Evaluating Vocational Materials for Incarcerated Veterans With Mental Illness or Substance Abuse

Study Overview
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Brief Summary
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The purpose of this research is to test the usefulness of a vocational rehabilitation program for veterans with a history of felonies who also have a mental illness or have substance dependency.

Detailed Description
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The Department of Justice's Bureau of Justice Statistics (BOJS, 2000) reported in 2000 over 225,000 veterans were incarcerated in the nations' criminal facilities; 1 in 5 of these veterans saw combat during service. Approximately 78,000 veterans annually will be released from incarceration with 30% of those released from incarceration are re-arrested within 3 months, 44.1% re-arrested at one year, and 67.5% within 3 years. These numbers are higher with those with serious mental illnesses: 54.3% re-arrest rates at one year and 72% at 3 years. The living status that many of these veterans with felonies return to is dire. In a survey of dually diagnosed and mentally ill offenders, 22% of mentally ill offenders and 43% of mentally ill offenders with substance addiction believed they would be homeless upon release. Ex-felons often return to more disadvantaged communities where employment is scarce (La Vigne, Mamalian, Travis, & Visher, 2003). Employers are reluctant to hire those with a history of incarceration due to biases against ex-offenders or due to legal liability (Connerley, Arvey, & Bernardy, 2001) or other biases (Holzer, 1996). Overall, employers have been shown to be less likely to hire ex-convicts than those with little work experience or those who are receiving welfare benefits (Holtzer, 1996). The goal of this study is to identify successful vocational re-integration modalities for mental health and/or substance dependent veterans recently released from incarceration and those with felony histories. Specific Goals are 1) test time to employment between manual conditions; 2) test total time employed over the 12 months following training period; and 3) test economic impact between manual conditions The study will be a controlled 3 group randomized design. The independent variable will be the amount of vocational services received. Veterans will be randomly assigned to one of three conditions: 1) Basic vocational services but no manualized vocational program; 2) self-study of the manualized program; and 3) a full program consisting of the manualized program with vocational staff and peer vocational support specialists. All veterans enrolled in the study will have access to a Veteran's Employment Resource Center to provide infrastructure for job search. Three primary dependent variables will be used. The first is the time till employment. The second is the total time employed during the 12 months following training. The third will be the economic impact of the training through differences in services required (e.g. emergency room visits, food stamps, cost of shelters, costs of rearrests) and income earned. Type of job skills, job history, and time incarcerated are some of the variables that potentially will be statistically controlled.

Official Title
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Evaluating Vocational Materials for Incarcerated Veterans With Mental Illness

Conditions
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Mental Illness

Intervention / Treatment
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* Other: Basic Vocational Services
* Other: Self-Study
* Other: Group Program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: underemployed or unemployed has a mental health or substance dependence diagnosis desires to enter the workforce through competitive employment. History of at least one felony conviction Emphasis will be placed on returning OEF/OIF veterans, combat veterans, and women veterans. Veterans entering the study can be recruited regardless of living situation. Exclusion Criteria: pursuing disability benefits due to unemployability diagnosis of dementia or evidence of severe cognitive impairment impaired reality testing due to psychosis actively suicidal or homicidal.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Basic Vocational Services<br>Veteran receives basic vocational services | Other: Basic Vocational Services<br>* Vocational services<br>|
| Active Comparator: Self-Study<br>Veteran participates in self-study vocational program | Other: Self-Study<br>* Veteran receives self-study resources<br>|
| Active Comparator: Group program<br>Group based vocational program | Other: Group Program<br>* Veteran participates in group vocational program<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time Till Employment in Days | Number of days until first day of competitive employment | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Test Economic Impact Between Manual Conditions (e.g., Cost-benefit Ratio) | overall economic impact, in dollars, will be evaluated by the following formula: income - healthcare cost - cost of incarceration | 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Veterans, Substance-Related Disorders, Mental Health