Why open access to vocational services in substance use treatment matters: Commentary on Cosottile and Defulio (2020).

Stevenson, Brian J.; Bakken, Shana; Mueller, Lisa; Drebing, Charles E.

doi:10.1037/adb0000753

Cited by 3 publications

(8 citation statements)

References 30 publications

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“…The benefits of VHA vocational rehabilitation, including the recovery from psychiatric and SUD diagnoses, is well-documented. Additional research reflects improved independent functioning and lowering of the need for medical, psychological, vocational, and homeless program services through the VHA (22,25,26,28). The current study results yielded program enrollment disparities for veterans with a history of AUD diagnoses and a history of depression, adjustment disorder, and PTSD.…”

Section: Discussionmentioning

confidence: 70%

“…For example, after examining nearly 100,000 veterans, Zivin et al (24) found that veterans with bipolar disorder, depression, post-traumatic stress disorder (PTSD), schizophrenia, or SUDs were more likely to be unemployed, have a disability or be retired than employed. Other studies have shown that veterans with SUD diagnoses or who were homeless at program entry were more likely to be employed at discharge, while receipt of public support income and severe mental illness decreased the inclusion in the competitive labor market (22,(25)(26)(27)(28).…”

Section: Vocational Rehabilitation and Mental Healthmentioning

confidence: 99%

“…National databases connected with VHA VR have been examined to evaluate its efficacy in employment and healthcare outcomes, and research findings have shown improvement in employment obtainment and retention (22) and lower healthcare needs (e.g., fewer visits in VHA vocational rehabilitation, outpatient mental health, homelessness program, and medical hospitalizations) post-discharge (25). However, the cooccurring/co-morbid nature of having both a psychiatric and SUD diagnosis concurrently lowers participation in competitive employment (29).…”

Section: Vocational Rehabilitation and Mental Healthmentioning

confidence: 99%

“…Due to low frequencies within early remission and sustained remission, the variable was condensed into no usage, active usage, and inactive usage (sustained and early remission SUD and AUD). Prior literature has shown that veterans with psychiatric disorders experience significant employment-related barriers (22). Therefore, psychiatric disorders was used as the other predictor variable.…”

Section: Predictor and Outcome Variables And Data Analysismentioning

confidence: 99%

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Disparities in program enrollment and employment outcomes for veterans with psychiatric and co-occurring substance use disorders referred or enrolled for VHA vocational rehabilitation

et al. 2023

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IntroductionThe purpose of the study was to investigate factors that influence vocational rehabilitation program enrollment and employment at discharge of veterans with psychiatric and co-occurring alcohol and other substance use disorders enrolled at a veteran health administration (VHA) medical center.MethodsA sample of 2,550 veteran patients referred for VHA vocational rehabilitation between 2016 and 2021 were examined for the current study. The current study was classified as quality improvement/assurance, thus resulting in exempt research by the U.S. Department of Veteran Affairs Institutional Review Board.ResultsVeterans with active alcohol use disorders (AUDs) and co-occurring depression, anxiety, post-traumatic stress disorder, or bipolar disorders were less likely to be enrolled for vocational rehabilitation program services compared to those without these co-occurring diagnoses. Veterans with AUD (active & in-remission status combined into one category) and a diagnosis of anxiety were less likely to be employed at discharge compared to veterans with AUDs and no anxiety diagnosis (anxiety diagnosis – 3.5% vs. no anxiety diagnosis – 5.8%).DiscussionVHA vocational rehabilitation can be an effective intervention to assist veterans in reintegrating back into the community. Yet, there appears to be some disparities in the program enrollment and employment at discharge, depending on the nature of the psychiatric diagnosis. Investigating the factors contributing (mediating or moderating) to these discrepancies are needed. Although it appears access is not the issue in being referred for vocational rehabilitation services, other factors are likely contributing to program entry.

