Depression is a common mental disorder and is associated with work disability. For the implementation of evidence-based interventions, such as Individual Placement and Support (IPS) for people with ...depression in Germany, the aim of this study was to investigate client variables that predict return to work.BACKGROUNDDepression is a common mental disorder and is associated with work disability. For the implementation of evidence-based interventions, such as Individual Placement and Support (IPS) for people with depression in Germany, the aim of this study was to investigate client variables that predict return to work.The sample consisted of 129 participants, initially treated in a psychiatric hospital due to major depression, who participated in IPS as part of a German clinical trial. Baseline demographic (age, sex, education, sickness absence days, employment status), psychiatric (symptom severity, comorbidity, general physical and mental health, disability), and neuropsychological (self-rated deficits, test performance) variables were included. Return to work within one year was predicted using separate and overall binary logistic regression analyses.METHODSThe sample consisted of 129 participants, initially treated in a psychiatric hospital due to major depression, who participated in IPS as part of a German clinical trial. Baseline demographic (age, sex, education, sickness absence days, employment status), psychiatric (symptom severity, comorbidity, general physical and mental health, disability), and neuropsychological (self-rated deficits, test performance) variables were included. Return to work within one year was predicted using separate and overall binary logistic regression analyses.A total of 70 participants (56 %) returned to work within the one-year follow-up period. >100 days of sick leave in the year prior to study entry (vs. <100 days) and higher self-rated cognitive deficits were significantly associated with reduced odds of return to work within one year of IPS.RESULTSA total of 70 participants (56 %) returned to work within the one-year follow-up period. >100 days of sick leave in the year prior to study entry (vs. <100 days) and higher self-rated cognitive deficits were significantly associated with reduced odds of return to work within one year of IPS.The sample consisted of participants with a relatively good work history who were assigned to IPS by the treatment team, thus, the generalizability of the results is limited.LIMITATIONSThe sample consisted of participants with a relatively good work history who were assigned to IPS by the treatment team, thus, the generalizability of the results is limited.People with depression who participate in IPS interventions might benefit from specifically targeting perceived cognitive deficits. Factors associated with prolonged sick leave due to depression and their role in return to work with IPS need further investigation.CONCLUSIONSPeople with depression who participate in IPS interventions might benefit from specifically targeting perceived cognitive deficits. Factors associated with prolonged sick leave due to depression and their role in return to work with IPS need further investigation.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Objective: Individual placement and support (IPS) is the evidence-based supported employment approach for people with serious mental illness. Because funding is the major barrier for states to ...implement IPS and increase access, the IPS Learning Community collected information about sources of IPS funding from 24 member states. Methods: In early 2020, IPS employment leaders from the public mental health authority and the state vocational rehabilitation (VR) authority completed a questionnaire identifying sources of funding for IPS in their states. Results: The main sources of funding were Medicaid, Substance Abuse and Mental Health Services Administration (SAMHSA) block grants, state and county government, the Ticket to Work program, and the federal-state VR programs. Conclusions and Implications for Practice: Funding IPS services requires braided funding from multiple sources. This complicated method limits scaling up services statewide. Solving this funding problem would require coordinated action from federal and state agencies.
Impact and Implications
Individual placement and support (IPS) services effectively assist people with serious mental illness to gain and benefit from competitive integrated employment, yet states have been unable to meet the demand. A funding survey of the 24 states in the IPS Learning Community demonstrates how each state uses multiple sources. State and federal policy leaders could coordinate efforts to develop a more efficient funding strategy to encourage expansion of IPS services.
