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This study is a secondary analysis of data from the Therapeutic Employment Placement and Support (TEPS) demonstration, conducted from 2001 to 2005. The TEPS demonstration focused on veterans experiencing homelessness who (1) were not receiving Department of Veterans Affairs (VA) health services, (2) expressed a desire to participate in competitive employment, and (3) were diagnosed with a psychiatric disability or substance use disorder. Cohort 1 of TEPS included 308 veterans who were offered standard VA services. Cohort 2 of TEPS included 322 veterans who were offered Individual Placement and Support (IPS) and standard VA services. The study uses data from 440 of the 630 veterans across the two cohorts. Veterans across both cohorts were assigned to five employment groups based on employment patterns in the six months after TEPS enrollment and included (1) 100 veterans not working at any time, (2) 96 veterans working only in TWE, (3) 30 veterans working in TWE followed by CE, (4) 58 veterans working in CE without IPS (Cohort 1 only), and (5) 156 veterans working in CE with IPS (Cohort 2 only). This study contrasts individuals who worked in CE (Group 4) with those who were employed only in TWE (Group 2). Other study reviews examine the other contrasts.
Individuals enrolled in the study between 2001 and 2003. (The final enrollment date is not provided, but the two-year TEPS follow-up concluded in 2005.) The study examines outcomes for six months after enrollment.
The study was based on work supported by the Mental Health and Behavioral Sciences Service, located in the VA central office in Washington, DC.
The study included 440 veterans experiencing homelessness who (1) were not receiving VA health services; (2) expressed interest in seeking competitive employment; and (3) had been diagnosed with a psychiatric disability and/or substance use disorder. The study did not report the characteristics of the overall sample of 440 individuals. Within the group who worked in competitive employment, 95 percent were male, 31 percent were White, and 86 percent had received an honorable discharge. Within the group who worked in TWE, 95 percent were male, 35 percent were White, and 86 percent had received an honorable discharge.
U.S. Department of Veterans Affairs
The TWE had been offered by the VA before this study as a standard service. The IPS is an established program model but was not previously offered at the VA centers included in the evaluation.
The intervention group includes all individuals in Cohort 1 who worked in competitive employment during the six months after TEPS enrollment. CE participants were military veterans who found unsubsidized jobs in the competitive market on their own. They received the standard VA services, including VA health care, education benefits, home loan assistance, disability compensation, and vocational rehabilitation and employment assistance, but no specific employment-focused intervention. Veterans could receive the standard services indefinitely.
The comparison group includes all individuals who worked in TWE during the six months after TEPS enrollment but who did not engage in competitive employment (with or without IPS) during that time. TWE helped participants develop work restoration plans and provided a real, rehabilitative work setting within the VA, other federal agencies, or private businesses in the community. TWE participants received at least 30 hours per week of structured vocational rehabilitation activities and were assigned to therapeutic work placements for between six months and one year. Participants also received case management to help them gain and enhance their employment skills and find and maintain competitive employment.
None
The study does not specify how long veterans received services.
The program took place within nine VA medical centers in the United States.
Housing; physical health; mental health; substance use; employment attitudes