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Clients at Community Connections, a large mental health agency in Washington, DC, were recruited to participate in the study. One hundred and fifty-two unemployed individuals with severe mental disorders who expressed interest in competitive employment were stratified according to work history and randomly assigned to IPS or EVR using computer-generated random numbers. The study team collected data on individuals at baseline and 6, 12, and 18 months after random assignment.
Individuals were enrolled in the study from January 1994 to July 1995 and were followed for 18 months.
Study funding was provided by the Substance Abuse and Mental Health Services Administration and the National Institute of Mental Health, both within the U.S. Department of Health and Human Services.
A majority of participants (83 percent) were African American, and 61 percent of participants were female. The mean age was about 39 years old. All clients had a severe mental disorder diagnosis, with the most commonly reported disorders being schizophrenia spectrum (67 percent) and bipolar (14 percent) disorders. Some individuals also reported alcohol use (9 percent) or drug use (14 percent) disorder diagnoses. The average individual had worked about eight months in the past five years.
Community Connections implemented IPS. The District of Columbia Rehabilitation Services Administration recommended several rehabilitation agencies to implement EVR.
IPS is a well-established program for helping people with severe mental illness attain employment. Community Connections did not appear to implement IPS before the study. The agencies that implemented EVR were described as well-established providers of similar vocational rehabilitation services. The study does not specify whether those services were enhanced with the addition of a vocational counselor for the purpose of the study.
Employment specialists within a mental health center helped individuals with severe mental illness obtain competitive jobs and provided ongoing support. The IPS model provided individualized and rapid job-search assistance based on participant preferences, a vocational assessment, job development, and optional interview accompaniment. There was no time limit on IPS services; employment support was given as needed.
Individuals received stepped vocational services through several rehabilitation agencies. All rehabilitation agencies involved with EVR had the goal of gradually preparing individuals for competitive employment through a stepped approach of prevocational experiences that primarily consisted of paid work adjustment training in a sheltered workshop. The services were called "enhanced" because an additional vocational counselor was responsible for monthly monitoring and ensuring participants were linked to rehabilitation agencies.
None
Services were available indefinitely.
Not available
The study took place in the Washington, DC, area. Services were provided by Community Connections, a large mental health agency .
Life skills; quality of life; self-esteem; mental health
Please note, I changed the Study name field to say "compared with" -- it originally said "versus."