title: Health and well-being of homeless veterans participating in transitional and supported employment: Six-month outcomes.
abstract: Supported employment, specifically individual placement and support (IPS), improves competitive employment (CE) rates for individuals with serious mental illness, but has not shown greater improvement in non-vocational outcomes than other rehabilitation approaches. The Department of Veterans Affairs offers two types of vocational services, IPS and transitional work experience (TWE), but no study has compared the effectiveness of these approaches. This secondary analysis of data from a study of homeless veterans compared 6 mo improvement in diverse outcomes for five employment patterns: never worked, worked only in TWE, worked in TWE followed by CE, worked in CE without IPS, and worked in CE with IPS referral. Veterans referred to IPS were more likely to be competitively employed. Those who worked in CE (whether following TWE or with or without IPS referral) showed the greatest increase in days worked, employment income, and total income and the greatest decrease in public support income when compared with those who worked only in TWE or not at all. Veterans in TWE showed the greatest increase in residential treatment days, but there were no other differences in non-vocational outcomes between groups. There are multiple paths to CE, but few differences in non-vocational outcomes across employment experiences.
authors.affiliation: Department of Veterans Affairs Connecticut Healthcare System, 950 Campbell Ave, Bldg 15, Rm 127, West Haven, CT 06516. meaghan.leddy@yale.edu.
authors.forename: Meaghan
authors.initials: M
authors.lastname: Leddy
authors.forename: Elina
authors.initials: E
authors.lastname: Stefanovics
authors.forename: Robert
authors.initials: R
authors.lastname: Rosenheck
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001294:Attitude to Health; D016832:Employment, Supported / Q000458:organization & administration / Q000523:psychology*; D005260:Female; D006304:Health Status; D006703:Ill-Housed Persons / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000534:rehabilitation*; D008875:Middle Aged; D009788:Occupational Therapy / Q000379:methods; D063868:Patient Outcome Assessment; D010549:Personal Satisfaction; D011788:Quality of Life; D012050:Rehabilitation, Vocational; D012649:Self Concept; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000534:rehabilitation; D014481:United States; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data*
keywords: compensated work therapy; employment; homeless; individual placement and support; recovery; severe mental 
  illness; substance use; supported employment; transitional 
  work experience; veterans