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CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ, UPUK
Researchers and policymakers are worried about the marginalisation of vulnerable youth who drop out of school and work, as a long range of policies and measures developed in many countries have not ...solved the problem. Several studies suggest individually tailored support as a vital measure, but the details of how such support contributes to inclusion remain unclear. This article explores how individually tailored support can contribute to the inclusion of vulnerable youth in school or work as well as its limitations. Qualitative data from four support processes were drawn from a Norwegian pilot project aimed at the inclusion of vulnerable youth in schools or work. While none of the youth fully completed school or found sustainable work during the observation period, several minor or temporary achievements – often ‘soft’ outcomes such as trustful relationships or better management of emotions – were reached. These achievements were experienced as vital and important to the youth, their families and to other support organisations involved. Using the capability approach as a lens, I found that individually tailored professional support contributes to bringing forward internal and external resources and transforming these resources into possibilities and capabilities. These contributions take place as ongoing processes. Further transformation of capabilities into achieved functionings, such as stable work, school completion and often other ‘hard’ outcomes, seems to be more difficult.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
BACKGROUND: People with intellectual and developmental disabilities (IDD) face chronically low rates of employment and high rates of poverty. These effects are amplified for women and ethnic ...minorities. Project SEARCH was developed to help address this disparity in employment. OBJECTIVE: This report looks at the demographic make-up of Project SEARCH participants and compares employment outcomes by gender, race and ethnicity, and disability type. METHODS: Authors examined data from 3,773 interns in the United States during the 2018-19 program year. Data were entered by representatives of 523 licensed program sites into the Project SEARCH database, which is accessed via a secure online Member Portal. RESULTS: The demographic make-up of Project SEARCH interns was representative of the U.S. population, but with some overrepresentation of racial and ethnic minorities and underrepresentation of females, consistent with patterns of enrollment in special education. There were no large differences in employment outcomes of Project SEARCH graduates based on race, ethnicity, gender, or disability type. Some small differences were observed, and these will be explored further in future studies. CONCLUSIONS: Project SEARCH serves a diverse population effectively and equitably. However, there are some differences in outcomes that warrant further investigation.
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DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Social Security Administration demonstration projects that are intended to help people receiving disability benefits have increased employment but not the number of exits from disability programs. ...The Supported Employment Demonstration (SED) is a randomized controlled trial (RCT) of services for individuals with mental health problems before they enter disability programs. The SED aims to provide health, employment, and other support services that help them become self-sufficient and avoid entering disability programs. The target population is people who have been denied Social Security disability benefits for a presumed psychiatric impairment. Thirty community-based programs across the United States serve as treatment sites; inclusion in the SED was based on the existence of high-fidelity employment programs that use the individual placement and support model, the ability to implement team-based care, and the willingness to participate in a three-armed RCT. In the SED trial, one-third of 2,960 participants receive services as usual, one-third receive services from a multidisciplinary team that includes integrated supported employment, and one-third receive services from a similar team that also includes a nurse care coordinator for medication management support and medical care. The goals of the study are to help people find employment, attain better health, and delay or avoid disability program entry. This article introduces the SED.
Semi-structured interviews were conducted to examine the perspectives of 11 job coaches who worked with employees with autism in supported employment programs. Responses were qualitatively analysed ...using thematic analysis, and three top-level themes emerged: a) facilitating factors and b) barriers from their experiences working with employees with autism and c) additional resources that job coaches wished to have. Some characteristics of autism and cooperative working relationships among job coaches were facilitating factors of job coaches' work, while employers' and co-workers' lack of knowledge and understanding about autism, inevitable changes in routine, and social communication difficulties of employees with autism were identified as barriers. Job coaches also mentioned that increasing autism awareness in the workplace and more practical training for job coaches would help them provide better support to employees with autism. These findings call for more structural support for all stakeholders to collaborate on making positive changes rather than put the full burden on job coaches. The need for the provision of evidence-based training programs for job coaches is highlighted.
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BFBNIB, NUK, PILJ, SAZU, UL, UM, UPUK
One in seven working-age adults identifies as having a disability in OECD countries, a share that is also substantial and growing among young people (8% in 2019). Many of them are excluded from ...meaningful work and have low levels of income and social engagement.
Supported employment initiatives have been shown to increase employment rates for autistic people who want to enter the workforce. Despite the success of supported employment initiatives in ...increasing employment rates, little is known about the first-hand experiences and views of those involved. In the current study, we examined the experiences and views of autistic young adults without intellectual disability (‘interns’), employers and parents regarding a previously unevaluated paid internship scheme that offers tailored support for interns and employers before, during and after the internship, the Employ Autism network. In total, 51 participants (19 interns, 22 employers, 10 parents), across eight internships, engaged in semi-structured interviews. Reflexive thematic analysis was used to identify three themes, shared across participant groups: (1) the internship was ‘an invaluable experience’, (2) the internship helped break down autism-specific barriers to employment and (3) stakeholder groups had some unmet expectations. Drawing on this multi-informant qualitative evaluation of a novel supported employment scheme, we derive recommendations of best practice for supported employment initiatives for autistic young adults without intellectual disability.
