Arizona | Connecticut | Maine | Maryland | Massachusetts | Pennsylvania | South Carolina | Texas

ARIZONA

The purpose of the Personalized Employment Supports Project was to conduct a controlled study of an integrated vocational service delivery model operating within a managed mental health care organization. This involved the random assignment of 300 mental health consumers in Phoenix, AZ, to either an integrated model of supported employment services or to customary vocational rehabilitation.

Interventions

Individuals randomly assigned to the experimental integrated employment program received a full array of case management and supported employment services from an integrated treatment team. This team was comprised of psychiatrists, case managers, rehabilitation counselors, employment specialists, job developers, and benefits specialists, all of whom were organized within a single administrative entity and worked in the same offices.

In contrast, individuals assigned to the control condition received their vocational rehabilitation services from community rehabilitation programs through traditional referral and purchase of service arrangements.

For more information on the Arizona site, contact:
Michael Shafer, Ph.D., Principal Investigator
Community Rehabilitation Division
721 N. 4th Ave.
Tucson, AZ  85705
(520) 917.0841
(520) 917.0845 FAX

CONNECTICUT

The New Hampshire-Dartmouth Psychiatric Research Center's project was located in the Capitol Region Mental Health Center in Hartford, CT. The purpose of this project was to conduct a controlled study comparing three different approaches to vocational rehabilitation for mental health consumers.

Interventions

Individual Placement and Support (IPS) emphasized minimal prevocational assessment, rapid job finding, matching jobs to consumers' interests, integrated jobs in community settings, provision of follow-along supports, and close integration with clinical services. IPS employment specialists were part of consumers' clinical treatment teams.

Transitional Employment (TE) was provided within a psychiatric rehabilitation program, the Chrysalis Center. Initially, consumers participated in vocational training or work crews that operated within the Center. Consumers then built upon their employment experience by working in transitional jobs in the community, and eventually obtained their own competitive jobs.

Standard Services (SS) consisted of vocational services which were available to mental health consumers in Hartford, CT, including sheltered (non-competitive) employment, off-site supported employment, and educational programs.

For more information on the Connecticut site, contact:
Kim Mueser, Ph.D., Principal Investigator
New Hampshire-Dartmouth Psychiatric Research Center
Main Building
105 Pleasant Street
Concord, NH  03301
(603) 271.5747
(603) 271.5265 FAX

MAINE

This project tested the effectiveness of an innovative strategy to establish competitive employment for mental health consumers. The strategy was based upon a comprehensive support model, extended to those who sought jobs as well as to the employers who provided them.

Interventions

All project participants received Family-Aided Assertive Community Treatment (FACT), which combined features of assertive community treatment with family psychoeducation, family participation in rehabilitation, and multiple-family support groups. Fifteen area businesses organized a Mental Health Employers Consortium (MHEC) in conjunction with Maine Medical Center's Hospital Industries Program. The MHEC promoted employment for mental health consumers, with employers pledging a minimum number of jobs each year. In the experimental intervention, employment specialists on the FACT teams worked with the MHEC companies to develop natural supports as well as reasonable accommodations. In the comparison condition, FACT teams applied more traditional job development approaches such as individualized job placement and support. The research compared the effectiveness of MHEC + FACT to FACT alone.

For more information on the Maine site, contact:
Bill McFarlane, M.D., Principal Investigator
Maine Medical Center, Department of Psychiatry
22 Bramhall Street
Portland, ME  04102
(207) 871.2091
(207) 871.6377 FAX

MARYLAND

The Maryland Project, using a controlled experimental design, compared the relative effectiveness of two vocational rehabilitation programs designed to improve competitive employment outcomes among consumers in the inner city.

Interventions

Through random assignment, half of the participants were enrolled in the Individual Placement and Support (IPS) program, a novel supported employment program embedded within a community-based continuous treatment team designed to provide mobile, mulitdisciplinary, comprehensive services 24 hours a day. The IPS model focused on rapid placement with continued follow-along support. Employment opportunities were consistent with consumers' preferences, skills, and abilities.

The other half of the participants received quality psychosocial support and a continuum of transitional and supported employment services which were coordinated with, rather than integrated into, consumers' treatment teams. Such services were widely available in Maryland during the time of the study.

Anthony Lehman, M.D., Principal Investigator
Professor and Chair
Department of Psychiatry
University of Maryland School of Medicine
701 W. Pratt Street, Suite 388
Baltimore, MD 21201
(410) 328-6735
(410) 328-3693 (FAX)

For more information on the Maryland site, contact:
Richard Goldberg, Ph.D.
Center for Mental Health Services Research
University of Maryland, Department of Psychiatry
685 West Baltimore Street, MSTF Building Room 300
Baltimore, MD 21202-1549
(410) 706-2490 (RG)
(410) 706-0022 (FAX)

MASSACHUSETTS

Fountain House, Inc. of New York city conducted an experimental evaluation in Worcester, MA of the relative effectiveness of the integrated vocational components of Assertive Community Treatment (PACT) and Clubhouse models.

