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Quality Measures Database

Detailed Results


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Supported Employment Overall Rank: 64
Percentage of adults with a serious mental illness receiving supported employment, the key elements of which include individualized job development, rapid placement emphasizing competitive employment, ongoing job support, and integration of vocational and mental health services.
The restoration of a person by therapeutic measures and re-education to participation in the activities of a normal life within the limitations of the person’s disorder or disability.
Additional Domain(s) : Patients with Chronic Conditions
Rationale
Evidence-based services that promote long-term recovery should be important components of any system that serves people with serious mental illnesses. The workgroup recognizes that not all states offer Supported Employment programs, and that not all persons with serious mental illnesses necessarily need such services, however research has demonstrated the effectiveness of these services for many consumers in obtaining and maintaining competitive employment. Supported employment was originally developed by Paul Wehman and colleagues (Wehman, 1986; Wehman & Moon, 1988) to help place and support persons with developmental disorders in competitive jobs in integrated settings. Since about the mid-1980s, SE has been adapted and used for persons with mental illness, integrating ideas from Wehmans original model, ACT, the job coach model and the clubhouse model (Bond, Drake, Mueser, & Becker, 1997). During the past decade, a substantial body of research has emerged showing the clear superiority of SE in obtaining competitive work compared both to no vocational programming and to other forms of vocational programming (e.g., sheltered work, transitional employment). In a recent review,
Bond and colleagues (1997) identified 7 pre-post studies, and 8 controlled studies (of which 6 were randomized) of SE and concluded that across studies, 58% of consumers in SE programs were employed vs. 21% for control subjects. SE consumers also tended to be employed longer and to earn more, and, contrary to fears from detractors, did not report either increased stress or increased use of the hospital.

Primary Reference
Lutterman T, Ganju V, Schacht L, Shaw R, Monihan K, et.al. Sixteen State Study on Mental Health Performance Measures. DHHS Publication No. (SMA) 03-3835. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, 2003. Retrieved on Aug 3, 2006 from: http://www.mentalhealth.samhsa.gov/funding/pilotstudy/pilotstudy.asp
Level of Evidence
I: Consistently higher quality studies specifically focused on primary mental health care.

Summarized CommentsAdd Comment
  • * Very important, but this is beyond control of primary care.
  • There is a serious need to recognize a person's limitations, many relapse when too much is expected of them.
Variation in Results
Ratings-based Rank
Relevance 45
Actionability 104
Overall Importance 41
 
Stakeholder Rank
Academics 72
Clinicians 68
Consumers 50
Decision Makers 39
 
Special Group Rank
First Nations 69
Rural Areas 82
Federal Stakeholders 55
Regional Rank
BC AB SK MB ON QC NB NS PE NL YT NT NU
51 67 96 41 72 45 22 57 112 67 39 2 57
 
Overall Rank

      

64


SA16a (H256)

 
Distribution of Survey Respondent Ratings
Relevance
100
90
80
70
60
50
40
30
20
10
0
0.54 0.36 1.08 0.43 1.39 5.19 18.08 38.14 34.8
1 2 3 4 5 6 7 8 9
Low High
Actionability
100
90
80
70
60
50
40
30
20
10
0
2.04 2.15 5.26 5.24 6.41 11.09 25.2 22.55 20.05
1 2 3 4 5 6 7 8 9
Low High
Overall Importance
100
90
80
70
60
50
40
30
20
10
0
2.51 20.55 76.95
3 2 1

3 = can live without
2 = nice to have
1 = indispensable
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The views expressed herein do not necessarily represent the official policies of Health Canada