Robert E Drake

Dartmouth College, Hanover, New Hampshire, United States

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Publications (355)980.76 Total impact

  • Alison Luciano, Gary R Bond, Robert E Drake
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    ABSTRACT: This review synthesized prospective evidence to assess whether achieving employment alters the course of schizophrenia-spectrum disorder.
    Schizophrenia Research 09/2014; · 4.59 Impact Factor
  • Gary R. Bond, Robert E. Drake, Kikuko Campbell
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    ABSTRACT: AimThe individual placement and support (IPS) model of supported employment was first developed in community mental health centres for adults with severe mental illness. While IPS is an established evidence-based practice in this broad population, evidence on its effectiveness focused specifically on young adults has been limited. The current study aimed to address this gap.Methods To investigate the effects of IPS on young adults, the authors conducted a secondary analysis on a pooled sample of 109 unemployed young adults (under age 30) from four randomized controlled trials employing a common research protocol that included a standardized measurement battery and rigorous fidelity monitoring. Researchers assessed these participants over 18 months on nine competitive employment outcome measures.ResultsOn all measures, the IPS group had significantly better employment outcomes. Overall, 40 (82%) of IPS participants obtained employment during follow-up compared with 25 (42%) of control participants, χ2 = 17.9, P < .001. IPS participants averaged 25.0 weeks of employment, compared with 7.0 weeks for control participants, t = 4.50, P < .001.Conclusions The current analysis supports a small number of previous studies in showing that IPS is highly effective in helping young adults with severe mental illness to attain competitive employment. When young adults acquire competitive jobs and initiate a path towards normal adult roles, they may avoid the cycle of disability and psychiatric patient roles that are demeaning and demoralizing.
    Early Intervention in Psychiatry 09/2014; · 1.65 Impact Factor
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    ABSTRACT: People with severe mental illness and a co-occurring substance use disorder (co-occurring disorders) who live in urban areas experience high rates of incarceration. This study examined sociodemographic, clinical, economic, and community integration factors as predictors of incarceration among people with co-occurring disorders.
    Psychiatric services (Washington, D.C.) 07/2014; · 2.81 Impact Factor
  • G R Bond, R E Drake, A Luciano
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    ABSTRACT: Aims. Young adults with early psychosis want to pursue normal roles - education and employment. This paper summarises the empirical literature on the effectiveness of early intervention programmes for employment and education outcomes. Methods. We conducted a systematic review of employment/education outcomes for early intervention programmes, distinguishing three programme types: (1) those providing supported employment, (2) those providing unspecified vocational services and (3) those without vocational services. We summarised findings for 28 studies. Results. Eleven studies evaluated early intervention programmes providing supported employment. In eight studies that reported employment outcomes separately from education outcomes, the employment rate during follow-up for supported employment patients was 49%, compared with 29% for patients receiving usual services. The two groups did not differ on enrolment in education. In four controlled studies, meta-analysis showed that the employment rate for supported employment participants was significantly higher than for control participants, odds ratio = 3.66 [1.93-6.93], p < 0.0001. Five studies (four descriptive and one quasi-experimental) of early intervention programmes evaluating unspecified vocational services were inconclusive. Twelve studies of early intervention programmes without vocational services were methodologically heterogeneous, using diverse methods for evaluating vocational/educational outcomes and precluding a satisfactory meta-analytic synthesis. Among studies with comparison groups, 7 of 11 (64%) reported significant vocational/education outcomes favouring early intervention over usual services. Conclusions. In early intervention programmes, supported employment moderately increases employment rates but not rates of enrolment in education. These improvements are in addition to the modest effects early programmes alone have on vocational/educational outcomes compared with usual services.
    Epidemiology and Psychiatric Sciences 07/2014; · 2.94 Impact Factor
  • Robert E. Drake, Deborah R. Becker
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    ABSTRACT: The authors have developed individual placement and support using many of the principles of psychiatric rehabilitation of Robert P. Liberman. These included respect for the individual, working in collaboration with the family, integrating skills and supports, using simple behavioral techniques to teach skills in a particular context, combining clinical and rehabilitative approaches, and insisting on rigorous research. As individual placement and support has become an evidence-based practice and has spread around the globe, Bob continues to be a tireless mentor, supporter, colleague, and friend.
