Barriers to Employment Among Social Security Disability Insurance Beneficiaries in the Mental Health Treatment Study.
OBJECTIVE
This study examined barriers to employment among Social Security Disability Insurance (SSDI) beneficiaries who received comprehensive vocational and mental health services but were not successful in returning to work.


METHODS
This study examined barriers to employment among 430 SSDI beneficiaries with mental disorders who received evidence-based vocational and mental health services for two years but worked less than one month or not at all. Comprehensive care teams, which included employment specialists, made consensus judgments for each participant, identifying the top three barriers to employment from a checklist of 14 common barriers.


RESULTS
Teams most frequently identified three barriers to employment: poorly controlled symptoms of mental illness (55%), nonengagement in supported employment (44%), and poorly controlled general medical problems (33%). Other factors were identified much less frequently.


CONCLUSIONS
Some SSDI beneficiaries, despite having access to comprehensive services, continued to experience psychiatric impairments, difficulty engaging in vocational services, and general medical problems that limited their success in employment.
Dr. Milfort is with Westat, Rockville, Maryland. Dr. Bond and Dr. Drake are with the Dartmouth Psychiatric Research Center, Lebanon, New Hampshire. Dr. McGurk is with the Center for Psychiatric Rehabilitation, Boston University, Boston. Send correspondence to Dr. Drake (e-mail: robert.e.drake@dartmouth.edu ).
Roline
R
Milfort
Dr. Milfort is with Westat, Rockville, Maryland. Dr. Bond and Dr. Drake are with the Dartmouth Psychiatric Research Center, Lebanon, New Hampshire. Dr. McGurk is with the Center for Psychiatric Rehabilitation, Boston University, Boston. Send correspondence to Dr. Drake (e-mail: robert.e.drake@dartmouth.edu ).
Gary R
GR
Bond
Dr. Milfort is with Westat, Rockville, Maryland. Dr. Bond and Dr. Drake are with the Dartmouth Psychiatric Research Center, Lebanon, New Hampshire. Dr. McGurk is with the Center for Psychiatric Rehabilitation, Boston University, Boston. Send correspondence to Dr. Drake (e-mail: robert.e.drake@dartmouth.edu ).
Susan R
SR
McGurk
Dr. Milfort is with Westat, Rockville, Maryland. Dr. Bond and Dr. Drake are with the Dartmouth Psychiatric Research Center, Lebanon, New Hampshire. Dr. McGurk is with the Center for Psychiatric Rehabilitation, Boston University, Boston. Send correspondence to Dr. Drake (e-mail: robert.e.drake@dartmouth.edu ).
Robert E
RE
Drake
D000328:Adult; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D016832:Employment, Supported / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007342:Insurance Benefits / Q000706:statistics & numerical data*; D018868:Insurance, Disability / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation*; D008605:Mental Health Services; D012943:Social Security / Q000706:statistics & numerical data*; D014481:United States