Employment Outcomes of a Distance Learning System for Formerly Incarcerated Veterans With Mental Illness.

IF 3.3 3区 医学 Q1 HEALTH POLICY & SERVICES Psychiatric services Pub Date : 2024-06-05 DOI:10.1176/appi.ps.20230408
James P LePage, Scott T Walters, Daisha J Cipher, April M Crawford, Edward L Washington
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Abstract

Objective: People with previous incarceration and a mental disorder, a substance use disorder, or both are less likely to obtain employment than are those without these characteristics. Distance learning and education (DLE) systems are increasingly being integrated into clinical care and provide a pathway to disseminate vocational services. DLE systems can help reach people with barriers to accessing services, including people without transportation, experiencing homelessness, living in rural areas, or who are homebound. This study evaluated the effectiveness of one DLE system, the COMPASS program, in assisting formerly incarcerated veterans with a mental or substance use disorder to obtain employment.

Methods: The authors used a randomized controlled trial to compare employment outcomes of 39 U.S. veterans receiving the COMPASS intervention with those of 43 veterans receiving a paper self-study vocational manual. All participants had previous legal convictions and had a mental disorder, a substance use disorder, or both. The COMPASS system provided vocational services through asynchronous (online practice assignments, reading, and videos) and synchronous (video and telephone practice interviews and live chats) methods. No in-person vocational services were provided in the COMPASS intervention.

Results: At 6 months, participants assigned to receive the COMPASS intervention were more likely to have found employment, defined as 1 day of competitive employment, compared with those assigned to receive the self-study manual (64% vs. 35%, respectively)-and to have found employment faster.

Conclusions: This study's findings provide evidence for the effectiveness of the COMPASS system in providing employment services and suggest that these services may benefit other vulnerable populations.

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针对曾被监禁的精神病退伍军人的远程学习系统的就业成果。
目标:与没有这些特征的人相比,曾经入狱并患有精神障碍、药物使用障碍或两者兼有的人获得就业的可能性较低。远程学习和教育(DLE)系统正越来越多地被纳入临床护理,并为传播职业服务提供了途径。远程学习和教育系统可以帮助那些在获得服务方面存在障碍的人,包括没有交通工具、无家可归、生活在农村地区或居家的人。本研究评估了一个 DLE 系统(COMPASS 计划)在帮助患有精神或药物使用障碍的曾被监禁的退伍军人获得就业方面的有效性:作者采用随机对照试验的方法,比较了接受 COMPASS 干预的 39 名美国退伍军人与接受纸质自学职业手册的 43 名退伍军人的就业结果。所有参与者都曾被判刑,并患有精神障碍、药物使用障碍或两者兼有。COMPASS 系统通过异步(在线练习作业、阅读和视频)和同步(视频和电话练习访谈和实时聊天)方式提供职业服务。COMPASS 系统不提供面对面的职业服务:6个月后,与接受自学手册的受试者相比,接受COMPASS干预的受试者更有可能找到工作,即找到1天有竞争力的工作(分别为64%和35%),而且找到工作的速度更快:本研究结果证明了 COMPASS 系统在提供就业服务方面的有效性,并表明这些服务可能会惠及其他弱势群体。
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来源期刊
Psychiatric services
Psychiatric services 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.80
自引率
7.90%
发文量
295
审稿时长
3-8 weeks
期刊介绍: Psychiatric Services, established in 1950, is published monthly by the American Psychiatric Association. The peer-reviewed journal features research reports on issues related to the delivery of mental health services, especially for people with serious mental illness in community-based treatment programs. Long known as an interdisciplinary journal, Psychiatric Services recognizes that provision of high-quality care involves collaboration among a variety of professionals, frequently working as a team. Authors of research reports published in the journal include psychiatrists, psychologists, pharmacists, nurses, social workers, drug and alcohol treatment counselors, economists, policy analysts, and professionals in related systems such as criminal justice and welfare systems. In the mental health field, the current focus on patient-centered, recovery-oriented care and on dissemination of evidence-based practices is transforming service delivery systems at all levels. Research published in Psychiatric Services contributes to this transformation.
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