    European Journal of Marketing 07/2014; 17(3). · 0.96 Impact Factor
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    ABSTRACT: Objective: Despite the large number of Latinos living in the United States, little research has evaluated the effectiveness of different vocational rehabilitation programs for individuals with severe mental illness in this rapidly growing minority population. This article presents a secondary analysis of a randomized, controlled trial comparing supported employment with 2 other vocational rehabilitation programs in 3 ethnic/racial groups of participants with severe mental illness: Latinos, non-Latino African Americans, and non-Latino Whites. Method: The data were drawn from a previously published randomized, controlled trial comparing supported employment with standard vocational rehabilitation services and a psychosocial clubhouse program in persons with severe mental illness (Mueser et al., 2004), including 64 Latinos, 91 non-Latino African Americans, and 43 non-Latino Whites. Comparisons were made between the 3 groups at baseline on demographic characteristics, clinical and psychosocial functioning, and quality of life. Within each ethnic/racial group, competitive employment and all paid employment outcomes were compared between the 3 vocational rehabilitation programs over the 2-year study period. Results: At baseline, the Latino participants had lower levels of education and disability income, were less likely to have worked competitively over the previous 5 years, had more severe symptoms, and worse psychosocial functioning than the non-Latino African American or non-Latino White participants. Latinos randomized to supported employment had better competitive and all-paid work outcomes than those assigned to either standard services or the psychosocial clubhouse program, similar to the non-Latino consumers. Rates of competitive work for consumers in supported employment were comparable across all 3 racial/ethnic groups. Discussion: Supported employment is effective at improving competitive work in Latinos with severe mental illness. Efforts should be made to increase access to supported employment in the growing population of Latinos with severe mental illness. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Psychiatric rehabilitation journal. 06/2014; 37(2):113-122.
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    ABSTRACT: Persons with severe and persistent mental disorders (SPMD) have extremely low earnings levels and account for 29.1 percent of all U.S. Social Security Disability Income (SSDI) disabled worker beneficiaries under age 50. Social insurance and disability policy experts pointed to several factors that may contribute to this situation, including disincentives and obstacles in the SSDI program, as well as lack of access to evidence-based behavioral-health interventions. In response, the Social Security Administration (SSA) funded the Mental Health Treatment Study (MHTS) demonstration that included 2,238 beneficiaries of SSDI whose primary reason for disability is SPMD. The demonstration, implemented in 23 different localities, consisted of two evidence-based services (individual placement and support supported employment (IPS-SE), systematic medication management (SMM)), and provision or coverage of additional behavioral-health services (OBH).
    The Journal of Mental Health Policy and Economics 06/2014; 17(2):75-90. · 0.97 Impact Factor
  • Robert E Drake, Gary R Bond
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    ABSTRACT: This issue of the Psychiatric Rehabilitation Journal presents an update on individual placement and support (IPS), the evidence-based practice of supported employment for people with psychiatric disabilities. The papers in this special issue testify to the enormous potential of the IPS model. Clients, families, researchers, policy experts, practitioners, and administrators continue to identify creative ways to expand services to reach more people. The state of the art of IPS is expanding, changing, and ramifying broadly. IPS is appearing in middle-income countries in Latin America and in new populations, such as young adults with autism-spectrum disorders in Europe. Continued growth should follow the fundamental principles of values and science. First, we must honor basic values by listening to and learning from clients (Strickler, 2014), as well from IPS trainers, mental health and vocational rehabilitation leaders, and practitioners who face the daily realities of developing and sustaining recovery-oriented services (Swanson et al., 2014). Second, we must insist on rigorous research to ground our employment services in hard evidence. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Psychiatric rehabilitation journal. 06/2014; 37(2):76-78.