Interventions

The PACT condition included a mobile team composed of a psychiatrist, nurse, clinicians, social workers, and vocational specialists who provided direct services in the community. The Worcester PACT team at Community Healthlink, Inc., was created by one of the PACT model's founders and ongoing mentorship of the team was provided by the developer of the original PACT vocational component. The Clubhouse was a planned community of staff and consumers who worked together in the program on a daily basis to provide and receive services such as meals, companionship, skills training, and paid work. The Worcester clubhouse, Genesis Club, Inc., was certified by the International Center for Clubhouse Development as operating in full compliance with the Standards for Clubhouse Programs.

Cathaleene Macias, Ph.D., Principal Investigator

For more information on the Massachusetts site, contact:
Kenn Dudek, MSW, Executive Director
Fountain House, Inc.
425 West 47th Street
New York, NY 10036
(212) 582-0340
(212) 397-1649 (FAX)

PENNSYLVANIA

This project was a randomized field study of the effectiveness of providing long term vocational supports to mental health consumers who were employed at program entry. The study was directed by the Matrix Research Institute, in Philadelphia, PA.

Interventions

Project participants were randomly assigned to one of two treatment conditions. Consumers in the experimental condition received long term employment training and supports (LETS) from an Employment Supports Counselor as well as mental health consumer peers. These supports and services included career and educational goals clarification; job development activities; creation of vocational profiles; securing job accommodations; decision support regarding on-the-job disclosure; building skills for coping with work problems; assistance with Social Security benefits; and peer support group meetings focusing on employment issues. Consumers in the control condition received only non-vocational peer supports along with services as usual in Philadelphia.

Laura Blankertz, Ph.D., Principal Investigator

For more information on the Pennsylvania site, contact:
Kate R. Donegan, Ed.D., ext. 300
The Matrix Center @ Horizon House, Inc.
120 S. 30th Street
Philadelphia, PA 19104-3403
(215) 386-3838

SOUTH CAROLINA

This project was operated by the Santee-Wateree Community Mental Health Center (CMHC) to evaluate two approaches for integrating supported employment, mental health, and case management services in a rural Southern community.

Interventions

Consumers assigned to the experimental condition received all of their services from an Assertive Community Treatment (ACT) team, modeled after the PACT program developed in Madison, WI. The team included a part-time psychiatrist and full-time nurses, clinical counselors, and vocational specialists. The vocational specialists used the Individual Placement and Support (IPS) model of supported employment developed at the New Hampshire-Dartmouth Psychiatric Research Center creating a new hybrid ACT + IPS approach.

Consumers assigned to the control condition received case management and other clinical services from the CMHC. In addition, they received transitional and supported employment services through a private vocational agency which used sheltered employment for work adjustment training and then transitioned clients to integrated community employment.

Neil Meisler, M.S.W., Principal Investigator

For more information on the South Carolina site, contact:
Paul B. Gold, Ph.D., Co-Principal Investigator
Medical University of South Carolina
Department of Psychiatry & Behavioral Sciences
P.O. Box 250861
67 President St., IOP 4th Floor South (29403)
Charleston, SC 29425
(843) 792.6892
(843) 792.6889 (FAX)

TEXAS

This project was grounded in the assumption that helping consumers build and strengthen their natural support networks, when combined with traditional supported employment services, would increase their ability to find and maintain employment and to cope with job-related stresses.

Interventions

The experimental intervention combined "rapid entry" supported employment (SE) with social network enhancement in a model called Employment Assistance through Reciprocity in Natural Supports (EARNS). Services were designed to help consumers move from support networks characterized primarily by professional support to more balanced networks that were larger, more diverse, and more reciprocal. This involved social network assessments, social network enhancement plans, and self-advocacy training for consumers. Staff also worked directly with employers, coworkers, family, and friends to strengthen existing network ties, develop new network relationships, and improve reciprocity.

The control group received standard SE services based on a "place-train" approach, which helped consumers find jobs and then provided training and supports related to that job.

For more information on the Texas site, contact:
Marcia Toprac, Ph.D.
Principal Investigator - Texas EARNS
formerly with Texas Department of MHMR (retired)
(512) 323-0913

Pamela Daggett
Senior Policy Analyst for Mental Health
Texas Department of State Health Services
1100 W. 49th Street
Austin, Texas 78756
(512)458-7111 (X3747)