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Section: Discussionmentioning

confidence: 70%

Section: Vocational Rehabilitation and Mental Healthmentioning

confidence: 99%

Section: Vocational Rehabilitation and Mental Healthmentioning

confidence: 99%

Section: Predictor and Outcome Variables And Data Analysismentioning

confidence: 99%

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Disparities in program enrollment and employment outcomes for veterans with psychiatric and co-occurring substance use disorders referred or enrolled for VHA vocational rehabilitation

et al. 2023

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“…First, we aimed to explore the ways in which personal experiences with mental health and substance use, as well as social-environmental variables influence vocational process of veterans with co-occurring mental health and substance use disorders. Second, since vocational interventions tend to be relegated as less important than interventions aimed at symptom reduction and/or substance use (Stevenson, Bakken et al, 2022), this study also aimed to explore the perceived usefulness of enhancing career outcomes (e.g., enhancing vocational identity and increasing goal clarity) among this population with intensive clinical needs. To accomplish our aims, we highlight the voices of those with lived experience by asking them to (1) describe their vocational journeys over time with emphasis on interests, goals, choices, environmental barriers, relationships, mental health, and substance use, and (2) describe the way that enhanced vocational clarity would impact their lives.…”

Section: Present Studymentioning

confidence: 99%

Mind the Overlap: A Qualitative Exploration of the Vocational Lives of Veterans Living With Mental Health and Substance Use Conditions

Stevenson

Chamberlin

Smith

et al. 2023

Journal of Career Assessment

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Veterans with mental health and substance use conditions have poor employment outcomes and would likely benefit from integrated career, mental health, and substance use related interventions. However, vocational psychology has overlooked this vulnerable population, and vocational interventions are often relegated as less important than other psychotherapeutic interventions that target substance use or symptom reduction. Drawing upon Social Cognitive Career Theory and Psychology of Working Theory, this qualitative study examined how external and internal factors influenced the vocational trajectories of eight veterans with mental health and substance use conditions. Additionally, this study examined participants’ perspective on the usefulness of improving career outcomes in supporting their lives and recoveries. Using Consensual Qualitative Research methodology, this study uncovered how personal, environmental, relational, mental health, and substance use factors impacted the vocational trajectories of veterans living with mental health and substance use conditions. Findings also highlight that veterans want fulfilling employment and more clarity in their vocational lives to support their mental well-being and prevent substance use. Implications for vocational psychology theory and integrative practice are discussed.

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The COVID-19 pandemic’s influence on employment outcomes of veterans enrolled in VA healthcare vocational rehabilitation

Sprong,

Blankenberger,

Pierce

et al. 2024

JVR

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BACKGROUND: Employment has been shown to be the fourth most commonly reported need for veterans and their families, and unemployment rates have ranged from 1–69% dependent on the mental health diagnosis. Complications from the COVID-19 pandemic have had a significant impact on psychological functioning, and social isolation has led to increased psychiatric symptoms. Vocational rehabilitation is an intervention provided to Veterans in an attempt to remove barriers to employment while also increasing involvement in gainful work activity. OBJECTIVE: The purpose of the current study was to examine the impact that COVID-19 has had on employment rates at discharge for veterans with mental health disorders participating in a VHA vocational rehabilitation program. METHODS: An outcome-based, summative program evaluation design was used to assess the quality of Veterans served (2016-2021) at a vocational rehabilitation program served at a medical center located in VISN 12 of the U.S. Department of Veteran Affairs. RESULTS: Findings showed that veterans with Bipolar and Psychosis were less likely to discharge with employment (not considering COVID-19). CONCLUSION: No significant meaningful differences existed in employment rates when comparing pre/post March 2020 (official start of COVID-19 pandemic) for veterans with psychiatric diagnoses.

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Why open access to vocational services in substance use treatment matters: Commentary on Cosottile and Defulio (2020).

Cited by 3 publications

References 30 publications

Disparities in program enrollment and employment outcomes for veterans with psychiatric and co-occurring substance use disorders referred or enrolled for VHA vocational rehabilitation

Disparities in program enrollment and employment outcomes for veterans with psychiatric and co-occurring substance use disorders referred or enrolled for VHA vocational rehabilitation

Mind the Overlap: A Qualitative Exploration of the Vocational Lives of Veterans Living With Mental Health and Substance Use Conditions

The COVID-19 pandemic’s influence on employment outcomes of veterans enrolled in VA healthcare vocational rehabilitation

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