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The empirical literature on the impact of psychiatric disability on employment outcomes has consistently shown that individuals with psychiatric disabilities are more likely than those without to experience adverse labor market outcomes. One strategy invoked to address barriers to employment has been reasonable job accommodations, developed originally through the Americans With Disabilities Act legislation. However, little is known about the factors associated with the request for reasonable job accommodations among those with serious psychiatric disabilities. Data for this study come from a longitudinal multisite demonstration project funded by the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration. Accommodations were reported by individuals with serious mental health disabilities who became employed. Results from logistic regression analysis found that those who disclosed their disability to their employers, who were more severely disabled, and who had positive social relationships were more likely to request accommodations. This study advances our knowledge of the factors that influence the decision of individuals with serious mental health disabilities to seek accommodation in the work environment and offers a framework for guiding rehabilitation counselors in ways that might help to enhance employment outcomes for this population. [ABSTRACT FROM AUTHOR]

BACKGROUND: Two decades since the passage of the Americans with Disabilities Act in 1990, individuals with psychiatric disabilities continue to face barriers to employment that includes sensitivity to the benefit structure of the Supplemental Security Income (SSI). OBJECTIVE: This study examines cost-savings to the SSI program due to enhanced employment outcomes for persons with psychiatric disabilities associated with the receipt of job accommodations. METHODS: Data come from a federally funded, multi-site, implementation effectiveness study of supported employment models for 987 working age adults. Cost-savings were estimated using ordinary least squares regression to examine averted SSI payment. RESULTS: Accommodations were associated with a marginal monthly SSI savings of $ 11.73, and these savings were 68 percent higher compared to the non-accommodations group. Being married, having independent housing, and recent employment history predicted savings increases. Physical and emotional problems affecting work, a schizophrenia diagnosis, and symptoms of social withdrawal and blunted affect predicted lower savings. CONCLUSIONS: This study adds to a small body of literature examining the impact of accommodations for persons with psychiatric disabilities. Future work in this area might examine savings to the Social Security Disability Insurance program and should include factors unavailable in this analysis. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore the effects of local unemployment rates on evidence-based supported employment (SE) programs tailored for people with psychiatric disabilities. Participants (n=1,273) from 7 states in the US were randomly assigned to experimental SE or services as usual/comparison conditions and followed for 24 months. Mixed-effects random regression analysis found that both local unemployment rate and study condition were significant predictors of competitive employment and working 40 or more hours per month. An interaction between study condition and unemployment rate was found, in which participants in areas with low unemployment receiving best practice SE had consistently better outcomes than all others. However, even in areas with high unemployment, those who received evidence-based SE had outcomes superior to those in the control condition. This confirms the influence of local labor market forces on individuals with psychiatric disabilities participating in vocational rehabilitation programs. It also suggests that those who are attempting to return to work in areas with weak local economies are likely to fare especially poorly if they are not receiving high quality SE interventions. Thus, use of evidence-based SE can help to ameliorate the effects of high unemployment on work outcomes. [ABSTRACT FROM AUTHOR]