Study Design

Arizona
Supported Employment (SE) vs. Services as Usual

Connecticut
Individual Placement & Support vs. Services as Usual

Maryland
Individual Placement & Support vs. Services as Usual

South Carolina
Assertive Community Treatment + Individual Placement & Support vs. Services as Usual

Pennsylvania
Long-term Employment Training and Supports vs. Services as Usual

Maine
Employer Consortium & Family-Aided Assertive Community Treatment (FACT) vs. FACT only

Massachusetts
ICCD Clubhouse vs. Program of Assertive Community Treatment (PACT) Vocational Model

Texas
Supported Employment and Employment Assistance through Reciprocity in Natural Supports (SE + EARNS) vs. Supported Employment only

Transcript

This slide shows the different types of service delivery models that were tested at each of the eight sites. In Phoenix Arizona, for example, 300 mental health consumers were randomly assigned, to either an integrated model of supported employment services or to customary vocational rehabilitation. The integrated model of supported employment services involved a very careful integration of vocational and managed health care. This team was comprised of psychiatrists, case managers, rehabilitation counselors, employment specialists, job developers, and benefits specialists, all of whom are organized within a single administrative entity and working within the same offices.

Individuals randomly assigned to the experimental integrated employment program received a full array of case management and supported employment services from an integrated treatment team. In contrast, individuals assigned to the control condition received their vocational rehabilitation services from community rehabilitation programs through traditional referral and purchase of service arrangements.

In Connecticut, the New Hampshire-Dartmouth Psychiatric Research Center’s Project is located in the Capitol Region Mental Health Center in Hartford. The purpose of this project was to conduct a controlled study comparing three different approaches to vocational rehabilitation for individuals with mental illness. These approaches included the Individual Placement and Support Model of Supported Employment, Transitional Employment, and Standard Services.

The Individual Placement and Support (or IPS Model) emphasizes minimal pre-vocational assessment, rapid job finding, matching jobs to consumers' interests, integrated jobs in community settings, provision of follow-along supports, and close integration with clinical services. IPS employment specialists are a part of the consumers clinical treatment teams. The next approach tested was Transitional Employment. This program was provided within a psychiatric rehabilitation program. Initially, consumers participated in vocational training or work crews that operate within the Center. Consumers then built upon their employment experience by working in transitional jobs in the community, and eventually obtain their own competitive jobs. The third approach tested in Connecticut was Standard Services. This consisted of vocational services which were available to mental health consumers in Hartford, CT, including sheltered (non-competitive) employment, off-site supported employment, and educational programs.

The models tested in Massachusetts were a Clubhouse model versus the Program of Assertive Community Treatment or PACT Vocational Model. A Clubhouse is a planned community of staff and consumers who work together in the program on a daily basis to provide and receive services such as meals, companionship, skills training, and paid work. This specific Clubhouse was certified by the International Center for Clubhouse Development. The program involved a planned community of staff and consumers engaged in what is called the “Work Ordered Day” or productive activity in which clients or “members” participate fully in running the program. Members could choose transitional employment, supported employment, or independent employment programs.

The second model was the Program of Assertive Community Treatment (PACT) Vocational Model. Mobile teams delivered services “in vivo,” meaning in real life, rather than in program or office settings. Clinical and vocational services were integrated, using a total team approach, with an emphasis on continual encouragement of vocational efforts and competitive community employment.

We are not going to go into detail regarding the remaining sites that you see here on this slide. However, if you are interested, there is a link in this lesson that will take you to more information. Please look in the Course Documents under “web links” for lesson one and find the link that reads EIDP Study Sites.