Mental Impairment
Conditions
Brief summary
The purpose of this study is to determine whether offering an evidence-based package of employment supports integrated with mental health services has a positive impact on employment and clinical recovery, and delays or diminishes the need for disability benefits.
Detailed description
SSA contracted with Westat to implement and evaluate the Supported Employment Demonstration (SED). The SED provides integrated mental health and vocational services to people with mental illness who were recently denied Social Security disability benefits. The evaluation will determine the impact of the SED on employment, clinical recovery, and receipt of disability payments. The evaluation is using a randomized controlled trial design to compare the outcomes of two treatment groups and a control group. In the full-service arm (n = 1,000), participants receive services from an Individual Placement and Support employment specialist, a care manager, and a nurse care coordinator (NCC) who provides medication management support, as well as modest funding for out-of-pocket prescriptions, essential work-related expenses, and other services in the participant's treatment plan. The basic-service arm (n=1,000), which is expected to cost about 50 percent less than the full-service arm, provides all services and funds except the NCC. Participants in the usual services (control) group (n = 1,000) seek services as they normally would but receive a comprehensive guide to local, state, and national resources. Data collection includes computer-assisted baseline (in-person) and blinded quarterly (telephone) interviews with participants, collection of SSA administrative and site-level program data, site visits (including fidelity assessments), qualitative interviews with site administrators and service providers, focus groups with study participants, and person-centered ethnographic interviews with participants and nonparticipants.
Interventions
BEHAVIORALFull Service
Receive Individual Placement and Support (IPS) model of employment services, behavioral health services, care management services, and Medication Management Support provided by a Nurse Care Coordinator (NCC).
BEHAVIORALBasic Service
Receive Individual Placement and Support (IPS) model of employment services, behavioral health services, and care management services.
Sponsors
United States Social Security Administration
Westat
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 49 Years
Healthy volunteers
No
Inclusion criteria
* Individuals denied Social Security disability benefits (SSDI or SSI) * Individuals alleging a mental impairment * Live in Community Mental Health Agency (CMHA) catchment area * Legally competent * Express desire to improve work situation
Exclusion criteria
* Intellectual disability * Reside in a nursing home or custodial institution * Already receiving supported employment services from CMHA site
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Employment | 36 months | Whether participant is employed in a paying job at any time during the 36 month study period. Assessed via quarterly computer-assisted telephone interviews. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total Hours Worked | 36 months | The reported total number of hours worked for pay during the 36-month study period. Assessed via quarterly computer-assisted telephone interviews. |
| Days to First Job | 36 months | The number of days from enrollment date to first job during the 36-month study period, for those not employed at enrollment. Assessed via quarterly computer-assisted telephone interviews. |
| Months Employed | 36 months | The number of months employed during the 36-month study period. Assessed via quarterly computer-assisted telephone interviews. |
| Job Tenure | 36 months | The longest number of consecutive months employed for any single job during the 36-month study period. Assessed via quarterly computer-assisted telephone interviews. |
| Employment (Competitive) | 36 months | Whether a participant is employed in a community job that pays at least minimum wage (as defined by the resident state) and is owned by the employer rather than a mental health center or rehabilitation agency at any time during the 36 month study period. Assessed via quarterly computer-assisted telephone interviews. |
| Months above SGA | 36 months | The number of months the participant reported earnings above Substantial Gainful Activity (SGA) levels over the 36-month study period. Assessed via quarterly computer-assisted telephone interviews. |
| Short-Form 12 Health Survey (SF-12) Mental Component Score (MCS) | 36 months | The difference between the Short-Form 12 Health Survey (SF-12) Mental Component Score (MCS) measured at baseline (Baseline Survey) and at study exit (final quarterly follow-up survey). Higher values of the SF-12 MCS indicate better outcomes. A higher SF-12 MCS at study exit than at baseline indicates a positive change. Assessed via computer-assisted telephone interviews. |
| Time Until Award | 36 months | The number of study days to disability award. Assessed using Social Security Administration administrative data. |
| Total Earnings | 36 months | Total amount of reported earnings over the 36-month study period. Assessed via quarterly computer-assisted telephone interviews. |
Countries
United States
Outcome results
None listed