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    ABSTRACT: Persons with severe and persistent mental disorders (SPMD) have extremely low earnings levels and account for 29.1 percent of all U.S. Social Security Disability Income (SSDI) disabled worker beneficiaries under age 50. Social insurance and disability policy experts pointed to several factors that may contribute to this situation, including disincentives and obstacles in the SSDI program, as well as lack of access to evidence-based behavioral-health interventions. In response, the Social Security Administration (SSA) funded the Mental Health Treatment Study (MHTS) demonstration that included 2,238 beneficiaries of SSDI whose primary reason for disability is SPMD. The demonstration, implemented in 23 different localities, consisted of two evidence-based services (individual placement and support supported employment (IPS-SE), systematic medication management (SMM)), and provision or coverage of additional behavioral-health services (OBH).
    The Journal of Mental Health Policy and Economics 06/2014; 17(2):25-32. · 0.97 Impact Factor
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    ABSTRACT: Medicaid is now the main payment source and financing mechanism for services for adults with serious mental illness. Services formerly paid with state mental health funds have been converted to Medicaid, lightening the burden on state budgets affected by recession and other factors. The change has allowed states to maintain community care and inpatient services (in general hospitals). Medicaid service benefits include clinic and inpatient care, case management, and some rehabilitation services. But using Medicaid to finance some high-priority services such as supported employment has proven difficult. Now critical changes in Medicaid under the Affordable Care Act allow states to amend their Medicaid State Plans to provide more flexible services to people with serious mental illness. Advocacy and support may be needed to encourage this step. A national campaign to finance supported employment would join various stakeholders in the field, including professional organizations, family and service user groups, and organizations representing service providers. The authors of this editorial pledge their energies to support this campaign. They present suggestions for a campaign, including building a coalition, goals and targets, and online resources. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Psychiatric rehabilitation journal. 06/2014; 37(2):73-75.
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    ABSTRACT: Topic: The potential of technology to enhance delivery and outcomes of Individual Placement and Support (IPS) supported employment. Purpose: IPS supported employment has demonstrated robust success for improving rates of competitive employment among individuals with psychiatric disabilities. Still, a majority of those with serious mental illnesses are not employed (Bond, Drake, & Becker, 2012). The need to promote awareness of IPS and expand services is urgent. In this study, we describe ways that technologies may enhance delivery of IPS supported employment across the care continuum and stakeholder groups. Directions for research are highlighted. Sources Used: published literature, clinical observations, IPS learning collaborative. Conclusions and Implications for Practice: Technology has the potential to enhance direct service as well as workflow in the IPS supported employment process, which may lead to improved fidelity and client outcomes. Mobile and cloud technologies open opportunities for collaboration, self-directed care, and ongoing support to help clients obtain and maintain meaningful employment. Research is needed to evaluate efficacy of technology-based approaches for promoting client employment outcomes, to identify provider and organization barriers to using technology for IPS delivery, and to determine effective strategies for implementing technology with IPS in different settings and with diverse client audiences. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Psychiatric rehabilitation journal. 06/2014; 37(2):99-106.
  • Source
    Social security bulletin 05/2014; 74(2):27-46.
  • Robert E Drake, Rob Whitley
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    ABSTRACT: The notion of recovery has been embraced by key stakeholders across Canada and elsewhere. This has led to a proliferation of definitions, models, and research on recovery, making it vitally important to examine the data to disentangle the evidence from the rhetoric. In this paper, first we ask, what do people living with severe mental illness (SMI) say about recovery in autobiographical accounts? Second, what do they say about recovery in qualitative studies? Third, from what we have uncovered about recovery, can we learn anything from quantitative studies about proportions of people leading lives of recovery? Finally, can we identify interventions and approaches that may be consistent or inconsistent with the grounded notions of recovery unearthed in this paper? We found that people with mental illness frequently state that recovery is a journey, characterized by a growing sense of agency and autonomy, as well as greater participation in normative activities, such as employment, education, and community life. However, the evidence suggests that most people with SMI still live in a manner inconsistent with recovery; for example, their unemployment rate is over 80%, and they are disproportionately vulnerable to homelessness, stigma, and victimization. Research stemming from rehabilitation science suggests that recovery can be enhanced by various evidence-based services, such as supported employment, as well as by clinical approaches, such as shared decision making and peer support. But these are not routinely available. As such, significant systemic changes are necessary to truly create a recovery-oriented mental health system.
