title: Mental health and quality of life among veterans employed as peer and vocational rehabilitation specialists.
abstract: OBJECTIVE
  The study compared employment experiences, mental health recovery, and quality of life among peer specialists and vocational rehabilitation (VR) specialists hired by the U.S. Department of Veterans Affairs (VA), the VR specialists under the Homeless Veterans Supported Employment Program. Employment characteristics associated with mental health recovery were examined.
  
  
  METHODS
  The study was a national, observational survey of 152 peer specialists and 222 VR specialists across 138 VA health care systems in 49 states. The survey, administered over the Internet, included measures describing participant characteristics, employment factors, mental health, and quality of life. The two cohorts were compared by using t tests or chi square tests. Multiple regression analysis controlling for participant characteristics was used to identify employment factors associated with mental health and quality of life.
  
  
  RESULTS
  Peer specialists were more likely than VR specialists to share recovery stories, serve as a role model or mentor, and advocate for veterans. Activities by VR specialists tended to focus more narrowly on job skills. Overall, after adjusting for multiple comparisons, the analysis found high levels of mental health and average quality of life for both cohorts, with no significant differences between the groups. Satisfaction with amount of supervision was consistently associated with aspects of mental health recovery, including work-related and helping-related quality of life, for both cohorts.
  
  
  CONCLUSIONS
  The results highlight the value of work and the importance of supervision in realizing both the adoption of recovery-oriented services and the promotion of mental health in a community of veterans serving each other.
authors.affiliation: Dr. Eisen, Dr. Schultz, and Dr. Clark are with the Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts, and Dr. Eisen and Dr. Clark are also with the Department of Health Policy and Management, Boston University School of Public Health, Boston (e-mail: susan.eisen@va.gov ). Dr. Mueller is with the Mental Illness Research, Education and Clinical Center (MIRECC), Edith Nourse Rogers Memorial Veterans Hospital. Dr. Chang is with the U.S. Department of Veterans Affairs (VA) Boston Healthcare System, Boston, and the Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester. Dr. Resnick is with the MIRECC, VA New England Healthcare System, West Haven, Connecticut, and the Yale University School of Medicine, New Haven, Connecticut. Some of the results reported in this article were presented at the Academy Health Annual Meeting, Baltimore, June 23-25, 2013.
authors.forename: Susan V
authors.initials: SV
authors.lastname: Eisen
authors.forename: Lisa N
authors.initials: LN
authors.lastname: Mueller
authors.forename: Bei Hung
authors.initials: BH
authors.lastname: Chang
authors.forename: Sandra G
authors.initials: SG
authors.lastname: Resnick
authors.forename: Mark R
authors.initials: MR
authors.lastname: Schultz
authors.forename: Jack A
authors.initials: JA
authors.lastname: Clark
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation*; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D010379:Peer Group; D010549:Personal Satisfaction; D011788:Quality of Life / Q000523:psychology*; D012050:Rehabilitation, Vocational / Q000379:methods* / Q000523:psychology / Q000706:statistics & numerical data; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data