Promoting self-determination and financial security through innovative asset building approaches.

TOPIC: Studies indicate that asset development programs such as Individual Development Accounts (IDAs) can enhance the economic security of low-income populations; however, only a handful of asset development programs have been implemented specifically to serve people with psychiatric disabilities, and larger programs have not collected disability-specific information. PURPOSE: The purpose of this article is to increase our knowledge about the use of IDAs to enhance self-determination and recovery for people with psychiatric disabilities. SOURCES USED: Background information about IDAs is presented followed by case studies of two IDA programs that serve people with psychiatric disabilities. CONCLUSIONS: The use of IDA programs in enhancing self-determination among people with psychiatric disabilities is discussed, along with barriers and future directions.

VR closure rates for two vocational models.

BACKGROUND: The Individual Placement and Support (IPS) model of supported employment is an evidence-based practice for individuals with psychiatric disabilities. To be financially viable, IPS programs require funding from the state-federal vocational rehabilitation (VR) system. However, some observers have questioned the compatibility of IPS and the VR system. METHOD: Using a randomized controlled trial comparing IPS to a well-established vocational program called the Diversified Placement Approach (DPA), we examined rates of VR sponsorship and successful VR closures. We also describe the establishment of an active collaboration between a psychiatric rehabilitation agency and the state VR system to facilitate rapid VR sponsorship for IPS clients. FINDINGS: Both IPS and DPA achieved a 44% rate of VR Status 26 closure when considering all clients entering the study. IPS and DPA averaged similar amount of time to achieve VR sponsorship. Time from vocational program entry to Status 26 was 51 days longer on average for IPS. CONCLUSIONS: Even though several IPS principles seem to run counter to VR practices, such as zero exclusion and rapid job search, we found IPS closure rates comparable to those for DPA, a vocational model that screens for readiness, provides prevocational preparation, and extensively uses agency-run businesses.

A randomized controlled trial comparing two vocational models for persons with severe mental illness.

The authors compared 2 approaches to vocational rehabilitation for individuals with severe mental illness: the individual placement and support (IPS) model of supported employment and the diversified placement approach (DPA), which emphasizes work readiness and offers a range of vocational options, including agency-run businesses and agency-contracted placements with community employers. In all, 187 unemployed participants with severe mental illness were randomly assigned to IPS or DPA. Over 2 years, IPS had significantly better competitive employment outcomes than DPA. Competitive employment rates over the 2-year follow-up were 75.0% for IPS and 33.7% for DPA. However, IPS and DPA did not differ on paid employment outcomes. The authors conclude that IPS is more effective than DPA in achieving competitive employment, but not paid employment.

A Controlled Trial of Supported Employment for People With Severe Mental Illness and Justice Involvement.

OBJECTIVE: Employment is a key to participation in community life for people with severe mental illness, especially those who have been involved in the criminal justice system. Although the Individual Placement and Support (IPS) model of supported employment has been established as an evidence-based practice for helping people with severe mental illness attain competitive employment, little is known about whether IPS is effective for people with severe mental illness who have a history of arrest or incarceration. This study examined this question. METHODS: A randomized controlled trial examined competitive employment outcomes for 85 participants with severe mental illness and justice involvement who were assigned to IPS or to a comparison group that offered a job club approach with peer support. RESULTS: At one-year follow-up, a greater proportion of participants in the IPS group than in the comparison group had obtained competitive employment (31% versus 7%; p<.01). The IPS and comparison groups did not differ significantly during follow-up in rates of hospitalization (51% versus 40%) or justice involvement-either arrests (24% versus 19%) or incarceration (2% for both groups). CONCLUSIONS: Although IPS was shown to be an effective model for helping justice-involved clients with severe mental illness achieve employment, the outcomes were modest compared with those in prior IPS studies. The IPS model provided a useful framework for employment services for this population, but augmentations may be needed.