A Needs Assessment of Employment Services for People with Serious Mental Illness in Northwestern Nevada

Abstract

AbstractThis needs assessment sought to determine the extent of need for expanded employment services for people with serious mental illness (SMI) in northwestern Nevada (including Washoe, Carson City, Storey, Douglas, Lyon, Churchill, and Pershing counties). Consumers of mental health services (n = 121), support persons of people with SMI (n = 24), and service providers in the fields of mental health (n = 72) and vocational rehabilitation (n = 9) completed a self-administered survey with 95-116 items. Consumers with SMI in the region had an unemployment rate of 54.9%. Nearly three quarters (74.7%) of consumers who were not currently working expressed a desire to work. Stakeholders perceived many potential benefits but also significant potential barriers to working. There was high (89.6%-100%) awareness among all stakeholder groups of the main providers of employment services in the region, while consumer service utilization rates were somewhat lower (52.9%-55.6%). Satisfaction with existing services was low (11.1%) to moderate (70.7%). The need for expanded employment services was clearly identified, and all four stakeholder groups expressed interest in the addition of supported employment. Rural consumers were more likely than urban consumers to be employed and to work full-time (versus part-time). They were less likely to be aware of or have used existing services, to have been satisfied with services used, to have gotten a job as a result of using services, and to express an interest in supported employment services than their urban counterparts. The need to address barriers to employment and service utilization with sensitivity to the differences between rural and urban areas is discussed. Individual Placement and Support (IPS) emerged as an evidence-based supported employment model capable of addressing many of the identified needs in the region. IPS had high levels of acceptability among service providers and can be implemented on a regional or local level. Recommendations for implementation and directions for further research are presented.