Rockville, Maryland. Dr. Goldberg is with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Capitol Health Care Network, Baltimore. Dr. Braude and Dr. Dougherty are with DMA Health Strategies, Lexington, Massachusetts. Dr. Delphin-Rittmon is with the Office of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville. Send correspondence to Dr. George (e-mail: [email protected]). This article is part of a series of literature reviews that will be published in Psychiatric Services over the next several months. The reviews were commissioned by SAMHSA through a contract with Truven Health Analytics and were conducted by experts in each topic area, who wrote the reviews along with authors from Truven Health Analytics, Westat, DMA Health Strategies, and SAMHSA. Each article in the series was peer reviewed by a special panel of Psychiatric Services reviewers.
Preethy George, Ph.D.
Dr. Marshall, Dr. Daniels, Dr. Ghose, and Dr. George are with Westat, Rockville, Maryland. Dr. Goldberg is with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Capitol Health Care Network, Baltimore. Dr. Braude and Dr. Dougherty are with DMA Health Strategies, Lexington, Massachusetts. Dr. Delphin-Rittmon is with the Office of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville. Send correspondence to Dr. George (e-mail: [email protected]). This article is part of a series of literature reviews that will be published in Psychiatric Services over the next several months. The reviews were commissioned by SAMHSA through a contract with Truven Health Analytics and were conducted by experts in each topic area, who wrote the reviews along with authors from Truven Health Analytics, Westat, DMA Health Strategies, and SAMHSA. Each article in the series was peer reviewed by a special panel of Psychiatric Services reviewers.
Miriam E. Delphin-Rittmon, Ph.D.
Dr. Marshall, Dr. Daniels, Dr. Ghose, and Dr. George are with Westat, Rockville, Maryland. Dr. Goldberg is with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Capitol Health Care Network, Baltimore. Dr. Braude and Dr. Dougherty are with DMA Health Strategies, Lexington, Massachusetts. Dr. Delphin-Rittmon is with the Office of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville. Send correspondence to Dr. George (e-mail: [email protected]). This article is part of a series of literature reviews that will be published in Psychiatric Services over the next several months. The reviews were commissioned by SAMHSA through a contract with Truven Health Analytics and were conducted by experts in each topic area, who wrote the reviews along with authors from Truven Health Analytics, Westat, DMA Health Strategies, and SAMHSA. Each article in the series was peer reviewed by a special panel of Psychiatric Services reviewers.

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