title: Barriers and Facilitators Related to Work Success for Veterans in Supported Employment: A Nationwide Provider Survey.
abstract: OBJECTIVE
  Veterans with mental illness are at serious risk of poor work outcomes and career stagnation. Supported employment (SE) is an evidence-based model of vocational services that assists persons with mental illness to obtain competitive employment. The purpose of this study was to gain a rich understanding of barriers and facilitators related to competitive work success from the perspective of a nationwide sample of U.S. Department of Veterans Affairs (VA) SE staff, supervisors, and managers.
  
  
  METHODS
  This study utilized a mixed-methods approach in which 114 VA SE personnel completed an online questionnaire consisting of a survey of work barriers and facilitators; open-ended questions elicited additional factors affecting work success. Descriptive statistics characterized factors affecting work success, and an emergent, open-coding approach identified qualitative themes describing other key elements influencing employment.
  
  
  RESULTS
  The most prominent work facilitators were perceived veteran motivation, job match, the assistance of SE services, and veteran self-confidence. The highest rated barriers were psychological stress and a range of health-related problems. Qualitative findings revealed additional areas affecting work success, notably, the availability of resources, the capacity of frontline staff to form strong relationships with veterans and employers, the ability of staff to adapt and meet the multifaceted demands of the SE job, and the need for additional staff and supervisor training. The impact of employer stigma was also emphasized.
  
  
  CONCLUSIONS
  An array of elements influencing work success at the level of the veteran, staff, SE program, and employer was recognized, suggesting several implications for VA services.
authors.affiliation: Dr. Kukla and Dr. McGuire are with Health Services Research and Development, Center for Health Information and Communication, Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana (e-mail: mkukla@iupui.edu ). They are also with the Department of Psychology, Indiana University-Purdue University Indianapolis, where Dr. Salyers is affiliated. Dr. Salyers is also with the Assertive Community Treatment Center of Indiana, Indianapolis.
authors.forename: Marina
authors.initials: M
authors.lastname: Kukla
authors.affiliation: Dr. Kukla and Dr. McGuire are with Health Services Research and Development, Center for Health Information and Communication, Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana (e-mail: mkukla@iupui.edu ). They are also with the Department of Psychology, Indiana University-Purdue University Indianapolis, where Dr. Salyers is affiliated. Dr. Salyers is also with the Assertive Community Treatment Center of Indiana, Indianapolis.
authors.forename: Alan B
authors.initials: AB
authors.lastname: McGuire
authors.affiliation: Dr. Kukla and Dr. McGuire are with Health Services Research and Development, Center for Health Information and Communication, Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana (e-mail: mkukla@iupui.edu ). They are also with the Department of Psychology, Indiana University-Purdue University Indianapolis, where Dr. Salyers is affiliated. Dr. Salyers is also with the Assertive Community Treatment Center of Indiana, Indianapolis.
authors.forename: Michelle P
authors.initials: MP
authors.lastname: Salyers
mesh_terms: D000124:Achievement; D000328:Adult; D016832:Employment, Supported / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D028642:Persons with Psychiatric Disorders / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014481:United States; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data