Lay abstract
Internships designed for autistic people can help them to find employment, but there is little research about the experiences of those involved with internship schemes. To learn more about a new paid internship scheme in the United Kingdom, the Employ Autism network, we interviewed 19 interns, who were autistic young adults without intellectual disability taking part in one of eight different internships. We also interviewed 22 employers (who worked with the interns), and 10 parents (who supported their children in the internship). The interns, employers and parents told us that the Employ Autism network was a valuable experience that helped the interns become more confident. Also, the parents said it helped the interns become more independent. All the groups said the Employ Autism network removed common barriers to employment, and interns and parents said it would help interns get a job in future. Employers and interns said they understood each other better during the internship, and employers said the internship made them think about how their organisations might have accidentally had barriers in place that could stop autistic people getting employed (barriers that they wanted to address in future). However, all groups said some expectations of the internship were not met. These findings suggest the Employ Autism network is helpful for autistic young adults without intellectual disability and employers, but that there are ways that the internships could be improved in future. We discuss the lessons we can learn from the Employ Autism network that might help others who are thinking about setting up, or getting involved in, similar internship schemes.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
Objective: Different predictors of job tenure for people with a severe mental illness (SMI) have been documented. Conflicting results may be explained by the choice of indicators to measure job ...tenure. This study aimed to assess the contribution of employment specialist competencies working in supported employment programs, client variables, and work accommodations, in determining job tenure in the regular labor market. Method: A longitudinal study was conducted over 6 months, including people with SMI (n = 209) registered in 24 Canadian supported employment programs. Multivariable modeling analyses were performed. Results: Overall, 67% (n = 140) of the sample were employed at the 6-month follow-up. Multilevel analyses showed that shorter duration of unemployment (i.e., the number of weeks worked), employment specialist knowledge, and working alliance were the strongest predictors of job tenure for people with SMI. With respect to the number of hours worked per week, diagnosis, executive functions, social functioning, work accommodations, and employment specialist skills were the strongest predictors of job tenure for people with SMI, with 57% of variance explained. Conclusions and Implications for Practice: Understanding the various predictors of job tenure can assist employment specialists in providing better interventions for the work integration of people with SMI.
Impact and Implications
Job tenure for people with SMI remains a challenge, and this study underlined the importance of clients and employment specialist variables as well as work accommodations to improve longer job tenure. Understanding the direct and indirect relationships among these variables can support the work of employment specialists, providing better interventions for the work integration of people with SMI in the regular labor market.
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CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ, UPUK
Objective: Individuals with serious mental illness (SMI) who re-enter the labor market after extended unemployment may benefit from exposure to job interview training. This study explored the ...processes and perceived benefits of preparing for interviews using Virtual Reality Job Interviewing Training (VR-JIT) among employment specialists (ESs) and clients within the individual placement and support (IPS) model of supported employment. Method: This study analyzed secondary qualitative data from a randomized controlled trial (RCT) of VR-JIT including qualitative focus groups comprised of IPS employment specialists (n = 11) and IPS clients (n = 13), semistructured interviews with IPS employment specialists (n = 3), and semistructured interviews with IPS clients (n = 3). Additionally, semistructured interviews with IPS employment specialists (n = 8) who naturalistically implemented VR-JIT at four community mental health agencies independent of the RCT. All focus group and interview data were analyzed using grounded theory methodology. Results: Three main processes were viewed by employment specialists (and their clients) as beneficial for individuals with SMI receiving IPS with VR-JIT: (a) exposure to a simulated interview in a safe environment; (b) practicing and receiving job interviewing feedback; and (c) improved confidence and motivation in job seeking. Conclusions and Implications for Practice: VR-JIT improved IPS participants' confidence in job seeking through proposed mechanisms of exposure to a simulated job interview and repetition and practice of job interview skills. These critical elements indicate that VR-JIT has the potential to improve IPS client engagement particularly with those who have had prolonged periods of unemployment.
Impact and Implications
This study found that Virtual Reality Job Interview Training (VR-JIT) provided needed exposure and practice with job interviewing in a safe environment for unemployed individuals with serious mental illness. VR-JIT has the potential to enhance the IPS model of supported employment for this population.
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CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ, UPUK
