Predictors of employment for transition-aged youth with co-occurring substance use disorder and psychiatric disorder in the state vocational rehabilitation service-delivery system.

Abstract

Objective: To identify state vocational rehabilitation (VR) services that were associated with employment for transition-aged youth with co-occurring disabilities (TAYWCD). Method: Hierarchical logistic regression analyses were utilized. Participants were 830 youth aged 24 and younger who had a cooccurring substance use disorder and another mental illness. Results: After controlling for the effect of demographic covariates, assessment services (OR = .53, 95% CI [.35, .80], p < .01), job placement services (OR = 2.56, 95% CI [1.73, 3.78], p < .001), and supported employment services (OR = 3.7, 95% CI [2.33, 5.89], p < .001) were found to significantly impact employment outcomes. Conclusions and Implications for Practice: State VR services that aligned with the individual placement and support model of supported employment principles were correlated with successful employment outcomes for TAYWCD who received these services. Recommendations include the following: (a) prepare VR counselors to effectively work with individuals with psychiatric disabilities; (b) provide TAYWCD with high-quality assessment and the individual placement and support model of supported employment services; (c) require VR counselors who serve TAYWCD to collaborate with community partner agencies that provide coordinated specialty care model services; (d) require VR counselors to collaborate with community partner agencies that provide recovery-oriented and evidence-based services; (e) encourage clients to formulate a Wellness Recovery Action Plan (WRAP) as a state VR assessment and Individualized Plan for Employment planning service; (f) include the state VR on-the-job training service in the Individualized Plan for Employment; (g) make use of benefits counseling services; and (h) institute in-service learning opportunities in state VR agencies. Impact and ImplicationsState vocational rehabilitation counselors have direct access to a wealth of resources to support employment services and the ability to coordinate these services with partner agencies in the community. In state vocational rehabilitation, services that aligned with aspects of the individual placement and support model of supported employment were correlated with successful employment outcomes for youth with co-occurring substance use and psychiatric disorders who received these services.

Identifying characteristics of vocational rehabilitation journeys for patients who retain their success.

“…Vocational Rehabilitation (VR) is a concept that describes a multidisciplinary process involving health and social services where individuals with health conditions are supported in their aim of successful and permanent entry or re-entry to the workforce [1][2][3]. Certain service types such as job placements [4,5], on-the-job support [6], and financial support [7], are widely accepted as having a positive relationship with rehabilitation outcome. Nevertheless, the identification of key aspects of VR and combinations of services that improve patients' outcomes remains difficult.…”

“…Nevertheless, the identification of key aspects of VR and combinations of services that improve patients' outcomes remains difficult. Many studies consider the outcome of VR to be the employment status of an individual upon exiting the program [5,6,8,9]. Others have tried to measure and capture factors associated with longer-term success in VR [10,11], with the acknowledgement that initial success does not necessarily map to prolonged success.…”