N/A
N=119
Supported Employment in Patient Aligned Care Teams
Mental Disorder · Substance Use Disorders · Posttraumatic Stress Disorder · Major Depressive Disorder · Anxiety Disorder
Bottom Line
View on ClinicalTrials.gov: NCT02400736 ↗Enrolled (actual)
119
Serious AEs
8.4%
Results posted
Mar 2021
Primary outcome: Primary: Steady Worker — 26; 15 Participants — p=0.02
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Individual Placement and Support (IPS) (Behavioral); Treatment as Usual Vocational Rehabilitation/Transitional Work (TUA-VR) (Other)
- Age
- Adult, Older Adult · 19+ yrs
- Sex
- All
- Sponsor
- VA Office of Research and Development
- Primary completion
- Sep 2019
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Steady Worker |
26; 15 | 0.02 sig |
| SECONDARY Weeks Worked in a Competitive Job |
38.6; 24.6 | 0.003 sig |
| SECONDARY Time to First Competitive Job |
8.7; 17.6 | 0.005 sig |
| SECONDARY Income Earned From Competitive Jobs |
11,106; 6,605 | 0.033 sig |
| SECONDARY Symptom Checklist-90-Revised Change From Baseline to Month 12. |
0.036; 0.042 | 0.853 |
| SECONDARY Income Earned From All Sources |
17,960; 11,168 | 0.004 sig |
| SECONDARY Rosenberg Self-Esteem Scale Change From Baseline to 12 Months. |
1.23; 0.31 | 0.47 |
| SECONDARY Income Earned From Competitive Jobs in Participants Who Held a Competitive Job |
18,945; 13,813 | 0.062 |
Summary
In response to the Rehabilitation Research and Development (RR&D) Deployment Health Research, this study addresses the delivery of an evidenced-based vocational rehabilitation, specifically Individual Placement and Support (IPS), for Veterans who are facing unemployment and mental illness as they try to recovery and re-establish civilian life. This study provides the requisite evidence needed to guide the Veterans Health Administration (VHA) as to whether to expand the target population for IPS to Veterans with any mental disorder, delivered directly within the primary care setting (i.e. Patient Aligned Care Team; PACT). Such modifications in VHA practice could substantially improve Veteran vocational rehabilitation access and outcomes, moving a significantly greater number of disabled Veterans back to full and productive lives in the community.
Eligibility Criteria
Inclusion Criteria
- Age 19* (<19 years of age is the state of Alabama defined minor)
- Receiving primary care treatment in the Tuscaloosa VA Medical Center (TVAMC) PACT, called the Transition Center (i.e. served during the OEF/OIF/OND/other Southwest Asia conflicts) or other Primary Care PACT providing care for OEF/OIF/OND/other Southwest Asia Veteran
- Otherwise eligible for TVAMC vocational rehabilitation services, in the event that the Veteran is randomized to TW
- diagnosis that is disabling or potentially disabling (i.e. depressive, bipolar II, anxiety, obsessive-compulsive, trauma- and stressor-related, dissociative, impulse- control, and substance related/addictive (other than caffeine and nicotine) disorder classifications), other than those listed as exclusionary, within past 90 days according to Diagnostic and Statistical Manual 5th edition.
- Currently unemployed, defined as not working in a competitive job for a wage or under-employed, defined as (defined as: working less than 20 hours per week in a job that is low wage and is not in keeping with the Veteran's ability, aptitude, or skills)
- Expression of interest in competitive employment
- Willing and able to give informed consent.
Note: Veterans with history of mild traumatic brain injury (TBI) may be included in the study.
Exclusion Criteria
- Current diagnosis of (i) schizophrenia, (ii) schizoaffective, (iii) bipolar I disorder, or major depression with psychotic features, since these Veterans may receive IPS in mental health
- Diagnosis of dementia (evidenced in the medical record)
- Clinically significant unstable or severe medical condition, or terminal illness, that would contraindicate study participation or expose them to an undue risk of a significant adverse event
- Unlikely that participant can complete the study, e.g. expected deployment, incarceration, long-term hospitalization, or relocation from the vicinity of the TVAMC during the study period
- Active suicidal or homicidal ideation making it unsafe for Veteran to be included in study
- Current participation in another interventional trial.
Data sourced from ClinicalTrials.gov (NCT02400736). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.