MIRECC/CoE Mental Health Innovations Newsletter - December 2015
Announcing: Self-Help Resources: Resources to Empower Veterans Mental Health
Early vocational intervention may help prevent homelessness and other losses, such as family disruption.
A study at the Edith Nourse Rogers Memorial Veterans Hospital (Bedford VAMC) in Bedford, MA, has shown that early help for employment problems could be a good way to prevent homelessness in Veterans receiving mental health care, an area not studied before. Participants had a vocational need but were not currently enrolled in vocational rehabilitation services. Of 155 Veterans enrolled in the study, 31 (20%) were homeless when their employment problem began. Of the 124 who were not homeless when their employment problem started, 99 (79.8%) became homeless within seven years, many within two years.
Results showed that homelessness was often part of a gradual decline over several years after a vocational problem began. Progressive losses included:
- moves to less expensive housing;
- temporary residence with family or friends; and, eventually,
- time spent in shelters, jail/prison/institutions or on the street.
As VA works to eliminate homelessness, prevention becomes a more important strategy to pursue. Early vocational rehabilitation interventions may not only help prevent homelessness but might also help avoid other losses, such as disruption of families, that are so damaging to Veterans’ confidence and hope in recovery.
The study was funded by VA Rehabilitation Research & Development and involved the VISN 1 New England MIRECC, as well as the Dallas VA Medical Center and investigators at the Dartmouth Medical School. For more information, contact Charles E. Drebing, PhD, at Charles.Drebing@va.gov.
Education: Training Materials Being Developed to Support Self-Employment Program for Veterans
Training materials will soon be available to help Veterans interested in self-employment.
Training materials to help VA vocational rehabilitation services staff develop and manage self-employment services for Veterans are now being developed. They are based on the Supported Self-Employment (SSE) Program created and operating at the Bedford VAMC for the past 11 years. The program is designed to extend the Individual Placement and Support model, an evidence-based mental health practice.
The SSE Program at Bedford VAMC provides information usually given to those interested in being their own boss and education about business development. It also provides peer support and mentoring and assists Veterans in obtaining financing/small loans. An estimated one in five Veterans participating in VA vocational rehabilitation services is interested in self-employment.
In particular, VISN 1 New England MIRECC has supported the SSE with the development of its 18-session class, called “The Business Training Gym.” This weekly, 2-hour drop-in class trains Veterans in the practical basics of starting a small business. In addition, the program also restates principles of positive psychology in business terms, integrating recovery into the process of building a business.
VISN 1 New England MIRECC staff are now assisting the VHA Office of Therapeutic and Supported Employment Services in preparing these training materials, which should be ready in about six months. For more information, contact Charles E. Drebing, PhD at Charles.Drebing@va.gov.
Clinical: Implementation Efforts Assist in Getting Veterans with Schizophrenia Back to Work
Employment is increased among Veterans with schizophrenia through the implementation of Supported Employment (SE).
Supported Employment (SE) is an evidence-based treatment for individuals with schizophrenia. However, many Veterans with schizophrenia who receive treatment at the Veterans Health Administration do not use SE. Results of a study examining effectiveness and implementation at mental health clinics in four VISNs found that implementation efforts resulted in 2.3 times more Veterans receiving SE.
The study found that the availability, use and quality of SE were different across sites, but that all sites needed improvement in these quality of care indicators. Of the 406 Veterans who were interested in returning to work, 6% were employed at final follow-up. Of those who used SE during the study year, 16% were employed at follow-up, a significant difference.
At the time of the study, it was the largest quality-improvement study conducted in specialty mental health care. For more information, contact Alexander Young, MD, MSHS, at Alexander.Young@va.gov.
About Mental Health Innovations
There are 15 VA specialized mental health centers of excellence which include 10 Mental Illness Research, Education and Clinical Centers (MIRECCs), 4 Mental Health Centers of Excellence, and the National Center for PTSD. The centers share a mission to improve the health and well being of Veterans through cutting-edge science, education, and clinical initiatives. Mental health problems are often multiple complex conditions. Each center addresses a particular mental health disorder, environmental situation or Veteran cohort. To learn more about these centers, go to www.mirecc.va.gov.
Sara Chapman (Editor), Sonora Hudson, MA (Lead Writer), MIRECC Communications Workgroup (Contributors) and Rachel Warden (Designer)
©2015 U.S. Department of Veterans Affairs