Cost-Effectiveness of Two Vocational Rehabilitation Programs for Persons With Severe Mental Illness

Dixon, Lisa B.; Hoch, Jeffrey S.; Clark, Robin E.; Bebout, Richard R.; Drake, Robert E.; McHugo, Gregory J.; Becker, Deborah R.

doi:10.1176/appi.ps.53.9.1118

Cited by 40 publications

(40 citation statements)

References 20 publications

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“…In this regard, most mental rehabilitation programs are designed to improve PMI's social and vocational skills (Bae, 2006;Biegel, Pernice-Duca, Chang, & D'Angelo, 2012;Dixon et al, 2002). This study's findings confirmed that the clubhouse had the function of mental rehabilitation for its members in the broader meaning.…”

Section: Extended Meaning Of Rehabilitationsupporting

confidence: 64%

A Phenomenological Study of the Lived Experiences of Koreans with Mental Illness

Kang¹,

Kim²

2014

Journal of Social Service Research

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Section: Extended Meaning Of Rehabilitationsupporting

confidence: 64%

A Phenomenological Study of the Lived Experiences of Koreans with Mental Illness

Kang¹,

Kim²

2014

Journal of Social Service Research

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“…Of the many considerations in assisting people with a disability to return to work is the cost–benefit involved for the supported employment service. Dixon et al. (2002) examined the cost–effectiveness of the individualized placement support service (as previously described) compared with vocational rehabilitation programmes for people with mental illness.…”

Section: Aims and Scope Of This Papermentioning

confidence: 99%

Depression and other mental illnesses in the context of workplace efficacy

Edward

Munro

2008

Psychiatric Ment Health Nurs

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“…We do not present cost data in this article, but the comparatively high operating cost for specialized employment programs (71,72) suggests that providing supported employment through multiservice certified clubhouses would be especially costeffective (73), and vocationally integrated ACT could be reserved for consumers who need intensive clinical care. This assumption needs to be tested within the context of total service system costs.…”

Section: Discussionmentioning

confidence: 99%

Supported Employment Outcomes of a Randomized Controlled Trial of ACT and Clubhouse Models

Macias¹,

Rodican²,

Hargreaves³

et al. 2006

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Objective-In a randomized controlled trial, a vocationally integrated program of assertive community treatment (ACT) was compared with a certified clubhouse in the delivery of supported employment services.Methods-Employment rates, total work hours, and earnings for 121 adults with serious mental illness interested in work were compared with published benchmark figures for exemplary supported employment programs. The two programs were then compared on service engagement, retention, and employment outcomes in regression analyses that controlled for background characteristics, program preference, and vocational service receipt.Results-Outcomes for 63 ACT and 58 clubhouse participants met or exceeded most published outcomes for specialized supported employment teams. Compared with the clubhouse program, the ACT program had significantly (p<.05) better service engagement (ACT, 98 percent; clubhouse, 74 percent) and retention (ACT, 79 percent; clubhouse, 58 percent) over 24 months, but there was no significant difference in employment rates (ACT, 64 percent; clubhouse, 47 percent). Compared with ACT participants, clubhouse participants worked significantly longer (median of 199 days versus 98 days) for more total hours (median of 494 hours versus 234 hours) and earned more (median of $3,456 versus $1,252 total earnings). Better work performance by clubhouse participants was partially attributable to higher pay.Conclusions-Vocationally integrated ACT and certified clubhouses can achieve employment outcomes similar to those of exemplary supported employment teams. Certified clubhouses can effectively provide supported employment along with other rehabilitative services, and the ACT program can ensure continuous integration of supported employment with clinical care.Supported employment is designed to help adults with serious mental illness obtain jobs in socially integrated settings that pay at least minimum wage (1-3). Randomized controlled trials have established supported employment as an evidence-based practice on the basis of higher employment rates for specialized supported employment teams compared with interventions NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript that do not provide supported employment (4-9). The effectiveness of supported employment has been partially attributed to rapid job placement, which bypasses prevocational training, trial jobs, and sheltered work (9-12).However, being hired does not guarantee success on the job. Enrollees express interest in employment when entering a supported employment program, yet typically average only a few months of employment after finding a job (1,8,11,(13)(14)(15)(16). One explanation for brief work tenure is the failure of many supported employment specialists to work closely with treating clinicians (17). Encouraging integration of supported employment with case management and other rehabilitation services, such as supported housing or supported education, also seems beneficial (18,19). Research suggests...

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Cost-Effectiveness of Two Vocational Rehabilitation Programs for Persons With Severe Mental Illness

Cited by 40 publications

References 20 publications

A Phenomenological Study of the Lived Experiences of Koreans with Mental Illness

A Phenomenological Study of the Lived Experiences of Koreans with Mental Illness

Depression and other mental illnesses in the context of workplace efficacy

Supported Employment Outcomes of a Randomized Controlled Trial of ACT and Clubhouse Models

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