In this chapter, we describe the employment and program-participation patterns of people with disabilities before they applied for SSDI. ASPE is interested in understanding these characteristics so it can recommend policies and programs to help potential applicants remain in the workforce, thereby stemming the growth in the SSDI rolls. To uncover
We explored systematic reviews of RTW interventions in Organisation for Economic Co-operation and Development (OECD) countries, such as the United Kingdom, Canada, Finland, Sweden, the Netherlands, and others. Carroll et al. (2010) conducted a systematic review comparing workplace and non-workplace interventions for persons with back pain. He foun
SE can be described as a form of competitive employment in which rapid job search and placement is followed by intensive on-the-job support provided to an individual with a disability for a certain period, followed by extended services to support job maintenance. It is distinguished from SE for people with mental health disabilities (described in
In the United States, VR refers to training and supports for persons to obtain work, return to work, or stay at work. There are different types of rehabilitation programs (for example, medical and vocational) and various organizations and funding sources that support rehabilitation services, including federal, state, and private entities. Although
There is considerable policy concern about and interest in interventions designed to help SSI and SSDI beneficiaries find or resume work. We identified two rigorous evaluations of interventions targeted to SSI or SSDI beneficiaries that have been conducted in the last ten years. The quasi-experimental evaluation of SSA's TTW program assessed the i
We identified several systematic reviews of DM or workplace disability management (WPDM) interventions. These DM interventions are primarily sponsored by employers and are aimed at employees with work limitations or endangered work tasks, or at individuals who have discontinued work. DM programs vary widely, depending on the employer and the impai
In Chapter II , we reviewed evidence on the effectiveness of employment supports for individuals with SMI in the three target populations: individuals who are now or who are expected to be long-term clients of mental health agencies, employees at risk of job loss due to mental illness, and individuals experiencing a FE of psychosis and needing EI
In addition to the more rigorously evaluated types of employment supports described in preceding sections, a variety of other services have been postulated by stakeholders to positively affect employment outcomes.
In this section, we discuss EI employment supports offered to individuals before or soon after a FE of psychosis and for TAY, which is commonly defined as ranging from 14-25 years old or 16-30 years old. The EI programs we reviewed are generally similar, with slight deviations along four dimensions: stage of illness, whether providers specialize i
In this section, we summarize findings on the current state of knowledge on interventions to improve employment outcomes among workers with mental illness at risk of job loss. Following a framework established by Nieuwenhuijsen et al. (2008) and Krupa (2007), our review divides interventions into two main groups: individual or worker level interve
In this section, we review the literature on services and interventions for people who are now or who are expected to be long-term clients of traditional mental health services and who are in the process of applying for SSDI or SSI ( Appendix A , Table A.3 ).
1. There is strong evidence that SE is more effective in helping people with SMI obtain competitive employment than traditional vocational programs. Yet, even with SE, about half of participants did not find competitive work. For those that did, jobs were part-time and of short duration, and earnings were low.
In this chapter, we consider the evidence for improving employment outcomes for people with psychiatric disorders, to provide background for our discussion of the three targeted subgroups of people with SMI we consider in later sections of this chapter. We begin by describing the evidence on SE services for people with psychiatric disabilities in
The remainder of the report is organized as follows. In Chapter II , we summarize the findings of a systematic review of evidence on employment services and supports provided to people with SMI in the three subgroups mentioned above. In Chapter III , we synthesize evidence on the effectiveness of work supports and services currently available to
The Office of the Assistant Secretary for Planning and Evaluation (ASPE) in the U.S. Department of Health and Human Services (HHS) funded the Improving Employment Outcomes for People with Psychiatric Disorders and Other Disabilities Project. The purpose of this project is to identify policy measures that are barriers or facilitators to employment