Supported Employment: Building Your Program - SAMHSA Store ...

No evidence of negative effectsPractitioners, consumers, and family members aresometimes concerned that competitive work will bea stressful experience that may increase the chancesof relapses and rehospitalizations. However, theresearch on SE has consistently found that nonegative effects relate to participating in an SEprogram. Specifically, consumers who participatein SE programs do not experience more severesymptoms or higher levels of distress, nor do theyrequire more intensive psychiatric treatment suchas emergency room visits or psychiatrichospitalizations (Bond et al., 2001).Who benefits most fromSupported Employment?Research shows that consumer factors do notpredict better employment outcomes. Specifically,employment success has not been linked to any ofthe following: Diagnosis; Symptomatology; Age; Gender; Disability status; Prior hospitalization; Education; or Co-occurring condition of substance use(Bond et al, 2001).Although work history predicts better employmentoutcomes, SE remains more effective thantraditional vocational services for consumers withboth good and poor work histories. Consequently,we speculate that the professional assistance thatSE programs provide at every stage of theemployment process compensates for consumerdeficits in a way that less assertive vocationalrehabilitation approaches do not.Some consumer factors have not beensystematically examined in the literature.For example, few studies research the effectof employment services for people with seriousmental illnesses who are homeless. However, Workas a Priority (Shaheen, Williams, & Dennis, 2003)addresses the need for employment services to becoordinated with housing and other services forthis population.The majority of studies were conducted in settingswith significant numbers of Caucasian, AfricanAmerican, and Latino consumers (Bond et al.,2001). Although more replications are needed, allthe evidence to date suggests that the effectivenessof SE compared to traditional vocational servicesgeneralizes to both the African American andLatino populations.Further research is needed to determine whetherSE is equally effective across all ethnic groups.However, anecdotally, we know that culture andlanguage pose significant barriers to providing SEin some populations.Where should Supported Employmentbe provided?Community characteristics do not appear to imposea major barrier to implementing an SE program.SE has been successfully implemented in both veryurban and very rural settings as well as in mid-sizedcities in many different states.Nearly all research on the effectiveness of SE hasbeen conducted in community mental healthcenters. The extent to which SE can be successfullyadapted to other types of agencies is the subject ofcurrent research, but no strong conclusions can bedrawn now.Building Your Program 7 What Is Supported Employment