Supported Employment

The unemployment rate among people with serious mental illnesses (SMI) is the highest among all disability groups in the US. Research and personal accounts support the positive effects of work. Employment enhances quality of life, increases one’s self-esteem, provides access to goods and services, and has a positive effect on overall physical health. Unfortunately, individuals with SMI have interrupted developmental experiences due to the common onset of illness during adolescence and young adulthood and often never fully, if at all, realize the goal of embarking on careers. Limited access to quality employment services, specifically the evidence based model of Supported Employment (SE) contributes significantly to the very low employment rate among people with SMI. Access may be further impeded by mental health service providers who lack the adequate skills and resources needed to support individuals in their employment goals.

The federal definition of Supported Employment is: 

Competitive work in integrated work settings . . . consistent with the strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice of the individuals, for individuals with the most significant disabilities for whom competitive employment has not traditionally occurred; or for whom competitive employment has been interrupted or intermittent as a result of a significant disability (Rehabilitation Act Amendments of 1998: Title IV of the Workforce Investment Act of 1998, Pub Law 105-220, 112 Stat 936).

Supported Employment is based on eight principles developed by researchers from Dartmouth University. The eight principles of the Individual Placement and Support (IPS) model of SE include:

  1. Every person with severe mental illness who wants to work is eligible for supported employment.
  2. Employment services are integrated with mental health treatment services.
  3. Competitive employment is the goal.
  4. Personalized benefits counseling is provided.
  5. The job search starts soon after a person expresses interest in working.
  6. Employment specialists systematically develop relationships with employers based upon
  7. Job supports are continuous.
  8. Client preferences are honored

Evidence for the Effectiveness of SE:

Employment services that incorporate the IPS principles achieve enhanced employment outcomes compared to other vocational services. In one of the largest multisite randomized trials of SE interventions, individuals who received SE were more likely to become competitively employed and work 40 or more hours per month, as well as have higher monthly earnings compared to those who received services as usual. Participants in SE services also experience improvements in non-vocational outcomes including, decreases in symptom distress, substance abuse, service utilization, and crises, as well as increases of housing stability, self-esteem, and overall quality of life.

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