Skip to main content

Implementation of supported employment for homeless veterans with psychiatric or addiction disorders: Two-year outcomes (Rosenheck & Mares 2007)

Absence of conflict of interest.

Citation

Rosenheck, R. A., & Mares, A. S. (2007). Implementation of supported employment for homeless veterans with psychiatric or addiction disorders: Two-year outcomes. Psychiatric Services, 58(3), 325-333.

Highlights

  • The study examined the impact a newly implemented Individual Placement and Support (IPS) program had on employment and earnings outcomes of homeless veterans who were diagnosed with a psychiatric or substance abuse problem.
  • The study team compared raw and adjusted outcome data for veterans who received IPS services and veterans who did not. The team used study participant interviews, activity logs, and employer contacts as data sources.
  • The study found a statistically significant relationship between participation in the IPS program and competitive employment.
  • The quality of causal evidence presented in this report is low because the data on the two groups were not collected at the same time. This means we are not confident that the estimated effects are attributable to the IPS program; other factors are likely to have contributed.

Intervention Examined

Individual Placement and Support (IPS)

Features of the Intervention

IPS is a job placement program with a focus on quick job placement, emphasizing competitive employment, ongoing job support, client choice in jobs, vocational support, and clinical care. The IPS program was implemented by employment specialists within a program for homeless veterans at Veteran Affairs’ (VA) medical centers. The employment specialists and other VA mental health staff received a one-day, on-site, face-to-face orientation; follow-up support took place through case reviews and conference calls.

Features of the Study

The study team used statistical tests to compare raw and adjusted outcome data for veterans who received IPS services and veterans who did not. To participate in the study, veterans had to be homeless, have received a diagnosis of a psychiatric or substance abuse problem, and have expressed an interest in obtaining employment. The comparison group was recruited before the IPS program became available and the intervention group was recruited after the program became available. Data included interviews with study participants. Additionally, employment specialists communicated with employers and kept logs of study participants’ activities. The study took place across nine VA medical centers from January 2001 to March 2005.

Findings

Employment

  • The study found a statistically significant relationship between rates of competitive employment and participation in the IPS program. Veterans who received IPS services had higher rates of competitive employment (44 percent compared to 40 percent). The study found no statistically significant relationships between participation in the IPS program and any employment or noncompetitive employment.
  • The study found a statistically significant relationship between days per month of competitive employment and participation in the IPS program. Veterans who received IPS services worked more days per month in competitive employment (8.4 compared to 7.3). The study found no statistically significant relationships between participation in the IPS program and days per month of any employment or noncompetitive employment.

Earnings

  • The study found no statistically significant relationships between participation in the IPS program and average annualized income, or between participation in the IPS program and hourly wages or monthly earnings.

Considerations for Interpreting the Findings

The comparison and intervention groups were recruited and received services at different times; however, there was an 18-month overlap. Recruitment began in January 2001 for the comparison group and in July 2001 for the intervention group. All participants were invited to take part for at least two years. Date of service initiation determined time of data reporting for each group. This means the study team collected baseline and follow-up data for each group at different points in time. Differences in data collected at different time points could be attributable to time-varying variables, such as changes in the economy, and not the intervention.

Causal Evidence Rating

The quality of causal evidence presented in this report is low because the data on the two groups were not collected at the same time. This means we are not confident that the estimated effects are attributable to the IPS program; other factors are likely to have contributed.

Reviewed by CLEAR

May 2020

Topic Area