Reasons for job loss among homeless veterans in supported employment

ABSTRACT Individual Placement and Support (IPS) improves competitive employment rates for those with serious mental illness (SMI) and is available through the Veterans Healthcare Administration (VHA). IPS clients often have difficulty maintaining jobs, and various reasons for job loss have been identified for those with SMI. No study has yet investigated IPS job loss in a homeless and largely substance-using population. An analysis of data from a quasi-experimental demonstration examined the association of various reasons for job loss with the duration of the first IPS job and with veteran characteristics. This study also examined the relationship of job duration and reasons for job loss with subsequent employment. Veterans’ most commonly identified reason for termination was drug/alcohol use; mental and/or physical health problems were uncommonly cited as reason for job loss. Those whose jobs ended due to drugs/alcohol were less likely to find subsequent employment. They also had greater scores on alcohol (but not drug) use measures and were more likely to have alcohol (but not drug) use diagnoses, highlighting a potentially unique role of alcohol in job loss in veterans who were homeless. These analyses reveal distinctive work-related challenges among homeless IPS participants. Suggestions to improve vocational services for homeless individuals are provided.