Long-Term Effects of Evidence-Based Supported Employment on Earnings and on SSI and SSDI Participation Among Individuals With Psychiatric Disabilities

Judith Α. Cook · Jane K. Burke-Miller · Emily L. Roessel

27 citations0/0 files storedAmerican Journal of Psychiatry

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Disability Education and Employment Schizophrenia research and treatment Employment and Welfare Studies

Abstract

OBJECTIVE: This study examines the long-term effects of evidence-based supported employment services on three vocational outcomes: labor force participation, earnings, and attainment of Social Security Administration (SSA) nonbeneficiary status through suspension or termination of disability cash payments due to work (NSTW). METHOD: Data from 449 individuals with psychiatric disabilities who participated in a multisite controlled trial of supported employment were matched to SSA data over a 13-year period (2000-2012) following supported employment services. Long-term outcomes were analyzed using random effects regression models comparing participants in the experimental and control conditions on measures of employment, earnings, and attainment of NSTW. The authors adjusted for time, age, race/ethnicity, gender, education, schizophrenia diagnosis, substance abuse history, and geographic region. RESULTS: Overall outcomes were modest across the 13-year follow-up, with 32.9% of participants having any earned income and 13.1% ever attaining NSTW. Supported employment recipients were almost three times as likely as control subjects to be employed over 13 years (odds ratio=2.89). Although earnings were low, supported employment participants had significantly higher earnings per month than control subjects over time (parameter estimate=$23.82) and were more likely than control subjects to attain NSTW (odds ratio=12.99). The supported employment effect diminished and was completely attenuated over time. CONCLUSIONS: The study's findings indicate a small but significant vocational advantage accruing to recipients of evidence-based supported employment in the decade following service delivery, adding to the evidence on the durability of supported employment effects. Results can inform policies designed to help workers enhance economic security and reduce dependence on Social Security disability benefits.

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References

2008An update on randomized controlled trials of evidence-based supported employment.2001Helping people with severe mental illness to obtain work: systematic review 1997An update on supported employment for people with severe mental illness 2005Results of a Multisite Randomized Trial of Supported Employment Interventions for Individuals With Severe Mental Illness 2008The Impact of Supported Employment and Working on Clinical and Social Functioning: Results of an International Study of Individual Placement and Support 2006Employment Barriers for Persons With Psychiatric Disabilities: Update of a Report for the President's Commission 2013Supported Employment: Assessing the Evidence 2014Long-Term Effectiveness of Supported Employment: 5-Year Follow-Up of a Randomized Controlled Trial

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2021Umsetzung der Prinzipien des Supported Employment in Deutschland 2018Predictors of Sustained Employment Among Individuals With Serious Mental Illness 2016Why can’t we fund supported employment?

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