Meaghan Leddy, PhD; Elina Stefanovics, PhD; Robert Rosenheck, MD

1. Health and well-being of homeless veterans participating in transitional and supported employment: Six-month outcomes Meaghan Leddy, PhD; Elina Stefanovics, PhD; Robert Rosenheck, MD

2. Aim • Compared homeless veterans’ 6 mo outcomes for five employment patterns: • Never worked. • Transitional work experience (TWE). • TWE followed by competitive employment (CE). • CE without individual placement and support (IPS). • CE with IPS referral. • Relevance • Supported employment, specifically IPS, improves CE rates for individuals with serious mental illness. • However, it has not shown greater improvement in non-vocational outcomes than other rehabilitation approaches.

3. Method • Secondary analysis of data from study of homeless veterans. • Compared 6 mo improvement in diverse outcomes for 5 employment patterns: • Never worked. • Worked only in TWE. • Worked in TWE followed by CE. • Worked in CE without IPS. • Worked in CE with IPS referral.

4. Results • Veterans referred to IPS: • More likely to gain CE. • Veterans in CE (following TWE, with or without IPS referral): • Greatest increase in days worked, employment income, and total income. • Greatest decrease in public support income. • Veterans in TWE: • Greatest increase in residential treatment days. • No other differences in non-vocational outcomes between groups.

5. Conclusion • There are multiple paths to CE, but few differences in non-vocational outcomes across employment experiences. • This study is first to compare outcomes of VA’s two vocational programs, IPS and TWE. • Provides further evidence that IPS fosters engagement in CE but does not improve non-vocational domains.