Figure - uploaded by Steven Stern
Content may be subject to copyright.
Source publication
We construct a structural model of participation in vocational rehabilitation for people with mental illness. There are multiple services to choose among, and each has different effects on employment, earnings, and receipt of DI/SSI. This is the first paper to jointly estimate VR service receipt, employment outcomes, and DI/SSI receipt. We estimate...
Context in source publication
Context 1
... the main results appear to largely re ‡ect the fact that we distinguish between di¤erent types of VR services rather than using a single indicator for whether the client received substantial VR services. Table 7 presents estimates of the counselor and o¢ ce instruments on VR service receipt. There are two types of coe¢ cient estimates reported in the table: a) the counselor and o¢ ce e¤ects and b) the missing counselor e¤ects. ...Similar publications
The probability that an individual participates in the labor force declines precipitously beyond age 50. This feature of labor supply suggests that ongoing shifts in the age distribution of the population will put substantial downward pressure on the aggregate labor force participation rate. However, the aggregate rate is also influenced by trends...
Citations
... Their results indicate that K6 would not be able to capture many of the significant results they find. Dean et al. (2017) use two dummy variables to measure the existence of and the severity of mental health problems. While there are notions of severity within the K6 questions, they are missing questions that identify some of the mental health problems most commonly assumed to be most severe (for example, psychosis and schizophrenia). ...
... The K6 cutpoint of 13 has been used to define serious mental illness. Most papers that use a mental health variable as an explanatory variable use such a binary measure (for example, Kessler et al., 2001;Baldwin and Marcus, 2007;Drake et al., 2009;Stern, 2014;Dean et al., 2017). 2 Most of the time, a binary variable is used because the available measure for mental illness in the data is binary. ...
... Other explanatory variables look more reasonable (see also Ettner, Frank, and Kessler, 1997;Luciano and Meara, 2014;Dean et al., 2015;and Dean et al., 2017 when controlling for mental illness). People of races other than White are less likely to work (-0.085, -0.182). ...
We consider many ways to use K6 as an explanatory variable in equations for marriage and employment. We find that a) it is inappropriate transform K6 into a binary variable; b) it is inappropriate to add the K6 variables into a single sum of Lykert scales; c) there are serious issues associated with using each of the K6 variables separately; and d) each possible way to use K6 has critical issues making its use problematic.
... Giesen and Hierholzer [89] described their methodology as multilevel, and purposed to evaluate service patterns and the impact of VR on employment outcomes for people with BVI receiving social security benefits [9]. Concentrated on the service structure of VR for people with BVI and an identified mental illness, Dean et al. [62] formulated a multivariate model to capture service provision choices and corresponding service receipts. Clapp et al. [90] added to the literature by providing a descriptive analysis of a longitudinal data set consisting of cross-state variations of VR-related services and labor market outcomes for people with BVI. ...
... Dean et al's [62] study examined the types of services provided to people with BVI who have an identified mental illness. Results showed that when combining the employment and earnings effects together, apart from diagnosis and evaluation, all service types had positive long-run effects. ...
... While some studies on this theme did utilize RSA-911 data to explore characteristics of VR, [87,97] many studies highlighted its limitations [62,89,90,98]. ...
The present study highlights the Role of Rehabilitation Medicine in the Psychological Etiology of Blindness or Visual Impairment
... Despite the importance of facilitating work-related services for PwD, some research has questioned the credibility and effectiveness of the VR program. One study seeking to assess the construct validity of VR-related services specific to mental health found variations in return across client characteristics, 59 suggesting that clients with specific mental healthrelated needs have negative long-run rates of work-related returns. Specific to people with BVI, a more recent study asserted that people with BVI have unique stressors that are lacking critical examination, thereby impacting work-related security and retention. ...
... While some studies in this theme did utilize RSA-911 data to explore characteristics of VR, 86,94 many studies highlighted its limitations. 59,86,87,95 In McDonnall et al's 86 study, results indicated that job quality indicators were higher for consumers who were employed at application than for those not employed at application. Most notably, in terms of VR-related services, receipt of a certificate, receipt of an associate degree, and receipt of bachelor's or higher degree were positively associated with job quality at VR case closure; however, receipt of job readiness training and on-The-job supports-supported employment were negatively associated with job quality. ...
