Kukla Marina, McGuire Alan B, Salyers Michelle P
HSR&D Center for Health Information and Communication, Richard L. Roudebush VA Medical Center.
Department of Psychology, Indiana University-Purdue University Indianapolis.
Psychiatr Rehabil J. 2016 Jun;39(2):129-36. doi: 10.1037/prj0000184. Epub 2016 Apr 7.
The purpose of this mixed-methods study was to compare urban and rural supported employment programs on barriers and facilitators with employment for veterans experiencing mental illnesses.
A national sample of 114 supported employment staff, supervisors, and upper level managers employed by the Veteran's Health Administration were recruited. Participants completed an online survey of work barriers and facilitators, including open-ended questions regarding additional factors that impact the work success of veterans. Survey responses were compared between participants from rural (n = 28) and urban (n = 86) programs using independent groups t tests. Open-ended questions were analyzed using content analysis.
Supported employment personnel from rural programs perceived significantly more barriers to work success compared with urban personnel, particularly in the areas of access to services and a range of job-related factors, including job match and interpersonal relationships at the work site. In contrast, participants from urban programs reported greater facilitators in the domain of mental health services. Qualitative findings add depth to the quantitative findings and highlight challenges in rural supported employment programs impacting job development and job fit. Both urban and rural programs experienced unique barriers related to geography and transportation.
Findings from this nationwide mixed-methods survey provide a comprehensive picture of the obstacles to employment success for veterans living with mental illnesses and receiving supported employment services in rural areas. Suggestions for changes in policy related to services and resource allocation are presented to address these unique barriers, particularly in rural areas. (PsycINFO Database Record
这项混合方法研究的目的是比较城市和农村的支持性就业项目在影响患有精神疾病退伍军人就业的障碍和促进因素方面的差异。
招募了退伍军人健康管理局雇佣的114名支持性就业工作人员、主管和高层管理人员作为全国样本。参与者完成了一项关于工作障碍和促进因素的在线调查，包括关于影响退伍军人工作成功的其他因素的开放式问题。使用独立样本t检验比较了来自农村项目（n = 28）和城市项目（n = 86）的参与者的调查回复。对开放式问题进行了内容分析。
与城市工作人员相比，农村项目的支持性就业人员认为工作成功的障碍明显更多，特别是在服务获取以及一系列与工作相关的因素方面，包括工作匹配度和工作场所的人际关系。相比之下，城市项目的参与者报告在心理健康服务领域有更多的促进因素。定性研究结果为定量研究结果增添了深度，并突出了农村支持性就业项目在影响工作发展和工作适配方面的挑战。城市和农村项目都经历了与地理和交通相关的独特障碍。
这项全国性混合方法调查的结果全面描绘了患有精神疾病且在农村地区接受支持性就业服务的退伍军人就业成功的障碍。针对服务和资源分配相关政策的变革提出了建议，以应对这些独特障碍，特别是在农村地区。（PsycINFO数据库记录
