0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

Articles   |    
The Impact of Job Accommodations on Employment Outcomes Among Individuals With Psychiatric Disabilities
Clifton M. Chow, Ph.D.; Benjamin Cichocki, Sc.D., C.R.C.; Bevin Croft, M.A., M.P.P.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300267
View Author and Article Information

Dr. Chow is an adjunct professor with the Department of Economics, Southern New Hampshire University, Manchester, New Hampshire (e-mail: c.chow@snhu.edu). Dr. Cichocki and Ms. Croft are with the Human Services Research Institute, Cambridge, Massachusetts.

Copyright © 2014 by the American Psychiatric Association

Abstract

Objective  This study aimed to fill a gap in the literature on effectiveness of employment accommodations by comparing employment outcomes for individuals with psychiatric disabilities who received or did not receive accommodations, with models informed by a conceptual approach blending static labor supply theory, Sen’s capability approach, and the International Classification of Functioning.

Methods  Data for the study came from a longitudinal, four-year eight-state multisite demonstration project funded by the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration. All participants had been recruited from clinical populations receiving outpatient psychiatric services. The effects of job accommodations on hours worked were assessed with generalized linear modeling (N=1,538). The effects of job accommodations on duration of employment were assessed with a parametric duration model analysis (N=1,040) that incorporated multiple spells of employment among individuals over the study period.

Results  Controlling for covariates suggested by the conceptual model, analyses showed that individuals who reported job accommodations on average worked 7.68 more hours per month and those who reported receiving accommodations worked 31% longer, with each job accommodation reported decreasing the risk of job termination by nearly 13%.

Conclusions  Results demonstrate that job accommodations show potential to improve employment outcomes for individuals with psychiatric disabilities receiving supported employment services, indicating that job accommodations should be stressed in policy and continuing education efforts for program staff and clients.

Abstract Teaser
Figures in this Article

Your Session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
 
Username
Password
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Figure 1 Cumulative impact of workplace accommodations on job loss among persons with psychiatric disabilitiesa

a Risk of job loss is measured by the cumulative hazard.

Anchor for Jump
Table 1Descriptive statistics for variables for workers with psychiatric disabilities who received or did not receive accommodationsa
Table Footer Note

a All tabulations are based on results from the baseline interview.

Table Footer Note

b Scales for interpreting the mean values are fully described in the online data supplement to this article.

Table Footer Note

c Group means or expected frequencies are not statistically different from 0.

Table Footer Note

d These figures were averaged across all 48 months. Hours worked on a competitive job are by strict definition of the Employment Intervention Demonstration Project.

Table Footer Note

e Overall percentage calculated from N=1,022

Table Footer Note

f SSI, Supplemental Security Income

Table Footer Note

g SSDI, Social Security Disability Insurance

Table Footer Note

h Inference drawn from F distribution in one-way analysis of variance

Table Footer Note

i Associate’s through doctorate

Anchor for Jump
Table 2Impact of job accommodations on hours worked by persons with psychiatric disabilities, by generalized linear modela
Table Footer Note

a Hours refer to competitive jobs by strict definition of the Employment Intervention Demonstration Project. Family specified is gamma with log link. Robust standard errors are reported for heteroskedasticity. For the generalized linear model, N=1,407, intercept=1.998, SE=1.183, –2 log likelihood=–4,450.88, and scale parameter=6.19.

Table Footer Note

b Evaluated at variable means, except for binary regressors, where effect was evaluated at the discrete change from 0 to 1

Table Footer Note

c SSI, Supplemental Security Income

Table Footer Note

d SSDI, Social Security Disability Insurance

Table Footer Note

*p<.05, **p<.01

Anchor for Jump
Table 3Impact of job accommodations on hazard of job separation among persons with psychiatric disabilities: duration model resultsa
Table Footer Note

a Weibull proportional hazards with shared frailty (random effects), gamma distribution assumed. The likelihood ratio test determines whether the within-subject correlation (frailty) component (ϑ) is statistically significant. For N=2,357 jobs, the intercept was –1.642**, with SE=.568, –2 log likelihood=–4,129.29, ρ=.746, ϑ=.224, and the likelihood ratio test of ϑ giving χ2=46.28, p<.001.

Table Footer Note

b SSI, Supplemental Security Income

Table Footer Note

c SSDI, Social Security Disability Insurance

Table Footer Note

*p<.05; **p<.01

+

References

Gioia  D;  Brekke  JS:  Knowledge and use of workplace accommodations and protections by young adults with schizophrenia: a mixed method study.  Psychiatric Rehabilitation Journal 27:59–68, 2003
[CrossRef] | [PubMed]
 
Cook  JA;  Mulkern  V;  Grey  DD  et al:  Effects of local unemployment rate on vocational outcomes in a randomized trial of supported employment for individuals with psychiatric disabilities.  Journal of Vocational Rehabilitation 25:71–84, 2006
 
Bond  GR;  Drake  RE:  Making the case for IPS supported employment.  Administration and Policy in Mental Health and Mental Health Services Research 41:69–73, 2014
[CrossRef] | [PubMed]
 
MacDonald-Wilson  KL;  Rogers  ES;  Massaro  J:  Identifying relationships between functional limitations, job accommodations, and demographic characteristics of persons with psychiatric disabilities.  Journal of Vocational Rehabilitation 18:15–24, 2003
 
