Originally published here.

The Individual Placement and Support (IPS) model of supported employment is an evidenced-based practice that is highly effective at helping people with psychiatric disabilities to obtain gainful employment. Within the State Vocational Rehabilitation (VR) system , the On-the-Job Training (OJT) service supports the rapid placement, client choice, competitive work, disclosure, and follow along support components of the IPS model. We reviewed the Rehabilitation Services Administration (RSA) 911 data for fiscal years 2015 and 2016 to examine California's utilization of RSA Title I funds to provide the OJT service and examined the employment outcomes for individuals with psychiatric disabilities who utilized this service.

We found that OJT, although highly effective (71.4% successfully employed), was underutilized (N=14,384, n=105). Furthermore, in an analysis of individuals with serious psychiatric disabilities (as indicated by receipt of Social Security Administration [SSA] disability benefits at application, coded as significantly or most significantly disabled, and coded with a primary psychiatric disability), 59.3% of the OJT clients were employed , compared to 15.4% of the non-OJT clients (c 2 = 10.85, p < .01). We provide a number of recommendations to both enhance the use of OJT services and improve employment outcomes for this population.

The results indicate that there was a significant increase in successful employment outcomes for theindividuals that received the OJT service. This was expected after reviewing the literature that thesupported employment IPS model is an evidence-based practice for individuals with serious psychiat-ric disabilities. As noted previously, the OJT service as it is provided at DOR supports the rapid place-ment, client choice, competitive work, disclosure, and follow-along support components of the IPSmodel.

The OJT intervention was associated with successful employment. Sixteen individuals out of the 27in the group that received the OJT service were closed successfully employed (59.3%). The compari-son group had employment outcomes that were substantially lower than the average for this popula-tion served in the DOR system. Only four of the individuals out of this comparison group of 26 individ-uals were closed successfully employed (15.4%).

This analysis indicates that individuals with serious psychiatric disabilities receiving the OJT servicehad significantly better employment outcomes than those who did not receive OJT. These findingsare important because individuals with serious psychiatric disabilities can be difficult to place in con-tinued, long-term employment as indicated by our comparison group.

Traditional state-federal VR services have been inadequate to the needs of job seekers with seriouspsychiatric disabilities (Ackerman & McReynols, 2005; Leahy et al., 2016; Peterson & Olney, in press;Rosenthal et al., 2007; Salzer et al., 2011). Based on our findings, we have several recommendationsfor policy, research, and practice that, if implemented, will improve outcomes for this diverse and tal-ented group of individuals. Within our existing State-Federal VR system, the services that have beenshown to significantly improve outcomes for this population are currently available:

1. In most cases, the “place then train” (IPS) model of services should be used to substitute for thetraditional “train then place” (i.e., community college training followed by job placement) modelwhen individuals with serious psychiatric disabilities are seeking employment.

2. State VR agencies should expend more Title I funds to establish OJT services for individuals withpsychiatric disabilities.

3. Caseload sizes tend to be high in State VR agencies, and it is difficult for VR counselors to devote ahigh level of individualized service. VR agencies should provide for more collaboration betweenVR counselors and contracted job developers so that job developers can devote more individual-ized attention to implementing elements of the IPS model within service-delivery including ar ranging for the OJT servisse with na employer to be funded by the VRagency. Furthermore, the OJT service offers a significant financial incentive to employers to hire an individual with a disability.

4. VR staff should be encouraged to include services in the IPE that support the eight principles ofthe IPS supported employment model for individuals with psychiatric disabilities, including the(1) OJT service to support competitive employment, (2) eligibility based on client choice, (3) inte-gration of rehabilitation and mental health services, (4) attention to worker preferences, (5) per-sonalized benefits counseling, (6) rapid job search, (7) systematic job development, and (8)time-unlimited and individualized support.

5. The IPE should include the client’s Wellness Recovery Action Plan (WRAP) or other plan forself-management of symptoms which have been demonstrated to improve the employment out-comes for individuals with serious psychiatric disabilities (Olney & Emery-Flores, 2017). TheWRAP plan also supports the IPS elements of integration of rehabilitation and mental health ser-vices, attention to worker preferences, and time-unlimited and individualized support becausethe client can express their individual choices in all these areas within the WRAP plan.6. Qualitative and quantitative studies should be conducted that focus on the OJT service and theexperiences of the clients, VR staff, community partner agency staff, and employers who partici-pate in coordinating the OJT service.7. Research findings should be used to enhance training curriculum for emerging rehabilitationcounseling professionals both at the university level and for staff development training withinState VR.

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