Wednesday, August 6, 2014

Counseling Veterans on Benefits Can Increase Their Working Rate and Mental Health Service Use

Veterans applying for psychiatric disability benefits are likely to work more days and to use more mental health services if they receive counseling about the value of working, said Department of Veterans Affairs (VA) researchers based on data they published in Psychiatric Services in Advance.

The researchers randomized 84 veterans who had applied for disability benefits based on psychiatric illness to either a four-session intervention program of benefits counseling or a general introduction to the VA’s health system (control subjects). The counseling used motivational interviewing and other techniques to “increase the veterans’ desire to engage in work and related activities,” said Marc Rosen, M.D., an associate professor of psychiatry at Yale University School of Medicine, and colleagues. Rosen is also affiliated with the VA Connecticut Healthcare System in West Haven.

The control group showed no change in the average number of days worked at six months from baseline, but the group that received counseling significantly increased their working time from 6.6 days to 10.5 days per month.

The increase came not from a few veterans working more hours but from more veterans going back to work, Rosen and colleagues pointed out. The counseling intervention also increased these veterans' use of mental health services.

“Benefits counseling might help veterans who have applied for disability because of a service connection to obtain other evidence-based services that help them successfully find and maintain employment,” the researchers concluded.

“This study summarizes the dilemma that both veteran/patients and providers face in trying to encourage veterans to get back into the workforce without losing their disability benefits,” said former U.S. Army psychiatrist Elspeth Cameron Ritchie, M.D., M.P.H., chief medical officer of the District of Columbia Department of Behavioral Health. “Providing briefings is a good idea, but the effect size is relatively mild, and more work is needed to determine just how we can get veterans back to the work.”

To read about programs that help people with psychiatric disabilities remain employed, see the Psychiatric News article, “Study Finds Evidence Showing Supported Employment Works.”

(Image: Sean Locke Photography/


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