... Based on findings from Giesen and Hierholzer's 86 study on the systematic patterns of VR services and their connections to employment outcomes, it is suggested that employment outcomes are multidimensional; therefore, it is difficult to conclude that job quality outcomes are indicative of objective evaluations solely. Dean et al 59 ...
Purpose
Roughly 3 million adult Americans have a visual impairment or blindness, and over 4 million adults aged 40 and older. Despite data demonstrating an elevated prevalence of mental health symptoms in people with BVI, this population remains largely untreated. Given that people with BVI often interface with multiple systems of rehabilitative care that are designed to improve quality of life, the relatively low rates of initiation of mental health care services are particularly alarming. In this review, the systematic processes of mental health care services across pertinent rehabilitation groups are identified and critically examined.
Patients and Methods
A comprehensive literature review was conducted. The literature review utilized a critical systems typology, whereby relevant literature was selected, reviewed, and analyzed intra and extra organizationally. In addition, a thorough discussion of disability-related factors was provided, lending a socio-political lens to the problem.
Results
Considerable data indicates that short-term mental health care services for people with BVI are ineffective treatment methods, albeit primarily employed in health-rehabilitative processes. Multiple studies offered data indicating the presence of diverse and entangled mental health issues relative to vocational rehabilitation services, mobility tool utility, and emotional reactions to vision loss. Many studies suggested that disability identity work be integrated into health-rehabilitative processes for people with BVI.
Conclusion
To improve the utility of mental health care services for people with BVI, a reenergization of the mental health care needs of this population must occur. A critical podcast or forum focused on educating listeners about the health-rehabilitation factors that influence the provision of mental health care services can aid to improve future mental health policy and practice for people with BVI. Disability scholars need to advance research on integrating critical theories in work with people with BVI and accelerate qualitative, community-based methods to enhance understanding of this population and their unique mental health needs.
... Most correlational/observational studies have applied logistic regressions [32][33][34][35][36][37] and revealed a positive significant effect of the treatment on the increased probability of employment. Also, some heterogeneous effects are found, e.g., gender-specific or service-specific effects (i.e., Kaya [37] indicates that some services may reduce employment and similar is shown also in the case of educational services [38]). However, we have found only a handful of causal identification studies. ...
... In general, the evidence seems to suggest that vocational rehabilitation has a positive effect on employment outcomes [17,23,24,32], yet few studies demonstrate robust effects [38,41,43] and their duration. In addition, there is limited evidence of economic cost-efficiency on it, however, some earlier studies indicate significant positive returns [17,38,44]. ...
... In general, the evidence seems to suggest that vocational rehabilitation has a positive effect on employment outcomes [17,23,24,32], yet few studies demonstrate robust effects [38,41,43] and their duration. In addition, there is limited evidence of economic cost-efficiency on it, however, some earlier studies indicate significant positive returns [17,38,44]. ...
Purpose
The purpose of this study is to examine the effect of the Estonian active labor market reform in 2016, which introduced a new policy concerning vocational rehabilitation services. As a research question, we investigate how such services may have affected the employment outcomes of people with mental and/or physical impairments.
Methods
Our sample includes 9244 people from 2016 to 2020, with a mean age of 46 years. Due to multiple entries to the services, we have more than 11,000 cases with over 100,000 monthly observations. We use propensity score matching in combination with fixed effects panel regressions to analyze how the completion of the scheduled rehabilitation plan affected monthly employment duration.
Results
Our findings indicate that completing the rehabilitation service results on average in 2.6 months longer post-rehabilitation employment, compared to matched individuals who discontinued the service. This effect was larger when already employed and male participants entered the service, while weaker effects were observed in the case of individuals with only mental disabilities.
Conclusions
Overall, we conclude that while completing the scheduled rehabilitation plan has a positive effect on employment outcomes, still maintaining employment status seems to remain a challenge, based on the relatively modest effect sizes. Thus, we question the economic arguments behind the reform.
... Most correlational/observational studies have applied logistic regressions [32][33][34][35][36][37] and revealed a positive significant effect of the treatment on the increased probability of employment. Also, some heterogeneous effects are found, e.g., gender-specific or service-specific effects (i.e., Kaya [37] indicates that some services may reduce employment and similar is shown also in the case of educational services [38]). However, we have found only a handful of causal identification studies. ...
