Publications by authors named "Justin D Metcalfe"

Objective: The Supported Employment Demonstration (SED), a large, multisite randomized controlled trial, provided evidence-based supported employment to help individuals recently denied Social Security disability benefits for reason of mental illness to gain competitive employment and avoid disability. Monthly, client-level measurement of participation in individual placement and support permitted the first detailed exploration of potential ethnoracial disparities in the IPS participation process, from enrollment to end of follow-along job supports, in a vulnerable population with ready access to the intervention.

Method: Monthly participation data in a subsample of enrollees randomized to receive supported employment enabled decomposition of IPS service participation into take-up, effectiveness, and follow-along support phases, yielding times to participation duration milestones, job start, and end of follow-along supports for 614 non-Hispanic White, non-Hispanic Black, and Hispanic SED enrollees.

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Objective: The Supported Employment Demonstration (SED) trial, which studied the effects of individual placement and support (IPS) among individuals initially denied Social Security Administration disability benefits for mental illness, reported racial-ethnic differences in IPS' effect on employment. Because of high rates of attrition in the SED, this finding warranted further study. The current reanalysis used a subsample with a directly observed measure of competitive employment and less attrition to try to corroborate the reported racial-ethnic differences.

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Individual Placement and Support (IPS) has been shown to effectively help people with serious mental illness obtain competitive employment, and IPS programs have been established in over 40 U.S. states and at least 20 other countries.

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Objective: Co-occurrence of substance use disorder and mental illness complicates treatment and is associated with increased disability. However, identification of substance use disorder in populations recently engaged in treatment can be challenging. This study aimed to examine traditional screening tools for substance use disorder and proxy characteristics (i.

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Individual placement and support (IPS) was the primary intervention in the United States Social Security Administration's supported employment demonstration (SED), a large randomized trial that sought to increase employment and reduce disability among those whose first application for disability benefits was denied. Researchers developed a measure of participation in IPS services to quantify participation among enrollees assigned to receive IPS. The IPS participation measure, which IPS teams completed monthly for individual clients, recorded clients assigned to IPS as being either out of contact with their IPS treatment teams or, if in contact, according to their employment status (employed or not employed) and receipt of IPS job search services (participating or not participating).

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Objective: The authors examined the prevalence and correlates of psychotropic medication prescribing among outpatient youths with intellectual and developmental disabilities.

Methods: The authors reviewed cross-sectional data on medications for 1,333 youths (ages 5-21 years) with intellectual and developmental disabilities who were referred to a community-based mental health crisis service. Descriptive statistics and regression analysis were used to describe the study group and to identify correlates of psychotropic polypharmacy, antipsychotic use, and anticonvulsant use in the absence of a seizure disorder.

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Individual Placement and Support (IPS) is an evidence-based model of supported employment for people with serious mental illness. We assessed the effects and relative contributions of predictors of employment among IPS recipients using measures of baseline client characteristics, local economic context, and IPS fidelity. A recent work history, less time on the Social Security rolls, greater cognitive functioning, and a lower local unemployment rate were associated with greater probability of employment.

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As Individual Placement and Support (IPS) has become the international standard for vocational rehabilitation of adults with serious mental illness, researchers must consider the relationship between IPS and local environments. This meta-analysis used mixed-effects meta-regressions to assess the impact of site-level moderators on the likelihood that IPS recipients, compared with recipients of alternative vocational services, achieved competitive employment. Potential moderators included change in gross domestic product (GDP), local unemployment and unionization rates, and indices describing employment protection regulations, level of disability benefits compensation, and efforts to integrate people with disabilities into the workforce.

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For people with psychiatric disabilities, demographic characteristics and measures of clinical status are often used to allocate scarce employment services. This study examined a battery of potential client predictors of competitive employment, testing the hypothesis that evidence-based supported employment would mitigate the negative effects of poor work history, uncontrolled symptoms, substance abuse, and other client factors. In a secondary analysis of 2055 unemployed Social Security Disability Insurance beneficiaries with schizophrenia or affective disorders, we examined 20 baseline client factors as predictors of competitive employment.

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Objective: The influence of employment on subsequent psychiatric hospitalization for people with serious mental illness is unclear. This study examined whether unemployed people with serious mental illness were more or less likely to experience psychiatric hospitalization after gaining employment.

Methods: A secondary analysis was conducted of data from the Mental Health Treatment Study.

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