    Canadian journal of psychiatry. Revue canadienne de psychiatrie 05/2014; 59(5):236-242. · 2.48 Impact Factor
  • Robert E. Drake, Ilirjana Bajraktari
    Acta Psychiatrica Scandinavica 03/2014; · 4.86 Impact Factor
  • Deborah R Becker, Robert E Drake, Gary R Bond
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    ABSTRACT: Objective: Learning collaboratives aim to improve the quality and outcomes of health care. This paper updates the Johnson & Johnson-Dartmouth Community Mental Health Program, a 12-year learning collaborative on supported employment for people with mental illness. Methods: We gathered data from quarterly employment reports, monthly Individual Placement and Support (IPS) meetings, and presentations at the 2013 annual meeting of the learning collaborative. Results: The number of participant states or regions (and sites within these jurisdictions) was expanded to 16 jurisdictions in the United States and 3 in European countries. The quarterly rate of competitive employment has averaged 43% over 11 years in the U.S. sites. The collaborative has spawned numerous interactions, trainings, innovations, and research projects. Conclusions and Implications for Practice: Long-term learning collaboratives can produce high quality services, good outcomes, sustainability, and innovation. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Psychiatric Rehabilitation Journal 02/2014; · 0.75 Impact Factor
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    ABSTRACT: Individual Placement and Support (IPS) is an evidence-based model to help people with serious mental illness achieve employment. This study examined variation in model adherence in small and large communities. We compared program-level ratings on a standardized 25-item IPS fidelity scale (range = 25-125) for 79 sites in eight states categorized by local community size. Programs in large and small communities achieved comparable fidelity scores (mean = 100 and 104, respectively). Fidelity-outcome correlations within the two groups were both of moderate size. As a practical guide, the IPS fidelity scale is suitable for use in both small and large communities.
    Community Mental Health Journal 12/2013; · 1.03 Impact Factor
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    ABSTRACT: State administrative supports of evidence-based practices (EBPs) may critically affect sustainability. As part of a larger follow-up to the multistate National Implementing Evidence-Based Practices Project, 13 leaders from eight States reported on recent statewide policies and resources that influenced the maintenance of 49 EBP programs 6 years after implementation. Nearly three-quarters (71 %) of the programs were currently operational and adhering to State fidelity standards. Most of the programs had level or increased funding over the last few years, and most received other State support and resources, such as training and technical assistance. Steady State funding as well as State-sponsored training and expertise appear critical to long-term EBP program maintenance.
    The Journal of Behavioral Health Services & Research 09/2013; · 0.78 Impact Factor
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    ABSTRACT: Topic: A growing research literature indicates that cognitive enhancement (CE) interventions for people with schizophrenia can improve cognitive functioning and may benefit psychosocial functioning (e.g., competitive employment, quality of social relationships). Debate continues regarding the strength of evidence for CE and related policy implications, such as the appropriateness of funding CE services. Purpose: This paper summarizes and updates a meeting of experts and stakeholders convened in 2008 by the New York Office of Mental Health to review evidence on the impact of CE for people with schizophrenia and other serious mental illnesses, and addresses whether the evidence base for CE interventions is sufficient to warrant funding. Sources Used: Specific recommendations based on the extant literature are provided regarding the structure and components of CE programs that should be present in order to improve cognitive and psychosocial outcomes and therefore merit consideration of funding. Conclusions and Implications for Practice: These recommendations may serve as a starting point in developing standards for CE programs. Establishing evidence-based practice standards for implementing CE interventions for people with serious mental illnesses may facilitate dissemination of programs that have the greatest potential for improving individuals' functional outcomes while minimizing incremental costs associated with providing CE services. Important open questions include how the performance of CE programs should be monitored and which individuals might be expected to benefit from CE as evidenced by improved functioning in their everyday lives. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
