Affiliations: Dartmouth Medical School, New Hampshire-Dartmouth
Psychiatric Research Center, Lebanon, NH 03766, USA | Department of Rehabilitation Psychology, Indiana
University-Purdue University Indianapolis, Indianapolis, IN 46202-3275,
USA
Note: [] Address for correspondence: Professor Robert E. Drake, Dartmouth
Medical School, New Hampshire-Dartmouth Psychiatric Research Center, 2 Whipple
Place, Suite 202, Lebanon, NH 03766, USA. Tel.: +1 603 448 0126; Fax: +1 603
448 0129; E-mail: Robert.E.Drake@Dartmouth.edu
Abstract: Objective: For many years, vocational and clinical services for
persons with severe mental illness have been separated (i.e., non-integrated)
in the United States. Recent research on supported employment shows, however,
that combined vocational and clinical services within the same team (i.e.,
integrated services) produce higher rates of competitive employment than
non-integrated services. Design: To understand the advantages of integrating vocational and
clinical services, the authors examined quantitative process data, ethnographic
findings, and qualitative interview data from practitioners in three
independent studies of supported employment. Results: Integrated services offer four consistent advantages over
non-integrated services: (1) more effective engagement and retention, (2)
better communication, (3) opportunities for clinicians to understand and focus
on employment, and (4) incorporation of clinical information into vocational
plans and services. Conclusions: Combining clinical and vocational services within
multidisciplinary teams is consistent with the general movement toward
developing integrated systems of care. Integrated services are more effective
than parallel services because clinicians rather than clients assume the burden
of coordination, consistency, and coherence.
