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Center for Health Services and Outcomes Research

Patient Outcomes – Patient Reported

Impact of Employment Interventions for Persons with Serious Mental Illnesses on Non-employment Patient-Centered Outcomes

The effect of initiation of evidence-based supported employment services (Individual Placement and Support-IPS) was compared to traditional vocational services for persons with serious mental illnesses enrolled in Medicaid and qualifying for state or federal disability.  Data were compiled from Medicaid claims, Maryland Public Mental Health System and the Maryland Division of Rehabilitative Services.  Patterns of medical and mental health care and client-reported functional status, use of alcohol and drugs, and interactions with law enforcement were examined. Reports address continuity and coordination of health and mental health care, and effects on patient-reported mental health functional status, substance use, and arrests.

Associations between supported employment compared to traditional vocational services were neutral or positive for medication continuity and not significant for provider continuity. Associations between supported employment and coordination of care were mixed and not statistically significant. A smaller than expected sample size may have contributed to less statistical significance as might have variations in employment program selection of clients and employment services provided.

The effects of patient-reported mental health functional status, substance use and arrests were examined for the employment intervention groups.  The study groups did not differ on these outcomes.

Reports:

Comparison of Alternative Employment Services for Persons with Serious Mental Illness: Effects on Patient-Reported Mental Health Functional Status, Substance Use, and Arrests.

Comparison of Evidence-Based and Traditional Employment Services for Persons with Serious Mental Illness: Implications for Somatic and Mental Health Care Continuity and Coordination