Employment Outcomes of a Distance Learning System for Formerly Incarcerated Veterans With Mental Illness.

Objective: People with previous incarceration and a mental disorder, a substance use disorder, or both are less likely to obtain employment than are those without these characteristics. Distance learning and education (DLE) systems are increasingly being integrated into clinical care and provide a pathway to disseminate vocational services. DLE systems can help reach people with barriers to accessing services, including people without transportation, experiencing homelessness, living in rural areas, or who are homebound.

Development and evaluation of an online vocational program for veterans with legal convictions and psychiatric illness.

Purpose: We describe the development and pilot evaluation of an online vocational rehabilitation program, the About Face Online System (AFOS), for veterans with a history of felony convictions and either mental illness and/or substance use disorders.

Method: Phase One was the development and acceptability testing of the online system. Phase Two was a small, randomized trial comparing the likelihood of obtaining employment among people using the AFOS, compared to people receiving a self-directed hardcopy manual, after 6 months.

The association between time incarcerated and employment success: Comparing traditional vocational services with a hybrid supported employment program for veterans.

This study evaluates the effects of time incarcerated on employment outcomes between a manualized vocational program, the About Face Vocational Program (AFVP), and a hybrid program of the AFVP and Individualized Placement and Support, Supported Employment (AFVP + IPS-SE). Eighty-four veterans with the histories of felony convictions and a mental illness or a substance use disorder were randomly assigned to the AFVP or AFVP + IPS-SE conditions and followed for 6 months. The associations between time to employment and months incarcerated were evaluated using nonparametric tests.

Individualized Placement and Support Supported Employment for Justice-involved Homeless and Unemployed Veterans.

Background: Homelessness is a significant issue affecting the general US population. Two subsets of the population overrepresented in the US homeless population are justice involved individuals and Veterans. However, relatively little research has addressed alleviating homelessness in justice-involved Veterans (JIV).

Substance Use Rates of Veterans with Depression Leaving Incarceration: A Matched Sample Comparison with General Veterans.

Formerly incarcerated military veterans-comprising approximately 8% of the prison population-experience significant barriers to reentry including homelessness, mental illness, and mortality. One of the most consequential barriers is relapsing into substance use. Most justice-involved veterans (JIV) possess histories of substance abuse before imprisonment, and this rate continues upon release.

Blending Traditional Vocational Services and Individualized Placement and Support for Formerly Incarcerated Veterans.

Objective: This study compared two vocational programs: the About Face Vocational Program (AFVP), a traditional group-based vocational program created for formerly incarcerated veterans, and a hybrid program combining the AFVP with principles of individual placement and support-supported employment.

Methods: The study evaluated 111 veterans with at least one felony conviction who had a mental illness, substance use disorder, or both. Veterans were randomly assigned to either vocational condition.

Predictors of dropout from a randomized clinical trial of cognitive processing therapy for female veterans with military sexual trauma-related PTSD.

Many veterans do not complete evidence-based treatments (EBTs) for posttraumatic stress disorder (PTSD). Veterans with military sexual trauma (MST)-related PTSD were shown to have higher than average rates of dropout from PTSD treatment in a national study of EBT implementation. Although predictors of dropout from EBTs have been identified, these factors are largely unmodifiable (e.

The association between time incarcerated and the search for employment in a veteran sample with substance use disorders.

Objective: Incarceration and substance use disorders/mental illness can have a significant negative impact on finding employment. However, it is unclear in what phase of the search for employment, that is, applying for jobs, obtaining interviews, being offered employment, does time incarcerated have the most effect. This study will determine how time incarcerated in the past 10 years is associated with negative job search process outcomes.

Vocational rehabilitation for veterans with felony histories and mental illness: 12-month outcomes.

Lack of employment is an important barrier to successful reintegration encountered by those released from prison with mental illnesses and/or substance use disorders. This study compares 3 different vocational reintegration modalities for a veteran population: (a) basic services; (b) self-study using the ; and (c) the About Face Vocational Program, a standardized group program focused on the . One-hundred eleven veterans with a history of at least one felony conviction and a mental illness and/or substance use disorder were recruited from a large urban Veterans Affairs (VA) medical center.

Individual Placement and Support in Spinal Cord Injury: A Longitudinal Observational Study of Employment Outcomes.

Objective: To determine the effects of a 24-month program of Individual Placement and Support (IPS) supported employment (SE) on employment outcomes for veterans with spinal cord injury (SCI).

Design: Longitudinal, observational multisite study of a single-arm, nonrandomized cohort.

Setting: SCI centers in the Veterans Health Administration (n=7).

Incorporating Individualized Placement and Support Principles Into Vocational Rehabilitation for Formerly Incarcerated Veterans.

Objective: This study evaluated the six-month outcomes of incorporating the principles of supported employment, specifically Individual Placement and Support (IPS), into the About Face program, an existing standardized group-based vocational program for previously incarcerated veterans.

Methods: Participants (N=84) with a history of at least one felony conviction and a substance use disorder (88%) or mental illness or combination (59%) were recruited from a large urban veterans hospital. Veterans were randomly assigned to either the About Face program (AF) or to that program plus a modification of IPS (AF+IPS).

Redesign of a Screening Process for VA Homeless Housing.

Standardizing the screening processes for homeless housing among VA facilities can make programs more accessible to veterans experiencing homelessness and improve provider knowledge of existing and available services.

Effects of structured vocational services in ex-offender veterans with mental illness: 6-month follow-up.

