Clinical trial NCT00648115: Evaluating Vocational Materials for Incarcerated Veterans With Mental Illness or Substance Abuse
Official title: Evaluating Vocational Materials for Incarcerated Veterans With Mental Illness
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Mental Illness
Keywords: Veterans
Substance-Related Disorders
Mental Health
Lead sponsor: VA Office of Research and Development
Sponsor class: FED
First posted: 2008-04-01
Enrollment: 111
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: 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: 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.

Eligibility criteria: 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.

Primary outcomes:
measure: Time Till Employment in Days
timeFrame: 12 months
Secondary outcomes:
measure: Test Economic Impact Between Manual Conditions (e.g., Cost-benefit Ratio)
timeFrame: 12 months
Other outcomes:
Locations:
city: Dallas
country: United States
facility: VA North Texas Health Care System Dallas VA Medical Center, Dallas, TX
state: Texas
Study officials:
affiliation: VA North Texas Health Care System Dallas VA Medical Center, Dallas, TX
name: James P. LePage, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Garcia-Rea E, LePage JP. Reliability and validity of World Health Organization Quality of Life-100 in homeless substance-dependent veteran population. J Rehabil Res Dev. 2008;45(4):619-25. doi: 10.1682/jrrd.2007.03.0048.
citation: LePage JP, Washington EL, Lewis AA, Johnson KE, Garcia-Rea EA. Effects of structured vocational services on job-search success in ex-offender veterans with mental illness: 3-month follow-up. J Rehabil Res Dev. 2011;48(3):277-86. doi: 10.1682/jrrd.2010.03.0032.
citation: LePage JP, Lewis AA, Washington EL, Davis B, Glasgow A. Effects of structured vocational services in ex-offender veterans with mental illness: 6-month follow-up. J Rehabil Res Dev. 2013;50(2):183-92. doi: 10.1682/jrrd.2011.09.0163.