Veterans Health Administration vocational services for Operation Iraqi Freedom/Operation Enduring Freedom Veterans with mental health conditions
Veterans Health Administration vocational services for Operation Iraqi Freedom/Operation Enduring Freedom Veterans with mental health conditions
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DOI：
10.1682/jrrd.2012.08.0137
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发表时间：
2013-01-01
影响因子：
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通讯作者：
Resnick, Sandra G.
中科院分区：
文献类型：
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作者：
Twamley, Elizabeth W.;Baker, Leen G.;Resnick, Sandra G.
精神健康状况和失业率高是伊拉克自由行动/持久自由行动(OIF/OEF)老兵面临的重大问题。我们检查了2008-2009财年的两个国家退伍军人健康管理局(VHA)数据库：一个较大的数据库(n=75,607)，其中包括患有创伤后应激障碍、抑郁症、物质使用障碍或创伤性脑损伤(TBI)的OIF/OEF退伍军人，以及那些在参与YHA职业服务期间被跟踪就业的退伍军人的较小子集(n=1,010)。在更大的数据库中，只有8.4%的退伍军人获得了任何职业服务，而且保留率很低，大多数退伍军人参加了一到两次预约。患有创伤和心理健康状况的退伍军人总体上更有可能获得职业服务。只有2.2%的退伍军人获得了循证支持的就业。然而，支持就业是有效的，接受支持的退伍军人中有51%获得了竞争性工作。量化支持就业提供对竞争性工作成就、工作数量、工作期限和职业服务保留率的影响的影响大小很大。鉴于这些退伍军人获得支助就业的成功率很高，预计为这一群体增加支助就业专家将改善9/11事件后需要援助重返工作岗位的退伍军人的工作成果。
High rates of mental health conditions and unemployment are significant problems facing Veterans of Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF). We examined two national Veterans Health Administration (VHA) databases from fiscal years 2008-2009: a larger database (n = 75,607) of OIF/OEF Veterans with posttraumatic stress disorder, depression, substance use disorder, or traumatic brain injury (TBI) and a smaller subset (n = 1,010) of those Veterans whose employment was tracked during their participation in YHA vocational services. Only 8.4% of Veterans in the larger database accessed any vocational services and retention was low, with most Veterans attending one or two appointments. Veterans with TBI and with more mental health conditions overall were more likely to access vocational services. Only 2.2% of Veterans received evidence-based supported employment. However, supported employment was effective, with 51% of those Veterans receiving it obtaining competitive work. Effect sizes quantifying the effect of supported employment provision on competitive work attainment, number of jobs, job tenure, and retention in vocational services were large. Given the high success rate of supported employment for these Veterans, additional supported employment specialists for this population would be expected to improve work outcomes for post-9/11 Veterans who want assistance returning to work.