Ettner  SL;  Frank  RG;  Kessler  RC:  The impact of psychiatric disorders on labor market outcomes.  Industrial and Labor Relations Review 51:64–81, 1997
[CrossRef]
 
Chatterji  P;  Alegria  M;  Takeuchi  D:  Racial/ethnic differences in the effects of psychiatric disorders on employment.  Atlantic Economic Journal 37:243–257, 2009
[CrossRef] | [PubMed]
 
Mancuso  LL:  Reasonable accommodation for workers with psychiatric disabilities.  Psychosocial Rehabilitation Journal 14:3–19, 1990
[CrossRef]
 
Honig  HA:  Reasonable employment accommodations for persons with disabilities: a policy capturing approach.  Dissertation Abstracts International Section B: Sciences and Engineering , 1999
 
MacDonald-Wilson  KL;  Rogers  ES;  Massaro  JM  et al:  An investigation of reasonable workplace accommodations for people with psychiatric disabilities: quantitative findings from a multi-site study.  Community Mental Health Journal 38:35–50, 2002
[CrossRef] | [PubMed]
 
Fabian  ES;  Waterworth  A;  Ripke  B:  Reasonable accommodations for workers with serious mental illness: type, frequency, and associated outcomes.  Psychosocial Rehabilitation Journal 17:163–172, 1993
[CrossRef]
 
Sen  A:  Commodities and Capabilities .  New York,  Oxford University Press, 1999
 
Peterson  DB;  Rosenthal  DA:  The International Classification of Functioning, Disability and Health (ICF): a primer for rehabilitation educators.  Rehabilitation Education 19:81–94, 2005
 
Borjas  GJ:  Labor Economics , 4th ed.  Boston,  McGraw-Hill Irwin, 2008
 
Scheffler  RM;  Iden  G:  The effect of disability on labor supply.  Industrial and Labor Relations Review 28:122, 1974
[CrossRef]
 
Mitra  S:  The capability approach and disability.  Journal of Disability Policy Studies 16:236–247, 2006
[CrossRef]
 
 Towards a Common Language for Functioning, Disability and Health (ICF) .  Geneva,  World Health Organization, 2002
 
MacDonald-Wilson  KL;  Nemec  PB:  The International Classification of Functioning, Disability and Health (ICF) in psychiatric rehabilitation.  Rehabilitation Education 19:159–176, 2005
 
Cook  JA;  Leff  HS;  Blyler  CR  et al:  Results of a multisite randomized trial of supported employment interventions for individuals with severe mental illness.  Archives of General Psychiatry 62:505–512, 2005
[CrossRef] | [PubMed]
 
Salyers  MP;  McHugo  GJ;  Cook  JA  et al:  Reliability of instruments in a cooperative, multisite study: employment intervention demonstration program.  Mental Health Services Research 3:129–139, 2001
[CrossRef] | [PubMed]
 
Gill  J:  Generalized Linear Models: A Unified Approach .  Thousand Oaks, Calif,  Sage, 2001
 
Hardin  JW;  Hilbe  JM:  Generalized Linear Models and Extensions , 2nd ed.  College Station, Tex,  StataCorp, 2007
 
Manning  WG;  Mullahy  J:  Estimating log models: to transform or not to transform? Journal of Health Economics 20:461–494, 2001
[CrossRef] | [PubMed]
 
Tauras  JA:  An empirical analysis of adult cigarette demand.  Eastern Economic Journal 31:361–375, 2005
 
Basu  A;  Rathouz  PJ:  Estimating marginal and incremental effects on health outcomes using flexible link and variance function models.  Biostatistics 6:93–109, 2005
[CrossRef] | [PubMed]
 
Cameron  AC;  Trivedi  PK:  Microeconometrics: Methods and Applications .  Cambridge, United Kingdom,  Cambridge University Press, 2005
 
Blossfeld  H-P;  Golsch  K;  Rohwer  G:  Event History Analysis With Stata .  New York,  Psychology Press, 2007
 
Greene  WH:  Econometric Analysis , 7th ed.  Saddle River, NJ,  Pearson, 2012
 
Burke-Miller JRazzano LAGrey DD  et al:  Supported employment outcomes for transition age youth and young adults.  Psychiatric Rehabilitation Journal 35(3), 171–179, 2012
[CrossRef] | [PubMed]
 
Bollinger  CR:  Bounding mean regressions when a binary regressor is mismeasured.  Journal of Econometrics 73:387–399, 1996
[CrossRef]
 
Leff  HS:  Evidence in intervention science; in  Evidence-Based Mental Health Practice . Edited by Drake  RE;  Merrens  MR;  Lynde  DW.  New York,  Norton, 2005
 
Leff  HS;  Mulkern  VM:  Lessons learned about science and participation from multisite evaluations; in  Conducting Multiple Site Evaluations in Real-World Settings . Edited by Herrell  JMS;  Roger  B.  San Francisco,  Jossey-Bass, 2002
 
References Container
+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Related Content
Articles
Books
Textbook of Traumatic Brain Injury, 2nd Edition > Chapter 33.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 33.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 49.  >
Textbook of Traumatic Brain Injury, 2nd Edition > Chapter 33.  >
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 22.  >
Topic Collections
Psychiatric News
PubMed Articles