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Objective:

People who had a recent history of homelessness and had mental illness were studied to determine how many wished to be employed and were willing to accept supported-employment services and the factors associated with a decision to decline services.

Methods:

People (N=194) with mental illness receiving Housing First were assessed at three-month intervals over 24 months. Analyses determined variables that were associated with accepting or declining randomization to supported-employment services. A regression model was used to determine the odds of obtaining employment.

Results:

Of the 133 (69%) participants who wanted work, 75 (56%) accepted and 58 (44%) declined randomization to services. Those who declined had lower odds of obtaining employment (OR=.42, p=.022), less education, and fewer arrests and had spent less time homeless.

Conclusions:

People with a recent history of homelessness who have a mental illness want work. People who declined randomization to supported-employment services had fewer barriers to employment but had reduced odds of obtaining employment.