Study Details | Pathways to Work

5962.03-Study of U.S. Depart

Study quality: Low

Low

Reason for the rating: This study received a low study quality rating because the intervention was always provided in combination with another factor and the effect of the intervention cannot be disentangled from the effect of that other factor.

Intervention: U.S. Department of Veterans Affairs (VA) Individual Placement and Support (IPS) Employment Services

Population and employment barriers:

Military Service (Military veterans), Specific employment barriers (Disability(ies), Homelessness, Mental health condition)

Services provided:

Case management, Job placement, Job search assistance, Mental health services, Subsidized employment/transitional jobs, Treatment or recovery services for substance use disorder

Setting: Tested in multiple settings

Study design

Design:

Quasi-experimental design

Study group formation:

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 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 competitive employment (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 and received an IPS referral (Group 5) with those who were not working (Group 1). Other study reviews examine the other contrasts.

Time period of study:

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.

Pathways only reports results from studies with a study quality rating of high or moderate.

Sample characteristics

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 and received an IPS referral, 91 percent were male, 41 percent were White, and 86 percent had received an honorable discharge.

Sex

Female	9%
Male	91%

Specific employment barriers

Had a disability	86%
Had a mental illness	95%
Were experiencing homelessness	100%
Were military veterans	100%

Intervention implementation

Implementing organization:

U.S. Department of Veterans Affairs

Intervention services:

The intervention group includes individuals recruited into the study during Cohort 2 who were employed during the six months after TEPS enrollment, received an IPS referral. As part of the VA’s IPS program, an employment specialist worked with a larger team of clinicians and support staff to integrate treatment of underlying mental and physical health issues into the employment services for veterans experiencing homelessness. The employment specialist assessed participants’ vocational abilities and helped tailor an accelerated job search based on their strengths and preferences. Employment specialists also cultivated relationships with local employers, developed leads on competitive employment opportunities, and helped participants access other services such as job training and health care available through the VA. Intervention group members could also access standard VA services, including in TWE.

Mandatory services:

None.

Comparison services:

The comparison group includes individuals recruited into the study who were not employed at any point during the six months after TEPS enrollment. They could access standard VA services, including TWE.

Study publications

Leddy, Meaghan, Elina Stefanovics,, and Robert Rosenheck (2014). Health and well-being of homeless veterans participating in transitional and supported employment: Six-month outcomes, Journal of Rehabilitation Research & Development 51(1): 161-174. Available at https://www.rehab.research.va.gov/jour/2014/511/pdf/page161.pdf.

Rosenheck, Robert A., Alvin S. Mares (2007). Implementation of supported employment for homeless veterans with psychiatric or addiction disorders: Two-year outcomes. Psychiatric Services, 58(3), 325-333. Available at http://www.nchv.org/images/uploads/Implementation_of_Supported_Employment_for_Homeless_Veterans_With_Psychiatric_or_Addiction_Disorders-Two-Year_Outcomes.pdf.

View the glossary for more information about these and other terms used on this page.

The Pathways Clearinghouse refers to interventions by the names used in study reports or manuscripts. Some intervention names may use language that is not consistent with our style guide, preferences, or the terminology we use to describe populations.

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Study of U.S. Department of Veterans Affairs (VA) Individual Placement and Support (IPS) Employment Services—with transitional work experience (TWE)