... In general, the evidence seems to suggest that vocational rehabilitation has a positive effect on employment outcomes [17,23,24,32], yet few studies demonstrate robust effects [38,41,43] and their duration. In addition, there is limited evidence of economic cost-efficiency on it, however, some earlier studies indicate significant positive returns [17,38,44]. ...
... In general, the evidence seems to suggest that vocational rehabilitation has a positive effect on employment outcomes [17,23,24,32], yet few studies demonstrate robust effects [38,41,43] and their duration. In addition, there is limited evidence of economic cost-efficiency on it, however, some earlier studies indicate significant positive returns [17,38,44]. ...
External supervision is an expanding practice among social workers noted by many authors. However, the empirical evidence of its impact on work efficiency is mixed at best. In the current study, we empirically test the effect of external supervision on social workers’ work engagement and perceived self‐efficacy. Our treatment consists of five external supervision sessions. The survey instrument is designed to test the theoretical premises, allowing us to collect before and after data from the treatment and control group and construct a structural equation model for latent constructs such as engagement and self‐efficacy. Our sample consists of 73 social workers. We estimate treatment effects using differences‐in‐differences technique. After controlling for observable self‐selection, we show that external supervision has a weak positive effect on engagement but no effect on self‐efficacy. The mechanism—whether the content and length of the treatment are important—is under discussion. A weak positive effect of supervision on engagement is present only in the case of those who continued treatment in all five sessions.
... Assessment of labor market outcomes after vocational rehabilitation is complex, because return to work may be perceived as a multiphase and multifaceted process rather than a single event [11][12][13]. There is a large number of possible transitions between different labor market statuses around rehabilitation [14][15][16][17] as well as potential variation between shorter-and longer-term outcomes [10,18,19]. Moreover, the close link between a rehabilitee's preceding labor market history and subsequent labor market outcomes may lead to biased conclusions of the effects of vocational rehabilitation. ...
... Investigating labor market trajectories over a lengthy period of time surrounding vocational rehabilitation provides important insight into the factors associated with potential effectiveness of rehabilitation efforts. While previous studies have examined changes between different labor market statuses after vocational or other work-related rehabilitation [14][15][16][17][18], less is known of labor market trajectories covering the period both before and after vocational rehabilitation [19]. Furthermore, predictors of such trajectories remain unclear. ...
... Furthermore, by using a semiparametric group-based modelling strategy, we provided novel findings on latent trajectory groups of work participation around vocational rehabilitation. Including information on work participation both before and after vocational rehabilitation reduces some of the confounding effect of labor marker history on subsequent labor market outcomes [19]. ...
Background
Understanding diverse labor market trajectories around vocational rehabilitation provides important insight into potential effectiveness of rehabilitation efforts. We examined factors associated with work participation trajectories before and after vocational rehabilitation.
Methods
Using nationwide Finnish register data of 7180 vocational rehabilitees, we constructed latent trajectory groups of work participation two years before and two years after their rehabilitation episode starting in 2008–2010. We plotted changes in labor market statuses in these groups and examined other associated factors using multinomial logistic regression.
Results
We identified four trajectories based on work participation levels before and after vocational rehabilitation. The “High–Resumed” group (35.6%) typically returned to full duties. The “High–to–Negligible” group (20.7%) typically transitioned to full disability retirement or unemployment. Among the “Medium–Resumed” (25.5%) and “Longstanding Negligible” (18.3%) groups, work disability and unemployment were common before rehabilitation, but afterwards those assigned to the former group often returned to full or partial duties. Overall, older age, male gender, living in areas with lower employment rates, having lower education, being employed in the private sector, and having mental diagnoses were associated with the other three trajectories than the most favorable “High-Resumed” trajectory. Furthermore, certain industrial sectors, job exposures, and less common diagnoses further separated specific trajectories.
Conclusions
Work participation trajectories around vocational rehabilitation are diverse, only partly dependent on initial levels of work participation, and determined by various individual and work-related factors. Future nationwide studies should assess the effectiveness of vocational rehabilitation taking into consideration both individual and work-related factors.
