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Objective Patients and other stakeholders generally report high satisfaction with neuropsychological evaluations (NPEs), but no research has examined effects of cognitive, emotional, and other factors that often prompt evaluations. A prospective, quasi-experimental study was conducted to examine self-reported cognitive and psychiatric symptoms, self-efficacy, motivation, and satisfaction following a NPE. Method Participants from a neuropsychology clinic who were diagnosed with AD/HD and/or a DSM-IV mood disorder based on a NPE were included, and excluded if diagnosed with dementia or failure on performance validity tests. Results To examine whether a NPE with an interventional feedback session was associated with outcomes, changes from baseline to post-feedback session were examined with repeated-measures analysis of variance. Pearson correlations determined whether changes in hypothesized mechanisms (i.e. self-efficacy, goal importance and confidence ratings, and use of cognitive strategies) were related to changes in cognitive or psychiatric symptom severity. At follow-up, participants reported reductions in psychiatric (change in Brief Symptom Inventory depression: M  = -2.8, SD  = 4.4, range = −11 to 8, |${\eta}_p^2$| =.30; anxiety: M  = 3.2, SD  = 6.6, range = −21 to 10, |${\eta}_p^2$|  = .20) and cognitive symptoms (change in Multiple Ability Self-Report Questionnaire attention: M  = −0.3, SD  = 0.5, range = −1.6 to 0.5, |${\eta}_p^2$|  = .31; verbal memory: M  = −0.3, SD  = 0.5, range = −1.1 to 0.5, |${\eta}_p^2$|  = .24; language: M  = −0.4, SD  = 0.4, range = −1.3 to 0.4, |${\eta}_p^2$|  = .48), and improved cognition (change in Meta-Memory Questionnaire ability: M  = 4.4, SD  = 6.2, range = −10 to 16, |${\eta}_p^2$|  = .35; contentment: M  = 4.3, SD  = 4.5, range = −7 to 14, |${\eta}_p^2$|  = .49). Participants reported increased self-efficacy for general and evaluation-specific goals. Increased goal-specific self-efficacy was associated with large reductions in psychiatric symptoms. Conclusions Participants reported high levels of satisfaction with the NPE. Results support the clinical utility of NPE and feedback, and underscore the importance of individualized goal setting as part of the evaluation process. [ABSTRACT FROM AUTHOR]

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]

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]

Spending on mental and substance use disorders will likely grow more slowly than all health spending through 2020. We project that spending on mental and substance use disorders, as a share of all health spending, will fall from 7.4 percent in 2009 ($172 billion out of $2.3 trillion) to 6.5 percent in 2020 ($281 billion out of $4.3 trillion). This trend is the projected result of reduced spending on mental health drugs because of patent expirations, the low likelihood of innovative drugs entering the market, and a slowdown in spending growth for hospital treatment. By 2020 the expansion of coverage to previously uninsured Americans under the Affordable Care Act (ACA), combined with the projected slowdown in Medicare provider payment rates under the ACA and the Budget Control Act of 2011, are expected to add 2.7 percent to behavioral health spending, compared to spending without these changes. [ABSTRACT FROM AUTHOR]