Supported employment: evidence on economic impacts.

摘要

In 2013, the difficult U.S. budget situation, coupled with a negative cash balance in the Social Security Disability Insurance (SSDI) program, has directed policy makers' attention to reforming disability programs. The rapid growth of both the SSDI program and the Supplemental Security Income (SSI) program has created interest in the origins of the financial pressures being put on these programs and on the federal budget. Beneficiaries with severe and persistent mental illnesses have been among the most rapidly growing segments of both the SSI and the SSDI programs. Under such circumstances, clinical interventions that promise outcomes in the form of increased labor force activity, improved earnings, and reduced reliance on publicly funded income support programs are of great interest. For this reason evidence-based supported employment programs, such as the individual placement and support model, may offer interventions that contribute to policy solutions. These interventions have been carefully studied and have repeatedly been shown to produce encouraging results with respect to improving functional, social, and economic outcomes for a segment of the population with serious and persistent mental illnesses. It has also been claimed that supported employment programs may yield substantial savings to publicly funded income support and health insurance programs.