With more than 200,000 veterans incarcerated, a significant need exists for the development of technologies that help veterans with felony histories return to employment. This study evaluated the effect of three methods of vocational assistance on competitive employment over a 6 mo follow-up period: (1) basic vocational services, (2) self-study using a vocational manual designed for formerly incarcerated veterans, and (3) a group led by vocational staff using the vocational manual. We evaluated 111 veterans for time to obtain and total time of competitive employment.

Rapid HIV testing experience at Veterans Affairs North Texas Health Care System's Homeless Stand Downs.

In the USA, 21% of the estimated 1.1 million people living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) are unaware they are HIV-infected. In 2011, Veterans Health Administration (VHA)'s Office of Public Health in conjunction with VHA's Health Care for Homeless Veterans Program funded grants to support rapid HIV testing at homeless outreach events because homeless populations are more likely to obtain emergent rather than preventive care and have a higher HIV seroprevalence as compared to the general population.

Lifestyle coaching's effect on 6-month follow-up in recently homeless substance dependent veterans: a randomized study.

Objective: Behaviors and activities consistent with "healthy" lifestyles (i.e., leisure and recreational activities, social and family interactions, coping behaviors) have been shown to be related to prolonged substance dependence recovery.

Effects of structured vocational services on job-search success in ex-offender veterans with mental illness: 3-month follow-up.

With the high number of incarcerated veterans with mental illness and substance dependence returning to the community annually, a significant need exists for technologies that will help them return to employment. This study evaluates three methods of assistance: (1) basic vocational services, (2) self-study of a vocational manual designed for formerly incarcerated veterans, and (3) a group led by vocational staff using the vocational manual. We evaluated 69 veterans to determine the number finding employment within 3 months after enrollment in the study.

A comparison of the behavioral observation system (BOS) with clinician ratings of psychosis and mania.

This study investigated the relationship of the behavioral observation system (BOS; LePage & Mogge, 2001) and clinician ratings of psychosis and mania. Fifty interviews with psychiatric inpatients using the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms, and the Young Mania Rating scale were completed. Paraprofessionals completed a BOS on the patient during the same day of the clinician's interview.

Detecting random responding using the Assessment of Depression Inventory: a brief screening measure of depression.

Background: Traditionally, the assessment of random responding in psychological assessment tools has been the primary domain of large multi-scale inventories. However, the ability of clinicians to assess random responding when using short symptom inventories is also an important facet of reliably assessing psychopathology and psychological distress.

Methods: This study assesses the effectiveness of a short symptom inventory, the Assessment of Depression Inventory (ADI), to assess random responding.

Effects of hemodialysis on profound memory deficits in renal insufficiency due to multiple myeloma: a case study.

Multiple myeloma, a rare cancer for individuals less than 65 years of age, and its pathophysiological effects have a profound impact on neurocognitive function. Specific transient deficits in patients with renal failure secondary to multiple myeloma have been noted to improve with hemodialysis. We present a complex case of an individual with multiple myeloma, renal insufficiency, treated seizure disorder, and schizophrenia, paranoid type, who experienced functional improvements in memory and visuospatial function with short- and long-term administration of hemodialysis.

Reliability and validity of World Health Organization Quality of Life-100 in homeless substance-dependent veteran population.

The number of homeless individuals and specifically homeless veterans is increasing. Accurate assessment of quality of life is an important need in working with this population because of the myriad problems encountered. However, the reliability and validity of quality-of-life instruments have not been assessed in this population.

The association between healthy lifestyle behaviors and relapse rates in a homeless veteran population.

This study evaluates the association between Healthy Lifestyle Behaviors (HLBs) and relapse rates in a homeless residential rehabilitation program. Ninety-seven homeless veterans with Substance Dependence in Early Remission were evaluated. Veterans recorded recreational, social, coping/spiritual, and substance recovery activities.

Evaluating risk factors for violence at the inpatient unit level: combining young adult patients and those with mental retardation.

The current study demonstrates the use of patient case mix to evaluate the probability of aggression occurring on an inpatient psychiatric unit. The impact of combining young adult psychiatric patients with patients classified with mental retardation on the overall negative events and injuries on an inpatient psychiatric unit was evaluated. Results suggest when the combined number of young adults and patients classified with mental retardation exceeds 10 the unit is at high risk for aggressive behavior occurring.

The assessment of depression inventory (ADI): a new instrument used to measure depression and to detect honesty of response.

We examined the psychometric properties of the Assessment of Depression Inventory (ADI). This instrument assesses depression and also has validity scales that address response honesty. Three studies were conducted.

A brief behavioral activation treatment for depression. A randomized pilot trial within an inpatient psychiatric hospital.

The brief behavioral activation treatment for depression (BATD) is a relatively uncomplicated, time-efficient, and cost-effective method for treating depression. Because of these features, BATD may represent a practical intervention within managed care-driven, inpatient psychiatric hospitals. Based on basic behavioral theory and empirical evidence supporting activation strategies, we designed a treatment to increase systematically exposure to positive activities and thereby help to alleviate depressive affect.

Five-year outcomes following psychiatric consultation to a tertiary care emergency room.

Objective: The authors prospectively examined inpatient psychiatric hospitalization and mortality rates of psychiatric patients seen in the emergency room of a large Department of Veterans Affairs medical center.

Method: Charts of 504 patients receiving evening psychiatric consultation during a 13-month period were assessed 5 years after the consultation to determine rates of psychiatric hospitalization and mortality.

Results: Patients with multiple psychiatric diagnoses, including comorbid addiction disorders, had significantly higher rates of psychiatric hospitalization 5 years after an emergency room visit.