Article2002

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

Lisa B. Dixon · Jeffrey S. Hoch · Robin E. Clark · Richard R. Bebout · Robert E. Drake · Gregory J. McHugo +1 more

45 citations0/0 files storedPsychiatric Services

No readable copy stored yet — this record is metadata only.

No open-access location is known for this record yet.

Literature note Cite in a project Citation map

Disability Education and Employment Health Systems, Economic Evaluations, Quality of Life Employment and Welfare Studies

Abstract

OBJECTIVE: This study sought to determine differences in the cost-effectiveness of two vocational programs: individual placement and support (IPS), in which employment specialists within a mental health center help patients obtain competitive jobs and provide them with ongoing support, and enhanced vocational rehabilitation (EVR), in which stepwise services that involve prevocational experiences are delivered by rehabilitation agencies. METHODS: A total of 150 unemployed inner-city patients with severe mental disorders who expressed an interest in competitive employment were randomly assigned to IPS or EVR programs and were followed for 18 months. Wages from all forms of employment and the number of weeks and hours of competitive employment were tracked monthly. Estimates were made of direct mental health costs and vocational costs. Incremental cost-effectiveness ratios (ICERs) were calculated for competitive employment outcomes and total wages. RESULTS: No statistically significant differences were found in the overall costs of IPS and EVR. Participation in the IPS program was associated with significantly more hours and weeks of competitive employment. However, the average combined earnings-earnings from competitive and noncompetitive employment-were virtually the same both programs. The ICER estimates indicated that participants in the IPS program worked in competitive employment settings for an additional week over the 18-month period at a cost of $283 ($13 an hour). CONCLUSIONS: The analyses suggest that IPS participants engaged in competitive employment at a higher cost. When combined earnings were used as the outcome, data from the statistical analyses were insufficient to enable any firm conclusions to be drawn. The findings illustrate the importance of choice of outcomes in evaluations of employment programs.

Paper brief

Loading…

Cite this work

Citation unavailable for this work.

BibTeX RIS CSL-JSON

No public copy is stored for this record, so only the metadata is cited.

Citations in this library

Citation map →

Stored only when both papers are in the corpus — 45 citations exist upstream.

References

2001Implementing Supported Employmentas an Evidence-Based Practice 2002Something old, something new, something borrowed, something blue: a framework for the marriage of health econometrics and cost‐effectiveness analysis 1997An update on supported employment for people with severe mental illness 1998Confidence intervals or surfaces? Uncertainty on the cost-effectiveness plane 2001Does competitive employment improve nonvocational outcomes for people with severe mental illness?1999A Randomized Clinical Trial of Supported Employment for Inner-city Patients With Severe Mental Disorders 2002Improving Employment Outcomes for Persons With Severe Mental Illnesses 1983Making it Crazy: An Ethnography of Psychiatric Clients in an American Community.

Cited by

2003Supported Employment: Evidence for a Best Practice Model in Psychosocial Rehabilitation 2021Vocational Interventions to Improve Employment Participation of People with Psychosocial Disability, Autism and/or Intellectual Disability: A Systematic Review 2022Economic analyses of supported employment programmes for people with mental health conditions: A systematic review 2013Social Costs of Expanding Access to Evidence-Based Supported Employment: Concepts and Interpretive Review of Evidence

Explore the map →

Papers that cite the same references — the relational fallback while embeddings are still backfilling.

Imported from OpenAlex (CC0) — nothing here is generated.