Assisting Social Security Disability Insurance beneficiaries with schizophrenia, bipolar disorder, or major depression in returning to work.
OBJECTIVE
People with psychiatric impairments (primarily schizophrenia or a mood disorder) are the largest and fastest-growing group of Social Security Disability Insurance (SSDI) beneficiaries. The authors investigated whether evidence-based supported employment and mental health treatments can improve vocational and mental health recovery for this population.


METHODS
Using a randomized controlled trial design, the authors tested a multifaceted intervention: team-based supported employment, systematic medication management, and other behavioral health services, along with elimination of barriers by providing complete health insurance coverage (with no out-of-pocket expenses) and suspending disability reviews. The control group received usual services. Paid employment was the primary outcome measure, and overall mental health and quality of life were secondary outcome measures.


RESULTS
Overall, 2,059 SSDI beneficiaries with schizophrenia, bipolar disorder, or depression in 23 cities participated in the 2-year intervention. The teams implemented the intervention package with acceptable fidelity. The intervention group experienced more paid employment (60.3% compared with 40.2%) and reported better mental health and quality of life than the control group.


CONCLUSIONS
Implementation of the complex intervention in routine mental health treatment settings was feasible, and the intervention was effective in assisting individuals disabled by schizophrenia or depression to return to work and improve their mental health and quality of life.
Robert E
RE
Drake
William
W
Frey
Gary R
GR
Bond
Howard H
HH
Goldman
David
D
Salkever
Alexander
A
Miller
Troy A
TA
Moore
Jarnee
J
Riley
Mustafa
M
Karakus
Roline
R
Milfort
D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000188:drug therapy / Q000534:rehabilitation* / Q000628:therapy; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000534:rehabilitation* / Q000628:therapy; D006233:Persons with Disabilities / Q000534:rehabilitation; D019468:Disease Management; D016832:Employment, Supported / Q000523:psychology; D005260:Female; D006801:Humans; D018868:Insurance, Disability; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D012050:Rehabilitation, Vocational; D062707:Return to Work; D012559:Schizophrenia / Q000188:drug therapy / Q000534:rehabilitation* / Q000628:therapy; D012943:Social Security; D014481:United States