Can SSDI and SSI beneficiaries with mental illness benefit from evidence-based supported employment?

Abstract

Objective: Individuals with psychiatric disabilities are the fastest-growing subgroup of Social Security Administration disability beneficiaries and have negligible rates of return to competitive employment. Nevertheless, a new approach to vocational rehabilitation, termed supported employment, has increased the optimism regarding employment for this population. Methods: Aggregating data from four randomized controlled trials of evidence-based supported employment for persons with severe mental illness, the investigators compared 546 Social Security Administration disability beneficiaries with 131 nonbeneficiaries. Three employment measures were examined: job acquisition, weeks worked, and job tenure. Results: Beneficiaries receiving supported employment had better employment outcomes than those receiving other vocational services. Similar results were found for nonbeneficiaries. Overall, non-beneficiaries had better employment outcomes than beneficiaries. However, the effect sizes measuring the improved outcomes with supported employment were similar for beneficiaries (d=.52-1.10) and nonbeneficiaries (d=.78-.89). Conclusions: Evidence-based supported employment could enable many Social Security Administration beneficiaries with psychiatric disabilities to attain competitive employment even though receipt of disability benefits operates as a barrier to employment.