Assessing Supported Employment with Veterans with Felony Convictions and MI or SA

描述（由申请人提供）： 目标：比较1）以小组为中心的手工职业计划（MVP）干预与2）以小组为中心的手工职业计划加支持性就业增强（MVPSE）的疗效。补助金的重点是协助有重罪史的退伍军人，他们在获得和维持就业方面有精神健康和/或物质依赖。一个次级目标是评估这些方案对无家可归者和再次被捕者的影响。 总结：每年有超过63，000名被监禁的退伍军人从监狱和监狱中获释，迫切需要改善那些有重罪定罪历史的人的职业服务。统计数据表明，67%的人将在三年内再次被捕，57%的人将再次入狱（例如，Langan和Levin，2002年; LaVigne和Kachnowski，2005年）。再次被捕和总体生活质量的最重要因素之一是就业。然而，在任何一天，45%有重罪历史的人失业。 这些退伍军人有显著的心理社会压力源。有长期监禁史的退伍军人有更高水平的精神问题，使用成瘾严重程度指数的药物使用和酒精使用，以及比那些有短期监禁史或没有监禁史的人更高的双重诊断率（McGuire & Rosenheck，2004）。此外，监禁和无家可归之间的同时发生率很高。 虽然需要帮助的退伍军人人数很多，潜在的好处也很大，但仍然非常需要帮助这些退伍军人重返工作岗位的技术和方案。在帮助弱势群体获得和维持就业方面，一个已证明成功的领域是支助性就业（例如，Becker & Drake，2006年; Bond，2004年）。支持性就业提供持续的援助，以发展就业机会，获得就业，就业期间的支持，并与其他心理社会需求的协调。本研究将通过测试将支持性就业纳入经证实的手动治疗计划，寻求改善RR&D补助金D 6192-R“评估患有MI [精神疾病]或SA [药物滥用/依赖]的被监禁退伍军人的职业材料”的结果。预计调查结果将有助于改善患有精神疾病和/或物质依赖的退伍军人（VA康复研发优先领域）的功能和生活质量。我们的目标是比较一个既定的手工化的职业再融合计划的手工化计划加服务的基础上支持就业的原则，以确定是否支持就业可以提高就业成功率。 192名退伍军人将被随机分配到以下两种情况之一：1）由受过培训的职业工作人员领导的手工班;或2）由受过培训的职业工作人员领导的手工班加上基于支持就业原则和技术使用的个人服务（例如，获得就业后的持续支持，工作发展，工作指导，社区参与，快速求职等）。退伍军人将被跟踪24个月。具体目标1）测试MVP和MVPSE之间的就业时间和稳定就业时间2）比较MVP和MVPSE在培训期后24个月内的总就业时间3）确定MVP条件与MVPSE条件之间无家可归和再次被捕率的差异

DESCRIPTION (provided by applicant): Goal: To compare efficacy of 1) a group focused manualized vocational program (MVP) intervention versus 2) a group focused manualized vocational program plus enhancement using supportive employment (MVPSE). The focus of the grant is assisting veterans with histories of felonies who have mental health and/or substance dependence in obtaining and maintaining employment. A subgoal will be the assessment of the effect of the programs on homelessness and re-arrests. Summary: With over 63,000 incarcerated veterans being released from prisons and jails annually, there is a critical need to improve vocational services for those with histories of felony convictions. Statistics indicate that 67% will be re-arrested and 57% will return to prison within three years (e.g. Langan & Levin, 2002; LaVigne & Kachnowski, 2005). One of the strongest factors in re-arrests and overall quality of life is employment. However, on any given day 45% of those with felony histories are unemployed. These veterans have significant psychosocial stressors. Veterans with a long-term incarceration history had higher levels of psychiatric problems, drug use, and alcohol use using the Addiction Severity Index as well as higher rates of dual diagnosis than those with a short-term incarceration history or those with no history of incarceration (McGuire & Rosenheck, 2004). Additionally, there is a high level of co-occurrence between incarceration and homelessness. Though the number of veterans in need is large and the potential benefit great, there is a significant need for techniques and programs that assist these veterans in returning to work. One area that has proven successful in assisting vulnerable populations in obtaining and sustaining employment is Supportive Employment (e.g. Becker & Drake, 2006; Bond, 2004). Supportive Employment provides ongoing assistance in developing jobs, obtaining employment, support during employment, and coordination with other psychosocial needs. This study will seek to improve on the findings from RR&D Grant D6192-R "Evaluating Vocational Materials for Incarcerated Veterans with MI [mental illness] or SA [substance abuse/dependence]" by testing the incorporation of supportive employment into a proven manualized treatment program. It is expected findings will serve to improve functioning and quality of life of mentally ill and/or substance dependent veterans (a VA Rehab R&D priority area) with felony convictions. Our goal is to compare an established manualized vocational reintegration program to the manualized program plus services based on the principles of supported employment to determine whether supported employment can improve on job success rates. 192 veterans will be randomly assigned to one of two conditions: 1) a manual based class led by trained vocational staff; or 2) a manual based class led by trained vocational staff plus individual services based on the principles of and techniques use by supported employment (e.g. sustained support past obtaining employment, job development, job coaching, community engagement, rapid progression to job search, etc.). Veterans will be followed for 24 months. Specific Aims 1) Test time to employment and time to stable employment between the MVP and MVPSE 2) To compare total time employed between MVP and MVPSE over the 24 months following training period 3) Identify differences in rates of homelessness and re-arrests between those in the MVP condition compared to the MVPSE condition