MedPath

Supported Employment Demonstration

Not Applicable
Completed
Conditions
Mental Impairment
Interventions
Behavioral: Full Service
Behavioral: Basic Service
Registration Number
NCT03682263
Lead Sponsor
Westat
Brief Summary

The purpose of this study is to determine whether offering an evidence-based package of employment supports integrated with mental health services has a positive impact on employment and clinical recovery, and delays or diminishes the need for disability benefits.

Detailed Description

SSA contracted with Westat to implement and evaluate the Supported Employment Demonstration (SED). The SED provides integrated mental health and vocational services to people with mental illness who were recently denied Social Security disability benefits. The evaluation will determine the impact of the SED on employment, clinical recovery, and receipt of disability payments. The evaluation is using a randomized controlled trial design to compare the outcomes of two treatment groups and a control group. In the full-service arm (n = 1,000), participants receive services from an Individual Placement and Support employment specialist, a care manager, and a nurse care coordinator (NCC) who provides medication management support, as well as modest funding for out-of-pocket prescriptions, essential work-related expenses, and other services in the participant's treatment plan. The basic-service arm (n=1,000), which is expected to cost about 50 percent less than the full-service arm, provides all services and funds except the NCC. Participants in the usual services (control) group (n = 1,000) seek services as they normally would but receive a comprehensive guide to local, state, and national resources.

Data collection includes computer-assisted baseline (in-person) and blinded quarterly (telephone) interviews with participants, collection of SSA administrative and site-level program data, site visits (including fidelity assessments), qualitative interviews with site administrators and service providers, focus groups with study participants, and person-centered ethnographic interviews with participants and nonparticipants.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
3000
Inclusion Criteria
  • Individuals denied Social Security disability benefits (SSDI or SSI)
  • Individuals alleging a mental impairment
  • Live in Community Mental Health Agency (CMHA) catchment area
  • Legally competent
  • Express desire to improve work situation
Exclusion Criteria
  • Intellectual disability
  • Reside in a nursing home or custodial institution
  • Already receiving supported employment services from CMHA site

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Full Service TreatmentFull ServiceThe Full Service Arm receives the Individual Placement and Support (IPS) model of employment services integrated with behavioral health services and care management services, as well as Medication Management Support (MMS) from a Nurse Care Coordinator (NCC).
Basic Service TreatmentBasic ServiceThe Basic Service Arm receives the Individual Placement and Support (IPS) model of employment services integrated with behavioral health services and care management services.
Primary Outcome Measures
NameTimeMethod
Employment36 months

Whether participant is employed in a paying job at any time during the 36 month study period.

Assessed via quarterly computer-assisted telephone interviews.

Secondary Outcome Measures
NameTimeMethod
Employment (Competitive)36 months

Whether a participant is employed in a community job that pays at least minimum wage (as defined by the resident state) and is "owned" by the employer rather than a mental health center or rehabilitation agency at any time during the 36 month study period.

Assessed via quarterly computer-assisted telephone interviews.

Short-Form 12 Health Survey (SF-12) Mental Component Score (MCS)36 months

The difference between the Short-Form 12 Health Survey (SF-12) Mental Component Score (MCS) measured at baseline (Baseline Survey) and at study exit (final quarterly follow-up survey).

Higher values of the SF-12 MCS indicate better outcomes. A higher SF-12 MCS at study exit than at baseline indicates a positive change.

Assessed via computer-assisted telephone interviews.

Job Tenure36 months

The longest number of consecutive months employed for any single job during the 36-month study period.

Assessed via quarterly computer-assisted telephone interviews.

Time Until Award36 months

The number of study days to disability award.

Assessed using Social Security Administration administrative data.

Months Employed36 months

The number of months employed during the 36-month study period.

Assessed via quarterly computer-assisted telephone interviews.

Months above SGA36 months

The number of months the participant reported earnings above Substantial Gainful Activity (SGA) levels over the 36-month study period.

Assessed via quarterly computer-assisted telephone interviews.

Total Earnings36 months

Total amount of reported earnings over the 36-month study period.

Assessed via quarterly computer-assisted telephone interviews.

Total Hours Worked36 months

The reported total number of hours worked for pay during the 36-month study period.

Assessed via quarterly computer-assisted telephone interviews.

Days to First Job36 months

The number of days from enrollment date to first job during the 36-month study period, for those not employed at enrollment.

Assessed via quarterly computer-assisted telephone interviews.

Trial Locations

Locations (20)

Boley Centers

🇺🇸

Saint Petersburg, Florida, United States

Mental Health Center of Denver

🇺🇸

Denver, Colorado, United States

Penny Lane Centers

🇺🇸

Lancaster, California, United States

Bridgeway

🇺🇸

Pekin, Illinois, United States

Mental Health Association of South Central Kansas

🇺🇸

Wichita, Kansas, United States

Cornerstone Montgomery

🇺🇸

Silver Spring, Maryland, United States

Communicare

🇺🇸

Radcliff, Kentucky, United States

Pathways

🇺🇸

Waldorf, Maryland, United States

RISE

🇺🇸

Minneapolis, Minnesota, United States

Family Service League The Olsten Family Center

🇺🇸

Mattituck, New York, United States

Greater Cincinnati Behavioral Health Services

🇺🇸

Cincinnati, Ohio, United States

The Nord Center

🇺🇸

Sheffield, Ohio, United States

Mental Health Association Oklahoma

🇺🇸

Tulsa, Oklahoma, United States

Cascadia

🇺🇸

Portland, Oregon, United States

Anderson-Oconee-Pickens Mental Health Center

🇺🇸

Anderson, South Carolina, United States

Frontier Health

🇺🇸

Kingsport, Tennessee, United States

Helen Ross McNabb Center

🇺🇸

Knoxville, Tennessee, United States

Sunrise Services

🇺🇸

Mount Vernon, Washington, United States

Trilogy

🇺🇸

Chicago, Illinois, United States

Vinfen

🇺🇸

Boston, Massachusetts, United States

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