title: Receipt of employment services among Veterans Health Administration users with psychiatric diagnoses.
abstract: This study examined the population-based reach of Veterans Health Administration (VHA) employment services to VHA patients with psychiatric diagnoses. Reach of services includes the percentage and characteristics of people who accessed services compared with those who did not. Using clinical administrative data, we identified patients with a psychiatric diagnosis among a random sample of all patients who received VHA services in 1 yr. Among VHA patients with psychiatric diagnoses, we examined their likelihood of receiving any VHA employment services and specific types of employment services, including supported employment, transitional work, incentive therapy, and vocational assistance. We identified clinical and demographic characteristics associated with receiving employment services. Results indicated that 4.2% of VHA patients with a psychiatric diagnosis received employment services. After adjusting for clinical and demographic characteristics, VHA patients with schizophrenia and bipolar disorder were more likely to receive any employment services and to receive supported employment than were patients with depression, PTSD, or other anxiety disorders. VHA patients with depression and PTSD were more likely to receive transitional work and vocational assistance than patients with schizophrenia. Future studies should examine system-level barriers to receiving employment services and identify types of employment services most appropriate for Veterans with different psychiatric diagnoses.
authors.affiliation: University of Detroit Mercy, Department of Psychology, 4001 W McNichols Rd, Detroit, MI 48221-0445. abrahakm@udmercy.edu,Kristen.abraham2@va.gov.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Abraham
authors.forename: Dara
authors.initials: D
authors.lastname: Ganoczy
authors.forename: Matheos
authors.initials: M
authors.lastname: Yosef
authors.forename: Sandra G
authors.initials: SG
authors.lastname: Resnick
authors.forename: Kara
authors.initials: K
authors.lastname: Zivin
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D000368:Aged; D001007:Anxiety / Q000534:rehabilitation; D001714:Bipolar Disorder / Q000534:rehabilitation; D003430:Cross-Sectional Studies; D003863:Depression / Q000534:rehabilitation; D016832:Employment, Supported / Q000706:statistics & numerical data; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D006703:Ill-Housed Persons / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation*; D008875:Middle Aged; D012050:Rehabilitation, Vocational / Q000706:statistics & numerical data*; D012559:Schizophrenia / Q000534:rehabilitation; D013313:Stress Disorders, Post-Traumatic / Q000534:rehabilitation; D014481:United States; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data*; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data; D014830:Vocational Guidance / Q000706:statistics & numerical data; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult
keywords: PTSD; access; anxiety disorders; bipolar disorder 
  employment services; depression; mental illness; psychiatric 
  diagnosis; schizophrenia; supported employment; transitional work; veterans; vocational rehabilitation