O'Day Bonnie, Kleinman Rebecca, Fischer Benjamin, Morris Eric, Blyler Crystal
Mathematica Policy Research.
Psychiatr Rehabil J. 2017 Jun;40(2):123-152. doi: 10.1037/prj0000253. Epub 2017 Apr 3.
We identify effective services to assist 3 groups of people with mental illnesses become or remain employed and prevent dependence on disability cash benefits: (a) individuals, including youth, who are experiencing an initial episode of psychosis; (b) employed individuals at risk of losing jobs due to mental illness; and (c) individuals who are or may become long-term clients of mental health services and are likely to apply for disability benefits.
We searched for articles published between 1992 and 2015 using key word terminology related to employment support services and each subgroup, and prioritized articles by study design.
The individual placement and support model of supported employment is more effective than traditional vocational programs in helping people with serious mental illnesses who are engaged in treatment or receiving disability benefits obtain competitive employment. Some early intervention programs effectively serve people who experience a first episode of mental illness, but more research is needed to demonstrate long-term outcomes. Less is known about the effectiveness of employment interventions in preventing unemployment and use of disability benefits among individuals at risk for job loss or long-term mental illness.
States can fund employment supports to help prevent the need for disability benefit receipt by creatively combining federal sources, but the funding picture is imperfect. Medicaid expansion and other provisions of the Affordable Care Act may fund employment supports and assist in reducing dependence on disability benefits. (PsycINFO Database Record
我们确定有效的服务，以帮助三类患有精神疾病的人就业或维持就业，并防止他们依赖残疾现金福利：(a) 经历首次精神病发作的个人，包括青少年；(b) 因精神疾病而面临失业风险的在职人员；以及 (c) 正在或可能成为心理健康服务长期客户且可能申请残疾福利的个人。
我们使用与就业支持服务及每个亚组相关的关键词术语，搜索了1992年至2015年发表的文章，并根据研究设计对文章进行了优先级排序。
支持性就业的个人安置与支持模式在帮助接受治疗或领取残疾福利的严重精神疾病患者获得竞争性就业方面，比传统职业项目更有效。一些早期干预项目有效地服务了经历首次精神疾病发作的人群，但需要更多研究来证明其长期效果。对于就业干预在预防有失业风险或患有长期精神疾病的个人失业和使用残疾福利方面的有效性，我们了解得较少。
各州可以通过创造性地整合联邦资金来源，为就业支持提供资金，以帮助预防领取残疾福利的需求，但资金情况并不理想。医疗补助扩大及《平价医疗法案》的其他条款可能为就业支持提供资金，并有助于减少对残疾福利的依赖。（《心理学文摘数据库记录》