    Psychiatric Rehabilitation Journal 09/2013; 36(3):133-45. · 0.75 Impact Factor
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    ABSTRACT: OBJECTIVE People with psychiatric impairments (primarily schizophrenia or a mood disorder) are the largest and fastest-growing group of Social Security Disability Insurance (SSDI) beneficiaries. The authors investigated whether evidence-based supported employment and mental health treatments can improve vocational and mental health recovery for this population. METHOD Using a randomized controlled trial design, the authors tested a multifaceted intervention: team-based supported employment, systematic medication management, and other behavioral health services, along with elimination of barriers by providing complete health insurance coverage (with no out-of-pocket expenses) and suspending disability reviews. The control group received usual services. Paid employment was the primary outcome measure, and overall mental health and quality of life were secondary outcome measures. RESULTS Overall, 2,059 SSDI beneficiaries with schizophrenia, bipolar disorder, or depression in 23 cities participated in the 2-year intervention. The teams implemented the intervention package with acceptable fidelity. The intervention group experienced more paid employment (60.3% compared with 40.2%) and reported better mental health and quality of life than the control group. CONCLUSIONS Implementation of the complex intervention in routine mental health treatment settings was feasible, and the intervention was effective in assisting individuals disabled by schizophrenia or depression to return to work and improve their mental health and quality of life.
    American Journal of Psychiatry 08/2013; · 14.72 Impact Factor

Publication Stats

11k Citations
980.76 Total Impact Points

Institutions

  • 1997–2014
    • Dartmouth College
      • • Department of Psychiatry
      • • Department of Anthropology
      • • Department of Community and Family Medicine
      Hanover, New Hampshire, United States
    • University of Maryland, College Park
      • Department of Psychology
      College Park, MD, United States
  • 1988–2014
    • Geisel School of Medicine at Dartmouth
      • • Department of Psychiatry
      • • Institute for Health Policy and Clinical Practice
      • • Psychiatric Research Center
      • • Department of Community and Family Medicine
      Hanover, New Hampshire, United States
  • 2012
    • RAND Corporation
      Santa Monica, California, United States
  • 2011–2012
    • U.S. Department of Veterans Affairs
      Washington, Washington, D.C., United States
    • Ministry of Health (Israel)
      • Mental Health Services
      Yerushalayim, Jerusalem District, Israel
    • New York State Psychiatric Institute
      New York City, New York, United States
  • 2004–2011
    • McGill University
      • • Division of Social and Transcultural Psychiatry
      • • Department of Psychiatry
      Montréal, Quebec, Canada
  • 1997–2010
    • Indiana University-Purdue University Indianapolis
      • Department of Psychology
      Indianapolis, IN, United States
  • 2009
    • University of Connecticut
      • School of Social Work
      Storrs, CT, United States
    • Yale-New Haven Hospital
      New Haven, Connecticut, United States
  • 2008
    • Westat
      Maryland, United States
    • University of Birmingham
      Birmingham, England, United Kingdom
    • University of California, Los Angeles
      • Department of Psychiatry and Biobehavioural Sciences
      Los Angeles, CA, United States
  • 2007
    • Trimbos-instituut
      Utrecht, Utrecht, Netherlands
    • University of Massachusetts Medical School
      Worcester, Massachusetts, United States
  • 2004–2007
    • Mount Sinai School of Medicine
      • Department of Psychiatry
      Manhattan, NY, United States
  • 2003
    • St. George's School
      • Department of Psychiatry
      Middletown, Rhode Island, United States
  • 2001
    • Howard University
      • Department of Sociology and Anthropology
      Washington, WV, United States
    • University of Illinois at Chicago
      Chicago, Illinois, United States
  • 1998
    • University of South Florida
      • Department of Mental Health Law & Policy
      Tampa, Florida, United States
  • 1989
    • Duke University
      Durham, North Carolina, United States
    • Harvard Medical School
      • Department of Psychiatry
      Boston, MA, United States
  • 1984
    • Tufts University
      • Department of Psychiatry
      Georgia, United States