Wednesday, 20 August 2003
This presentation is part of : Health Care of the Elderly in the Rural and Frontier Areas (Globally and Domestically)

S064-003 Bridge to Mental Wellness: Transitioning from Institutional Living to Community/Family and Employment

Robert Drake, Dartmouth Psychiatric Research Center, Dartmouth Psychiatric Research Center, Dartmouth School of Medicine, Lebanon, NH, USA

The Johnson & Johnson-Dartmouth Community Mental Health Program helps people with mental illness succeed in the workplace. The Partnership funds and guides the development of evidence-based, consumer-oriented, supported employment programs in several states. Though meaningful employment has eluded many people with mental illness for years, they can be helped through supported employment to find jobs that they like and succeed in. The supported employment process requires assistance from mental health teams that include employment specialists.

This presentation will review the research evidence on supported employment. Most people with severe mental illness want to work, but they have had little success and minimal assistance. Recently, the most rigorous research, much of which has been done by Dartmouth researchers, shows that supported employment is dramatically effective in helping people with mental illness to succeed in competitive employment. The recent research includes four studies of conversions of day treatment programs to supported employment programs and nine randomized controlled trials comparing supported employment to other commonly used vocational rehabilitation approaches. Overall, the evidence indicates that approximately 20% in comparison programs do so. Persons who succeed in competitie employment benefit in other areas, such as self-esteem, relationships, and quality of life. Supported employment has been designated an evidence-based practice by the Cochrane Collaborative, PORT Team, and the Preesident's New Freedom Commission. However, only a small minority of persons with severe mental illness are able to access supported employment services.

Johnson & Johnson awarded the New Hampshire-Dartmouth Psychiatric Research Center a charitable gift to build supported employment programs in local community agencies through collaboration with state departments of mental health and vocational rehabilitation in 2001. The evidence-based supported employment project established three pilot programs in Vermont, Connecticut, and South Carolina. Based on successful implementations in the pilot phase, additional programs have been funded in these three states plus Oregon, Kansas, Maryland, and Washington, D.C. The New Hampshire-Dartmouth Psychiatric research Center provides clinical oversight in all seven states. The program is intended to increase access to supported employment, to implement supported employment within mental health teams, and to demonstrate the benefits of supported employment.

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