Individuals with psychiatric illness who received a modest cash account in combination with their supported employment had better job outcomes than those who received supported employment only, according to a report published today in Psychiatric Services in Advance.
Those receiving the cash account for buying essential goods and services had more days of employment, higher earnings, and reported greater financial security than those receiving only supported employment. Supported employment—which provides counseling and assistance with job seeking, interviewing, and retention—is an essential component of Coordinated Specialty Care.
Judith Cook, Ph.D., of the University of Illinois College of Medicine and colleagues note that the cash account “may have enabled workers to remain at their jobs longer by addressing barriers to transportation, job training, work skill acquisition, and specific expenses that are difficult for low-wage earners to afford.”
Sixty individuals with varying psychiatric diagnoses (predominantly depressive and bipolar disorders) were recruited from the vocational center of a large community mental health center and randomly assigned to receive individual job placement and support only (n=32) or job placement plus a $950 cash account. Participants receiving the cash account met with staff to identify employment goals and create a budget for purchases directly tied to these goals.
The participants were followed for 12 months, with the primary outcome being competitive employment. Secondary outcomes included job tenure, days worked, total earnings, and financial wellbeing, as measured by the eight-item InCharge Financial Distress/Financial Well-Being Scale. The study took place between April 2019 and October 2022, during the height of the pandemic and associated period of job insecurity.
Overall, 15 participants in each group secured competitive employment. Compared to those receiving job placement only, those receiving job placement and the cash account had a higher average job tenure (92 days versus 60 days), higher average total days employed (109 versus 82), and higher average total earnings ($4,723 compared to $3,612). Financial well-being increased by 10% among intervention participants and decreased by 2% among control participants. After adjusting for demographic differences and the year of participation (to factor in pandemic effects), the researchers found that these differences were statistically significant.
“The increase in financial security may have been especially important when people were facing the economic uncertainty of the COVID-19 pandemic,” the authors wrote. “The greater number of days worked by intervention participants also may have helped them feel more financially secure in the context of high rates of job loss during the pandemic.”
For related information see the Psychiatric News article “Jobs Programs for People With SMI Continue Through Economic Uncertainty.”
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