Journal of Rehabilitation Research & Development (JRRD)

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Volume 50 Number 5, 2013
   Pages 663 — 670

Abstract — Veterans Health Administration vocational services for Operation Iraqi Freedom/Operation Enduring Freedom Veterans with mental health conditions

Elizabeth W. Twamley, PhD;1–2* Dewleen G. Baker, MD;1–2 Sonya B. Norman, PhD;1–2 James O. E. Pittman, MSW;1 James B. Lohr, MD;1–2 Sandra G. Resnick, PhD3

1Center of Excellence for Stress and Mental Health, Department of Veterans Affairs (VA) San Diego Healthcare System, San Diego, CA; 2Department of Psychiatry, University of California, San Diego, CA; 3New England Mental Illness Research, Education, and Clinical Center, VA Connecticut Healthcare System, West Haven, CT; and Department of Psychiatry, Yale University, New Haven, CT

Abstract — High rates of mental health conditions and unemployment are significant problems facing Veterans of Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF). We examined two national Veterans Health Administration (VHA) databases from fiscal years 2008–2009: a larger database (n = 75,607) of OIF/OEF Veterans with posttraumatic stress disorder, depression, substance use disorder, or traumatic brain injury (TBI) and a smaller subset (n = 1,010) of those Veterans whose employment was tracked during their participation in VHA vocational services. Only 8.4% of Veterans in the larger database accessed any vocational services and retention was low, with most Veterans attending one or two appointments. Veterans with TBI and with more mental health conditions overall were more likely to access vocational services. Only 2.2% of Veterans received evidence-based supported employment. However, supported employment was effective, with 51% of those Veterans receiving it obtaining competitive work. Effect sizes quantifying the effect of supported employment provision on competitive work attainment, number of jobs, job tenure, and retention in vocational services were large. Given the high success rate of supported employment for these Veterans, additional supported employment specialists for this population would be expected to improve work outcomes for post-9/11 Veterans who want assistance returning to work.

Key words: brain injury, compensated work therapy, depression, employment, posttraumatic stress disorder, rehabilitation, service utilization, substance use disorder, supported employment, unemployment.


View HTML  ¦  View PDF  ¦  Contents Vol. 50, No. 5
This article and any supplementary material should be cited as follows:
Twamley EW, Baker DG, Norman SB, Pittman JO, Lohr JB, Resnick SG. Veterans Health Administration vocational services for Operation Iraqi Freedom/Operation Enduring Freedom Veterans with mental health conditions. J Rehabil Res Dev. 2013;50(5):663–70.
http://dx.doi.org/10.1682/JRRD.2012.08.0137
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